The 9^th of September 2025 marked the launch of the new NHS league tables, forming part of the Labour Government’s new 10-year health plan to reform the National Health Service.

In the hope of improving healthcare standards through the promotion of transparency, the rankings provide a detailed assessment of NHS trust performance across a wide range of metrics. Health Secretary Wes Streeting has expressed how ‘we must be honest about the state of the NHS to fix it.’ He went on to state that ‘patients know when local services aren’t up to scratch, and they want to see an end to the postcode lottery – that’s what this government is doing.’

Who Publishes the League Tables?

The league tables are compiled and published by NHS England, in collaboration with the Department of Health and social Care (DHSC).

The initiative stems from Labour’s planned commitment to increase accountability and ensure that public investment in the NHS delivers measurable improvements in both care quality and efficiency.

First introduced in June 2025, the framework is part of a larger reform agenda known as the Plan for Change. This aims to tackle regional disparities in care, rewarding high-performing trusts with greater autonomy and investment

What Data is Used to Rank the NHS Trusts and how are they Ranked?

Going forward, trusts are to be assessed quarterly across seven different services, including operation wait times, ambulance response times and mental health support. A trusts finances will also be assessed.

Using this data, the league tables will then rank hospital trusts, categorising them into four segments. Top performers will be within segment one and those facing the most significant challenges will be within segment four. It is worth noting however that those trusts facing financial issues cannot be ranked higher than segment three, no matter how good their standard of care.

Once categorised into their segments, the trusts are then ranked by their average metric score. The lower the score, the better the performance.

In an attempt to ensure fairness, the rankings consider the following factors:

• Trust type and size;
• Geographic and demographic differences;
• Recent mergers or acquisitions; and
• Confidence Intervals (indicating the reliability of the trust’s average score).

Why Does this Matter?

The aim of the league tables is to:

• Empower patients with clearer information about their local healthcare providers;
• Help NHS leaders identify areas for improvement;
• Encourage underperforming trusts to learn from top performers;
• Guide investment decisions and support allocation.

Chief executive of NHS England, Sir Jim Mackey hoped that the new initiative will help to put ‘more power’ into patients hands, enabling them ‘to make informed decisions on their choice of provider’. Machey went on to state that ‘letting Patients and the public access more data will help to drive improvement even faster by supporting them to identify where they should demand even better from their NHS’.

Who Are the League ‘Winners’?

Currently, sitting at the top of the league is Moorfields Eye Hospital NHS Foundation Trust in London with a score of 1.39. Coming in at second is Royal National Orthopaedic Hospital NHS Trust at 1.48, just beating out The Christie NHS Foundation Trust who sits at third, with a score of 1.51. All three are trusts that provide specialist care.  

Ranked at ninth, Northumbria Healthcare NHS Foundation Trust was the top performing non-specialist trust with a score of 1.74.

On the other end, sitting at the bottom of the table is The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust with a score of 3.35. Just above them is the Countess of Chester Hospital NHS Foundation Trust at 3.04. Both of these are categorised as small trusts.

The top ten trusts are displayed below.

What do the Experts Think?

Experts at King’s Fund thinktank have questioned the suitability of the tables, arguing that hospital performance is not as simple as ‘good or bad.’ Whilst one hospital may have relatively small A&E wait times, they may not for example provide patients with access to non-urgent care within the 18-week target.

Thea Stein, chief executive of the Nuffield Trust thinktank has stated that the fact that the trust’s finances came into play would be ‘of limited use for patients trying to choose the best hospital for their care.’

Whilst it may look good on paper, NHS England has highlighted that while the rankings offer valuable insights, they should be interpreted with caution. Performance can vary significantly across services within a single trust and averages may mask underlying issues.

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