Pre-election period for local elections 2026: a guide for members

This briefing sets out considerations for members of the NHS Confederation and NHS Providers (soon to be The NHS Alliance) during the pre-election period leading up to local elections in England on 7 May 2026.

It highlights the practical implications around external communications during this period, in addition to the requirements on government, the civil service and arm’s-length bodies to maintain political impartiality in carrying out their public duties and ensuring that public resources are not used for the purposes of political parties or campaign groups. 

The pre-election period for local authorities varies across local authority areas and will start from the publication of a notice of election. This will be no later than Tuesday 31 March.

All out elections, where all councillors will be up for election will be taking place in:

• 32 London boroughs
• six county councils
• six unitary authorities, including the newly created East Surrey and West Surrey
• 16 metropolitan districts
• three district councils.

A half of seats will be contested in:

• seven district councils

A third of seats will be contested in:

• 12 unitary authorities
• 16 metropolitan districts
• 38 district councils

In six local areas, including five London boroughs and Watford, voters will directly elect their council leaders, who are also known as local authority mayors (not to be confused with regional or metro mayors who hold a wider set of devolved functions).

Parish and town council elections will also be taking place across the country.

To see whether your council is affected, visit the Gov.UK website. 

The term ‘pre-election period’ is used across central and local government to describe the period of time immediately before elections or a referendum when specific restrictions on the activity of civil servants and officials, where appropriate, are in place. These restrictions prevent announcements from, and activities by, public bodies which could influence or be seen to influence the election. The term ‘purdah’ was previously used to describe this period.

For the government 

The Cabinet Office issues guidance for civil servants in UK departments on their role and conduct  during election campaigns. 

The 2026 local elections  guidance can be found on the Gov.UK website and sets out general principles: 

“These elections are different from a UK general election. The UK Government will remain in office whatever the outcome of the elections. UK Government Ministers, including the Secretaries of State for Scotland and Wales, will continue to carry out their functions in the usual way. Civil servants will continue to support their Ministers in their work. Subject to the principles set out below, UK Government business can continue.

“However, it needs to be borne in mind that the activities of the UK Government could have a bearing on the election campaigns.

"Particular care will need to be taken during this period to ensure that civil servants conduct themselves in accordance with the requirements of the Civil Service code. Care also needs to be taken in relation to UK Government announcements and other public actions which could have a bearing on the elections. In particular, civil servants are under an obligation:

a) to ensure that public resources are not used for party political purposes; and

b) not to undertake any activity that could call into question their political impartiality. It is important to remember that this applies to online communication, such as social media, in the same way as other activity.

“During the election period, the government retains its responsibility to govern, and ministers remain in charge of their departments. Essential business (which includes routine business necessary to ensure the continued smooth functioning of government and public services) must be allowed to continue. However, it is customary for ministers to observe discretion in initiating any new action of a continuing or long-term character.”   

“Decisions on matters of policy on which a new government might be expected to want the opportunity to take a different view from the present government should be postponed until after the election, provided that such postponement would not be detrimental to the national interest or wasteful of public money.”  

While the NHS is unlikely to be central to a local election campaign, local authorities do have a substantial role in public health and social care. It is therefore important for members to adopt the customs and practices of the pre-election period to avoid any impression of influencing the election or its outcomes. 

Access NHS England’s official guidance for NHS organisations.

Key principles

No activity should be undertaken which could be considered politically controversial or influential, which could compete for public attention, or which could be identified with a party/candidate/designated campaign group.

Would you do the same for everyone? NHS organisations have discretion in their approach, but must be able to demonstrate the same approach for every political party, official candidate and designated campaign groups in order to:

• Avoid allegations of bias or pre-judging the outcome of the election.
• Ensure you will be able to form a constructive relationship with whoever wins the seat. 

The NHS may be under the media spotlight. It is advisable to have a plan in place for:

• How the organisation will manage the pre-election period (with both its risks and its opportunities).
• The potential for the organisation or its partners to be singled out in the media.

Board meetings and normal regulation 

Normal business and regulation need to continue during the pre-election period. NHS England, for example, is not expected to alter the dates on which it expects information from providers. Where the

Care Quality Commission (CQC) has planned an inspection or to publish an inspection report, this is likely to go ahead (though providers may wish to check with their CQC contact). 

Where a board discussion or sign off is required, there is no problem with holding a board meeting. 

Where a board meeting needs to take place, the agenda should be confined to those matters that need a board decision or require board oversight. Matters of future strategy or the future deployment of resources may be construed as favouring one party over another and should be avoided.  

Use of the confidential part or part two of the agenda to discuss matters that may be politically controversial is not recommended. Such matters should be deferred until after the pre-election period.

Publishing information and making announcements 

Care should be taken not to comment on the policies of political parties or campaign groups, and websites should not be updated with any information that may be considered politically influential.

The rule of thumb should be that communications activities necessary for patient safety, quality and operational delivery purposes should continue as normal, but any other activity beyond that and not required in the pre-election period should wait until after the election.  

Wherever possible, information to be published about the organisation should be factual and released in advance of the pre-election period commencing. After the pre-election period begins, requests for new information are best handled by applying freedom of information (FOI) rules.  

Organisations should not start long-term initiatives or undertake major publicity campaigns unless time critical (such as a public health emergency) and should instead wait until after the local elections.

Public consultations should not be launched during the pre-election period. Those already in progress should continue, but it is advisable to extend the period to take account of the pre-election period and avoid public meetings and publicity.

Responses received should not be commented on and no announcements should be made until after the election. Service change consultations may become politically sensitive, and pausing or extending a consultation and resuming it after the election may be an appropriate course of action.

We would only expect the Department of Health and Social Care and arm’s-length bodies to release data (such as the regulator publishing trusts’ financial returns) when a precise publication date has been pre-announced.

Political visits and engagement

Official support must not be given to visits and events with a party political or campaigning purpose.  

Use of NHS property for ‘electioneering purposes’ is a decision for the relevant NHS body to make:

“...but should visits be permitted to, for example, hospitals, it should be on the basis that there is no disruption to services and that the same facilities are available to all candidates. Care should also be taken to avoid any intrusion into the lives of individuals using the services.” 

As such, NHS organisations have the discretion to decide whether or not to allow visits by politicians during an election campaign. When considering whether to host a visit, safety and operational considerations must come first and guidance states that campaign visits should not disrupt services or care.

In addition, the same approach must be applied to all requests from all official candidates (including independents) and political parties, irrespective of their size. All requests from candidates to visit may be declined, but if they are allowed, then all requests should be accepted. If you do not plan to permit any campaign visits, it is worth considering formally advising all candidates and campaign groups in advance at the same time to ensure clear and consistent understanding.

Organisations may wish to engage with prospective councillors and mayors while care should be taken to ensure that incumbent candidates are not treated any differently. Again, we would recommend that all candidates are treated in the same way and any invitations or opportunities for engagement are extended to all parties. For example, if one party or campaign group makes an announcement on site, it would be advisable to ensure that all parties do so.

Foundation trust governor elections

In law, there is nothing to prevent foundation trust governor elections from taking place during the pre-election period. In practice, however, it is best to avoid holding governor elections during this period.  

Providers should avoid activities that may be seen to favour any given political party and given that foundation trusts have no control over what governors may say in their election statements, at hustings or elsewhere, they cannot guarantee a politically neutral outcome.

What might be deemed to be party political can be quite broad – particular engagement with a local authority, for example, might be associated more with one party than with others. Similarly, while governor elections have for the most part not become party political events there is nothing in law to prevent them from becoming so.  

Our best advice therefore is not to hold governor elections during the pre-election period. However, if elections are already underway and there is no sensible opportunity to put the election ‘on hold’ we would suggest that they continue. In those circumstances organisations will need to seek to ensure that candidates do nothing that could be construed as politically biased. 

Activism onsite or by individual staff or governors

NHS employees and foundation trust governors are free to undertake political activism and public debate in a personal capacity. They should, however, avoid involving their organisation or creating any impression of their organisation’s involvement.

They are not permitted to use any official premises, equipment (including uniforms) or information they would only have access to through their work and which is not publicly available. Naturally, patient confidentiality must be preserved at all times and normal professional conduct and contractual rules apply as usual in this respect.

Especially given the prevalence of social media and the balancing act people perform in presenting their personal and professional lives and views, it becomes easier to blur or mistake the capacity within which individuals are contributing online. At all times every effort should be made to preserve public professional neutrality while not inhibiting personal activity.

Voter ID, voter registration, postal votes and proxy votes

Since October 2023, voters in England have been required to show photo ID to vote at polling stations in UK general elections.

Those without an accepted form of photo ID, can apply for a free voter ID document, which is known as a Voter Authority Certificate. Those voting by post will not need ID to do so. 

It might be helpful to advise staff on their organisation’s provisions for postal and proxy voting to support those – whether staff, patients, service users and their families – who may not be able to go to their polling station on the day. National advice is available on the Gov.UK website. 

If someone nominates a proxy, the nominee will need to show their own photo ID to cast the vote. They will not need to show the voter’s ID.

We would advise that NHS staff and organisations should not undertake any voter registration or proxy or postal voting activity for those in their care to avoid any possible concern being raised about inappropriate influence.

A lack of mental capacity is not a legal incapacity to vote. Those who meet the other registration qualifications are eligible for registration regardless of their mental capacity. An inpatient at a mental health hospital or similar place can register at the hospital address if they have spent sufficient time there to be regarded as a resident.

Short admissions can register to vote at the address where they would be living if not in hospital. The Electoral Commission provides guidance for patients in a mental health hospital.

Trade union activities and engagement  

Trade unions may be active during the election campaigning on issues concerning their members. All trusts will have existing relationships, channels and protocols for working effectively with trade unions and these should be used as normal.

Nevertheless, given the importance of NHS organisations preserving their neutrality, it is worth considering itemising the election for discussion at an imminent meeting.  

Sharing this briefing

We suggest members share this briefing and/or its specific pre-election planning with all staff and stakeholders who might find it useful to be aware of the steps you are taking.

Further support and guidance

If you have any questions about this guide, please get in touch with externalaffairs@thenhsalliance.org.

For support or guidance in engaging with new or existing local authority stakeholders after the local elections, the experts in our communications agency, HealthCommsPlus, would be delighted to discuss your requirements. For more information, please visit the website.