Selling into the NHS in 2026: the real routes to market

Selling into the NHS has never been simple, and 2026 is a year of rebuilding. The national bodies are being reorganised, the procurement rules are new, and the assurance bar for digital products has just been reset. The money has not gone away. What has changed is who holds it, and the rules they must follow to spend it.

The money is real, and it sits in a few large lines

In 2024-25 the Department of Health and Social Care spent £219.2 billion, or £204.7 billion after income, according to the National Audit Office. Three lines dominate: staff costs at £98.5 billion, clinical supplies and services at £27.5 billion, and the purchase of healthcare from non-NHS bodies at £24.1 billion.

Looking forward, the Spending Review 2025 committed up to £10 billion to NHS technology and digital transformation by 2028-29, which the Treasury describes as an almost 50% increase from 2025-26. The NHS in England also receives 3.0% real terms growth in day-to-day spending over the period.

What this means: there are substantial, recurring budgets that outside suppliers can win. But the technology money is tied to national priorities, such as the NHS App and a single patient record. A product that helps deliver those priorities is easier to fund than one that sits beside them.

The buyers are changing

In November 2025 the government confirmed it would bring NHS England back into the Department of Health and Social Care within two years. It approved a 50% cut to integrated care board headcounts, with around 18,000 administrative posts abolished and a saving of £1 billion a year expected by the end of the Parliament. The Health Bill, summarised by DHSC in May 2026, would abolish NHS England in law and create a single patient record, which the government intends to make available to clinicians in some specialties from as early as mid-2027.

Some national routes have already narrowed. NHS England now states that it cannot help initiate new call-off contracts from the Health Systems Support Framework, although existing call-offs remain in force.

What this means: relationships built only with national teams are less durable than they were. Buying decisions increasingly sit with trusts and integrated care boards, and those boards have fewer people to evaluate new suppliers. Your proposition has to be quick to understand and quick to assure. Do not build a sales plan around a framework that is no longer open for new business.

Two rulebooks, depending on what you sell

The Procurement Act 2023 governs most public purchasing of goods and non-clinical services. Its main provisions came into force on 24 February 2025, after the start date was moved from 28 October 2024. Notices now run through a central digital platform, an enhanced Find a Tender service with a Supplier Information Service, accessed through a single registration.

Healthcare services follow a different regime. The Provider Selection Regime has applied since 1 January 2024 to NHS England, integrated care boards, NHS trusts, foundation trusts and local authorities when they arrange health care services. It allows three direct award processes, a most suitable provider process and a competitive process. One direct award route applies where the existing provider is performing well and the contract is not changing considerably.

What this means: a software or device company is mostly dealing with the Procurement Act. A company delivering clinical services is dealing with the Provider Selection Regime, where a well-performing incumbent can be re-awarded without competition. New entrants in services need to know when contracts expire and must make the case for change well before decisions are taken.

For physical products, NHS Supply Chain remains central. Its 2026-27 business plan commits to £1 billion of efficiency savings for the NHS by 2030 and aims for 75% of its frameworks to carry measurable sustainability benefits. Suppliers should expect value and carbon questions to sit alongside price.

Assurance is the entry ticket

For digital products, the Digital Technology Assessment Criteria, known as DTAC, set the baseline. DTAC covers five areas: clinical safety, data protection, technical security, interoperability, and usability and accessibility. NHS England revised it with around 25% fewer questions, and the previous form should not be used from 6 April 2026. DTAC is used alongside the Data Security and Protection Toolkit.

Clinical safety rests on two standards. DCB0129 applies to manufacturers of health IT systems and DCB0160 to the organisations deploying them. Both require a named Clinical Safety Officer, with a clinical risk management plan, hazard log and safety case report.

What this means: arrive with the assurance pack already complete. A buyer with a thinner team will move faster on a product that has its DTAC submission, safety case and named Clinical Safety Officer in place than on one that promises to sort them out later.

Evidence sets the pace of adoption

The NICE Evidence Standards Framework, last updated in 2022, sets out the evidence NHS evaluators expect for digital health technologies. It is not mandated, but it is designed for use in commissioning and purchasing decisions. NICE early value assessments go further. In January 2026, for example, NICE said eight digital technologies for hip or knee osteoarthritis can be used during a three-year evidence generation period and paid for from core NHS funding, provided they have DTAC approval. Companies must fund the evidence generation themselves, and NICE advises commissioners to reflect the review point when negotiating contract length and licence costs.

What this means: an early value assessment can open the door to wider use, but it is a three-year commitment with real cost attached, and early contracts may be short. Plan the evidence programme, and the cash to run it, before you apply.

What to do first

First, decide which rulebook applies to you. Products and software follow the Procurement Act, while clinical services follow the Provider Selection Regime, and each needs a different sales plan.

Second, complete your assurance before you sell. That means the current DTAC form, DCB0129 documentation, a Data Security and Protection Toolkit submission and a named Clinical Safety Officer.

Third, map your evidence against the NICE Evidence Standards Framework and be honest about the gaps. If an early value assessment is relevant, budget for three years of evidence generation.

Fourth, register on the central digital platform and track the notices that matter to you. Then focus on a specific trust or integrated care board problem that links to a funded national priority, rather than a broad national pitch.

Minshall Group helps health businesses, including overseas health tech firms, plan UK market entry and build a practical route to selling into the NHS.