NHS National Oversight Framework: Our Progress and Performance
As part of the Government’s commitment to greater transparency and accountability in the NHS, a new performance assessment system has been introduced: the NHS National Oversight Framework (NOF).
December 2025 results
In the latest NHS England update for December 2025, our hospitals have remained ranked 17 out of 134 acute trusts, although we have moved up into segment 1.
This means that we are the highest-placed trust in the South West and the third-ranked large acute Trust in the country.
This is a result of the significant effort and commitment of staff across our hospitals in reducing waiting lists, improving services and supporting our patients, as well as ensuring finances are stable.
The focus from colleagues on continual improvement is making a real difference to our patients and to one another.
You can find more details on the league tables here: Acute Trust League Table and the more detailed dashboard here: NHS dashboard.
What is the National Oversight Framework (NOF)?
The framework provides a comprehensive view of how NHS Trusts are performing across a range of key metrics and is designed to help patients, staff and stakeholders understand how their local services compare nationally.
The National Oversight Framework assesses NHS Trusts across six domains, including:
- Elective and urgent care performance
- Quality of care
- Financial sustainability
- Workforce and leadership
- Patient experience
- Safety and outcomes
Each Trust is assigned a segment rating from 1 (high performance) to 5 (significant concerns).
These ratings are based on aggregated scores across 22 metrics for acute and community Trusts, and are published quarterly in the form of national league tables.
Why this matters
The league tables are updated quarterly and provide helpful context about how we are doing for the people of Gloucestershire and beyond.
They offer an open insight into our strengths and highlight where further improvements are needed.
This openness is central to our commitment to delivering safe, high-quality and compassionate care.
September 2025 results
In September, Gloucestershire Hospitals was placed in Segment 2, ranking 17th out of 134 NHS Trusts nationally, making us the third-highest placed large acute Trust in the country.
With the top eight places taken by single speciality acute trusts, the Trust’s position is a strong result and reflects the commitment of staff across the organisation.
The framework is an aggregate, external assessment of a wide range of metrics that fundamentally link to the quality and safety of care we provide.
While we recognise there are areas where we must continue to improve, the latest result is a direct impact of the efforts made by our staff.