Wes Streeting used the Institute for Government’s annual conference on 13 January 2026 to set out a five‑point NHS modernisation plan built around patient power, devolved responsibility with accountability, prevention, technology, and stricter stewardship of public money. He cited early progress but said further change is non‑negotiable to match public expectations of digital, simple services. ([gov.uk](https://www.gov.uk/government/speeches/secretary-of-states-keynote-institute-for-government-speech))
Patient‑facing changes are already visible. The Department of Health and Social Care (DHSC) reports heavier use of the NHS App, with online appointment requests replacing the 8am phone scramble in many practices, access to test results, and an ‘Amazon‑style’ prescription tracker now live across nearly 2,000 pharmacies. NHS England says the app has over 39 million registered users, with 62.3 million logins in November 2025 alone. ([gov.uk](https://www.gov.uk/government/speeches/secretary-of-states-keynote-institute-for-government-speech))
Streeting linked the drive for user control to safety. ‘Martha’s Rule’-the right for patients and families to trigger a rapid review by a different team when deterioration is feared-has moved from pilot to national implementation across acute hospitals in England, with NHS data showing thousands of calls and hundreds of changes to care in the first year. ([england.nhs.uk](https://www.england.nhs.uk/north-west/2025/09/04/marthas-rule-rolled-out-to-acute-hospitals-in-the-north-west/?utm_source=openai))
A flagship digital service, NHS Online, will offer remote specialist appointments from 2027, initially in areas with the longest waits, alongside in‑person tests and procedures booked through the app. NHS England has confirmed early clinical focus areas including prostate conditions and cataracts, with more to follow as safety allows. ([england.nhs.uk](https://www.england.nhs.uk/2025/09/new-nhs-online-hospital-to-give-patients-more-control-over-their-care/?utm_source=openai))
On structure, Streeting reaffirmed the abolition of NHS England and the transfer of its functions to DHSC over a two‑year transition, arguing it removes duplication and clarifies accountability. Independent coverage and professional journals record the decision and note mixed expert views on disruption risks and potential savings. ([bmj.com](https://www.bmj.com/content/388/bmj.r521?utm_source=openai))
Integrated Care Boards (ICBs) are being reshaped at the same time. NHS England guidance sets out boundary changes to achieve coterminosity with strategic authorities from April 2026 and April 2027, while ICBs have been instructed to halve their running costs and act primarily as strategic commissioners-moves several ICBs and procurement bodies have publicly acknowledged. ([england.nhs.uk](https://www.england.nhs.uk/long-read/implementing-integrated-care-board-mergers-and-boundary-changes-to-take-effect-in-april-2026-and-2027/?utm_source=openai))
Prevention measures are being legislated and regulated. The Tobacco and Vapes Bill would create a smoke‑free generation by raising the age of sale annually for those born on or after 1 January 2009, with strengthened controls on youth vaping. The legislation cleared the Commons and is progressing through the Lords. ([standard.co.uk](https://www.standard.co.uk/news/politics/government-nigel-farage-mps-proposals-house-of-commons-b1219083.html?utm_source=openai))
Diet‑related ill‑health is targeted via a mandatory ‘healthy food standard’ for large retailers and manufacturers. Government materials and independent modelling by Nesta suggest small shifts in the average shopping basket could reduce obesity by around a fifth over time; ministers frame the policy as part of the 10‑Year Health Plan. ([gov.uk](https://www.gov.uk/government/news/healthy-food-revolution-to-tackle-obesity-epidemic?utm_source=openai))
A national supervised toothbrushing programme for early years settings is underway in partnership with Colgate‑Palmolive, with 23 million toothbrushes and toothpastes pledged over five years. The scheme aims to reach up to 600,000 children in more deprived areas and reduce hospital admissions for dental decay. ([gov.uk](https://www.gov.uk/government/news/supervised-toothbrushing-for-children-to-prevent-tooth-decay?utm_source=openai))
Streeting emphasised technology as a productivity tool rather than a substitute for care. In Greater Manchester, an AI chest X‑ray programme is supporting faster triage and reducing unnecessary imaging and referrals at scale; nationally, robotic‑assisted bronchoscopy led by teams including Royal Brompton shows promise in diagnosing hard‑to‑reach lung nodules earlier. ([england.nhs.uk](https://www.england.nhs.uk/north-west/2025/08/01/artificial-intelligence-and-mobile-screening-services-improving-lung-cancer-care/?utm_source=openai))
Local operational reforms are being encouraged where results are demonstrable. Barking, Havering and Redbridge University Hospitals’ ‘TonKIDZ’ initiative delivered over 100 paediatric tonsillectomies in a high‑volume week and later treated 648 children across three months, materially shrinking a long waiting list. ([bhrhospitals.nhs.uk](https://www.bhrhospitals.nhs.uk/news/tonkidz-sees-ten-times-the-usual-number-of-children-have-their-tonsils-removed-than-an-average-week-4163/?utm_source=openai))
Performance data provides context for the claims. NHS England reports consecutive falls in the elective waiting list during 2024–25, with April and May reductions breaking long‑standing patterns, and Category 2 ambulance response times improving to below the 30‑minute operational target in several months of 2025. GP Patient Survey 2025 results show 75.4% rating overall practice experience as good, up on 2024, while ONS measures indicate more people find it easier to contact their GP than last summer. ([england.nhs.uk](https://www.england.nhs.uk/2025/07/nhs-delivers-record-numbers-of-treatments-as-waiting-list-drops-to-26-month-low/?utm_source=openai))
The restructuring programme has risks as well as potential benefits. The Institute for Government and others caution that abolishing NHS England and cutting ICB running costs could distract from delivery and affect workforce morale unless transitions are tightly managed and timelines realistic. Ministers argue the changes will redirect money from overheads to frontline care. ([instituteforgovernment.org.uk](https://www.instituteforgovernment.org.uk/publication/performance-tracker-2025/nhs/overview?utm_source=openai))
For service leaders, the near‑term tasks are practical: lock in the app‑based access gains, prepare for NHS Online pilots, plan ICB mergers and cost reductions, and maintain non‑digital routes for those at risk of exclusion. The policy direction is clear; execution will determine whether the promised improvements in access, safety and outcomes are realised at pace. ([england.nhs.uk](https://www.england.nhs.uk/2025/12/record-numbers-using-nhs-app-to-manage-health/?utm_source=openai))