The NHS England Medium Term Planning Framework (MTPF), officially published on 24 October 2025, establishes the operational and financial roadmap for Integrated Care Boards (ICBs) and providers for the three-year period spanning 2026/27 to 2028/29. This document represents a fundamental shift away from the legacy of crisis-driven, short-term annual planning toward a medium-to-long term system designed to foster local innovation and support long-term sustainability. The MTPF i