NHS League Tables 2025: Why They Matter for Patients

On 9 September 2025, NHS England published the first set of NHS league tables 2025 in more than two decades. These rankings cover every NHS trust in England — acute hospitals, community services, mental health trusts, and ambulance providers.

As CEO of TNA UK, I want to explain what these league tables mean, why they matter for patients, and how they will affect those living with trigeminal neuralgia (TN) and other facial pain conditions.

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Why NHS league tables have returned

The government says the aim is to:

• Provide transparency for patients and taxpayers.

• Reward high-performing trusts with more freedom and resources.

• Target is struggling with trust due to closer monitoring and leadership changes.

• End the postcode lottery in waiting times and care.

League tables were first introduced as “star ratings” in 2000, scrapped in 2010, and have now returned in 2025. This is a major shift in NHS policy.
(DHSC press release, 9 Sept 2025)

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How the NHS league tables 2025 are calculated

League tables are part of the NHS Oversight Framework 2025/26. Trusts are measured on around 30 indicators, including:

• A&E waiting times

• Planned surgery (elective care)

• Cancer diagnosis and treatment

• Ambulance response times

• Financial balance

• Staff and patient surveys

The process:

1. Each measure is scored 1 (best) to 4 (worst).

2. An average delivery score is created.

3. Trusts are placed into segments:

   • Segment 1 – best performing

   • Segment 2 – strong overall

   • Segment 3 – weaker, requires support

   • Segment 4 – most challenged, urgent help needed

   • Segment 5 – Recovery Support (Provider Improvement Programme)

4. Any trust in financial deficit cannot be placed higher than Segment 3.

5. Trusts are then ranked within their segment by score.

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Results – September 2025

Acute hospital trusts

Top 10 acute trusts:

Bottom 10 acute trusts:

(Full table – NHS England)

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Non-acute trusts (mental health, community, learning disability)

Top performers include:

• East London NHS Foundation Trust

• Cambridgeshire and Peterborough NHS Foundation Trust

• Hertfordshire Partnership University NHS Foundation Trust

Lower performers include:

• Norfolk and Suffolk NHS Foundation Trust

• Cornwall Partnership NHS Foundation Trust

• South West Yorkshire Partnership NHS Foundation Trust

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Ambulance trusts

Top performers:

• West Midlands Ambulance Service

• South Central Ambulance Service

Lowest performers:

• East of England Ambulance Service

• London Ambulance Service

(NHS England League Table Hub)

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Regional variation

• North East: Northumbria Healthcare leads among general hospitals.

• London: World-class specialists at the top, but big teaching hospitals like UCLH rank lower.

• North West: The Christie (cancer) is 3rd, yet Liverpool University Hospitals is near the bottom.

• South West: Royal United Hospitals Bath is poorly ranked.

• East of England: Royal Papworth in top 5, King’s Lynn bottom overall.

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Domain scores – beyond a single rank

NHS England also publishes domain scores for:

• Access

• Safety

• Workforce

• Finance

• Effectiveness and experience

This allows members to see if their trust is strong in one area but weak in another — for example, good on safety but poor on finance.

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Confidence intervals

Each rank comes with a confidence interval showing uncertainty. A trust ranked 25th could in reality, sit anywhere between 10th and 80th. Trusts with stable performance have narrow intervals; those with mixed results have wide intervals.

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Integrated Care Boards (ICBs)

From 2026, league tables will also cover Integrated Care Boards (ICBs). These bodies control funding and design local services. For TN patients, this will be crucial. ICBs decide whether neurology and pain services are prioritised. Their ranking will give us new leverage in campaigning for better pathways.

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Agency staff spend – what it means for patients

NHS England also tracks agency spend. Trusts spending heavily on agency staff often face shortages in permanent staff. For TN patients, this can mean:

• Longer waits for neurology or neurosurgery clinics.

• Delays in MRI scans due to a lack of radiographers.

• Gaps in pain services when consultants move between trusts.

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Patient voices

At TNA UK, members tell us what these statistics mean in real life:

• “I’ve waited 14 months for an MRI. My trust is in the bottom quarter of the league table.”

• “I finally got surgery, but only after repeated delays. Seeing my hospital ranked low confirms why.”

• “Knowing my trust is in Segment 4 gives me something to raise with my MP.”

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International comparisons

Other countries also publish performance data:

• United States: Medicare star ratings guide patient choice, but critics say they oversimplify.

• Australia: National reports track waiting times and outcomes, used by local commissioners to target investment.

• Europe: Several countries, including Denmark and the Netherlands, publish hospital outcomes to promote consistency.

Lesson: transparency can drive improvement, but rankings must be handled carefully to avoid unfair comparisons.

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Criticisms of the NHS league tables

Experts warn:

• Rankings oversimplify complex services.

• Finance rules can punish trusts serving deprived areas.

• Comparing a specialist with a district hospital is misleading.

• Low rankings may harm staff morale.

(King’s Fund, Sept 2025)
(Nuffield Trust, Sept 2025)

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What members can do

• Check your trust: Use the NHS England dashboard.

• Compare fairly: Look at similar types of trusts.

• Use the evidence: If you face delays, cite your trust’s ranking in letters to your MP or NHS leaders.

• Stay informed: TNA UK will track quarterly updates and explain what they mean for TN patients.

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Conclusion

The NHS league tables 2025 are not perfect. They oversimplify performance, and critics are right to warn of risks. But they provide something we have long lacked: clear, public evidence of variation in care.

For TN patients, these tables expose the postcode lottery in diagnosis, MRI scans, surgery, and pain services. TNA UK will use this data nationally and locally to campaign for timely, fair, and effective care for every patient.

With best wishes,

Aneeta

Aneeta Prem MBE JP
Chief Executive Officer
Trigeminal Neuralgia Association UK