This 'preparatory guidance' provides an overview of system planning, the financial settlement and operational planning requirements. The guidance does not include the full trust financial regime for next year, performance recovery trajectories, control total, indicative CCG allocations or any other deliverables for 2019/20. Full planning guidance is expected in January along with the NHS long term plan.

Key points

• There is a greater focus on system planning, with system control totals to be set for each Integrated Care System (ICS) and Sustainability and Transformation Partnership (STP). Providers within an ICS will be expected to link a proportion of their Provider Sustainability Fund (PSF) to the system control total. A full financial framework for ICSs will be published separately in the new year.
• The National Tariff Proposals remain largely unchanged from those published in October. Subject to the statutory consultation, the blended payment system for urgent and emergency care will go ahead, with £1bn from the PSF being transferred into emergency care prices. The proposals for funding centralised procurement and market forces factor remain.
• NHS England will place an increased emphasis on achievement against the mental health investment standard. STP/ICS leaders will have the opportunity to review CCG investment plans.
• Providers will be asked to deliver 1.1% efficiency over the next five years, with the guidance flagging a number of priorities from the Carter reviews that should be prioritised.
• The proposed changes to the NHS Standard Contract include splitting the sanction for 52-week waits between providers and commissioners.