On November 13, 2024, Health Secretary Wes Streeting announced a controversial plan to introduce league tables ranking NHS hospitals in England based on performance.

During his speech at NHS Providers' annual conference, Streeting outlined that failing hospitals would be publicly identified, and managers could face termination for poor patient care.

Streeting emphasized the urgency of reforming the NHS, stating, 'it's a case of reform or die,' and highlighted the need for accountability in financial management.

The league tables will assess all 215 NHS trusts using various indicators, including finances and patient access to care, aiming to improve overall service quality.

Proponents believe that the competition fostered by these rankings could drive NHS trusts to enhance their services.

However, experts have raised concerns that 'naming and shaming' could hinder recruitment and negatively impact patient care, suggesting that effective measures are needed instead of superficial rankings.

Critics, including health leaders, argue that league tables could demoralize staff and fail to account for the complex factors affecting hospital performance.

Streeting's proposals also include plans to dismiss persistently failing managers and deploy turnaround teams to struggling trusts.

Top-performing NHS trusts will gain greater financial control for modernization efforts, while failing managers will be denied pay raises unless they improve.

The Chancellor's recent autumn Budget allocated £22.6 billion to the NHS, viewed as a foundational investment in a 10-year improvement plan aimed at reducing waiting lists.

Additionally, the Department of Health and Social Care is considering banning NHS trusts from hiring agency staff for entry-level positions to cut costs.

Streeting's approach echoes previous reforms introduced by former Health Secretary Alan Milburn, who has been reappointed as a senior advisor to support these initiatives.