NHS England has confirmed details for its capital incentive scheme, which aims to incentivise and reward providers who make significant improvements to their referral-to-treatment (RTT) position, while also ensuring continued progress is made towards reducing the waiting list, including long waits.
The £40 million capital departmental expenditure limit (CDEL) uplift is being divided into two rounds of £20 million with the first round being allocated to providers in Q1 2026/27 based on performance from April to September 2025. This allocation is not cash-backed.
This first funding round will reward the 10 most improved providers who make the greatest improvements towards meeting the RTT standards. To qualify, these providers must also be on track to deliver the waiting list reductions they committed to in their planning submissions, including specifically meeting their targets for reducing the number of patients waiting over 52 weeks for treatment. Providers who submitted plans for growth in their waiting list are being asked to submit new trajectories which will need to show a reducing waiting list size. These providers will need to be on plan against these trajectories, rather than their original planning submissions.
Providers must also be demonstrating progress towards meeting their plan for RTT performance as of the end of September 2025.
Each of the 10 most-improved providers who meet the eligibility criteria will receive £2 million in capital funding. There are no mandated requirements for how successful providers use the capital funding, though they are encouraged to use it to support elective performance and transformation.
The details of a second round of funding will be shared later in the year.
Rationale
This scheme supports calls for a return to the 92% RTT Constitutional Standard in the 10 Year Health Plan and Elective Reform Plan, and transformation in how elective care is delivered.
Reform cannot be achieved using existing approaches alone but requires systematic change through innovation and redesign. The scheme recognises this effort by rewarding providers who deliver the biggest measurable RTT performance improvement, helping to support providers to deliver improved productivity, modernise pathways and invest in local solutions to enable a return to RTT Constitutional Standards.
