Mayuresh Kumbhar in
Every NHS trust in England is currently running two transformations at once. The first is structural: NHS England is being wound down into the Department of Health and Social Care, the 42 Integrated Care Boards are consolidating into roughly 26 clusters, and around 18,000 posts across NHSE, DHSC, and ICBs are being removed to cut central running costs. The second is financial: from 2026/27, trusts are expected to deliver breakeven budgets, at a time when the provider sector’s underlying gap between income and spending has been running into the billions.
For a chief technology officer, a PMO director, or a trust CEO, that combination changes what “good” project management looks like. Spreadsheets and email chains that used to just about hold a portfolio together are now the reason a trust cannot answer basic questions: which projects are actually on budget, which depend on a role that no longer exists, and which capital schemes are quietly draining money while a decision sits in someone’s inbox.
This article looks at what is driving NHS trusts to reconsider their project management tools in 2026, what a proper evaluation should cover, and where a platform like Celoxis fits, and where it does not.
Why 2026 Is a Different Kind of Pressure for NHS Project Delivery
A structural reset that touches every project’s governance
The government announced in March 2025 that NHS England would be abolished, with its functions absorbed into DHSC. The enabling legislation, the NHS Modernisation Bill, is working through Parliament, with legal abolition targeted for around April 2027. Meanwhile the 42 Integrated Care Boards are merging into roughly 26 clusters, and NHSE, DHSC, and ICBs together are removing around 18,000 posts to help save more than £1 billion a year.
For a PMO, that is not background noise. The people who sponsored a project or sat on its board may not hold that role in six months. Portfolios built around a particular ICB structure need re-mapping, without losing the audit trail that regulated capital projects require.
Breakeven budgets and a real deficit to close
NHS England’s finance business rules require every trust to deliver a breakeven revenue position from 2026/27 onward, barring exceptional circumstances. That lands on a sector that the Nuffield Trust estimates had an underlying gap between income and outgoings of at least £4.5 billion in the most recent full year, with most integrated care systems overspending against plan at the halfway point of 2025/26. Separately, UNISON’s analysis of trust workforce plans found a combined deficit exceeding £1.1 billion and more than 20,000 posts earmarked for removal by 2028.
Under those conditions, a project management tool that tracks schedules but not cost in the same view is a liability. Finance directors need to see committed, forecast, and actual spend against every live initiative, not reconcile it from spreadsheets after the fact.
Capital projects under national scrutiny
The New Hospital Programme illustrates what happens when a portfolio outgrows its own governance. Originally scoped to deliver 40 hospitals by 2030, it was reset in 2025 to 46 schemes costing around £60 billion. The National Audit Office’s most recent update found staff turnover and a recruitment freeze had created capability gaps in project delivery, digital, legal, and commercial skills, rating the risk of further delay as red. NHS Providers reports that delays are costing some trusts more than £1 million a month in extra maintenance, and the Public Accounts Committee found the programme’s early-years contingency sits at just 3%, against 21% across the wider scheme.
None of that is unique to construction. It happens on any large, multi-stakeholder programme when scheduling, budget, risk, and reporting are not connected in one system that everyone, from project manager to trust board, can see at once.
A digital mandate that adds volume, not less work
The government’s Fit for the Future 10 Year Health Plan, published in July 2025, commits the NHS to a shift from analogue to digital, hospital to community, and sickness to prevention. It requires organisations to ring-fence at least 3% of annual spend for service transformation, and sets out a new NHS App, a Single Patient Record starting with maternity care, and a new technology procurement framework due in 2026 and 2027. Alongside that, the elective recovery plan set interim targets, including 65% of pathways within 18 weeks by March 2026, a target the NHS met nationally though performance still varies by trust, on the way to 92% by 2029.
Every one of those commitments becomes a local project, usually several, competing for the same finite pool of clinical and technical staff and reporting to a board asking harder questions about value for money than it was two years ago.
Table of Contents
- Key Takeaways
- Why 2026 Is a Different Kind of Pressure for NHS Project Delivery
- Where the Old Approach Breaks Down
- What CTOs and PMO Directors Are Actually Evaluating
- Comparing the Platforms NHS Trusts Actually Shortlist
- Where Celoxis Fits for NHS Trusts
- A Practical Decision Framework
- The Bottom Line
- Frequently Asked Questions
Where the Old Approach Breaks Down
Most trusts did not choose their current mix of project tools deliberately. It accumulated: a Microsoft Project file for the capital programme, a shared spreadsheet for the digital roadmap, a departmental Trello or Planner board for service redesign, and a PMO that spends more time chasing status updates than analysing them. A few patterns show up consistently once that mix reaches a certain size:
- No single view across the portfolio. A CEO or CTO cannot see, in one place, which of the 40 or 50 live initiatives are on time, on budget, and appropriately resourced, without someone manually compiling a report.
- Resource conflicts that surface too late. The same specialist staff, informatics leads, estates project managers, clinical safety officers, get booked onto three projects at once, and nobody notices until a milestone slips.
- Governance that lives in documents, not in the workflow. PRINCE2 and MSP are the standard methodologies across NHS project management, and PRINCE2 is effectively mandatory for many IT business cases above £3 million. When the stage gates and approvals sit in Word and Excel rather than the tool people use daily, compliance becomes a reporting exercise instead of how the work actually gets done.
- Budget tracking that lags reality. Finance closes the books on a monthly cycle while projects move week to week, so overspend is often confirmed after it has already compounded.
- Confidential projects with no real access control. Workforce restructuring and commercially sensitive procurement need to be visible to a defined group and invisible to everyone else, which a shared drive cannot reliably do.
What CTOs and PMO Directors Are Actually Evaluating
When a trust compares project management platforms, the evaluation tends to centre on a handful of questions that matter more than feature checklists.
Which platforms actually improve executive visibility?
Boards do not want a tool that produces a better Gantt chart. They want a dashboard that tells them, without a manual report, which programmes are red, why, and what it will cost to fix, drawn from the same live data the project managers use rather than a separate slide deck someone updates on a Friday.
What holds up when teams are large and distributed?
An ICS-scale portfolio spans multiple hospital sites and often several provider organisations under shared governance. Platforms built for enterprise portfolio management, Celoxis, Planview, and Clarity PPM among them, cope better here because they were designed to coordinate hundreds of contributors across sites. Task-first tools such as Asana or Monday.com are easier to adopt for a single team, but were not built to carry portfolio-level governance for dozens of interdependent programmes.
Can it track numerous, dependent projects without a small army maintaining it?
This is where dependency mapping and portfolio dashboards matter more than aesthetics. A capital scheme, a digital rollout, and a workforce restructure frequently share the same constrained resources and the same approval chain. Software that surfaces those dependencies automatically, rather than relying on someone remembering to flag a conflict, is what actually reduces firefighting.
What does it cost once you account for how NHS governance works?
NHS projects involve wide stakeholder groups: clinical leads, finance business partners, estates, informatics, and non-executive directors who need visibility but rarely touch the software day to day. Per-seat licensing that charges full price for every reviewer or approver gets expensive fast. Flexible licensing that separates full project managers from lighter-touch collaborators tends to fit how NHS governance committees are actually staffed.
Where does the data live?
Cloud hosting is the default for most trusts now, but IT security teams still ask about data residency, role-based access, and how a platform fits alongside the trust’s Data Security and Protection Toolkit submission. Vendors offering both UK or EU cloud hosting and an on-premise option give IT leadership more room to satisfy internal policy without ruling the software out.
Comparing the Platforms NHS Trusts Actually Shortlist
Pricing changes frequently, so treat this as a starting point for a shortlist, and confirm current figures with each vendor. The pattern that matters most: collaboration-first tools help a department adopt new habits fast, but most were not built to carry regulated, multi-project financial governance. Enterprise PPM platforms ask more during setup but suit the cross-site, cross-department portfolio a trust or ICS is actually running.
Where Celoxis Fits for NHS Trusts
Celoxis was not built specifically for the NHS and it is not a clinical system, so it will not replace an EPR, a rostering system, or a clinical safety tool. What it is built for is the operational and capital side of running a healthcare organisation: Gantt-based scheduling, resource and capacity planning across sites, budget versus actual tracking, and custom workflows configured to reflect PRINCE2 or MSP stage gates rather than forcing a trust to abandon its existing governance.
A few things make it a reasonable shortlist candidate for trust-level and ICS-level portfolios:
- One data set for schedule, budget, and resourcing. A change to a project’s timeline shows up in its budget forecast and resourcing view automatically, instead of needing three people to update three documents.
- Role-based access and activity logs. Confidential workforce or reconfiguration projects can be restricted to a named group, with a record of who accessed or changed what. Celoxis is not a Data Security and Protection Toolkit-assessed clinical system, but it is built by an ISO-certified company, and its access controls and audit logging give an IT security team something concrete to evaluate.
- Deployment choice. Trusts with strict data residency or legacy infrastructure policies can run Celoxis on-premise or in the cloud rather than being locked into one model.
- Licensing built for wide stakeholder groups. Non-executive directors and clinical leads who need to review or approve, but not build, project plans can be added as collaborators without full per-seat pricing, which matters more under a breakeven mandate, not less.
- Adjacent regulated-sector track record. Its risk management and resource forecasting tools have been used in healthcare R&D and medical device engineering settings that share the NHS’s core constraints: distributed teams, confidential data, and specialist staff who cannot be substituted like generalist resource.
Where it does not fit: very small teams running one or two projects will likely find it more platform than they need, and trusts that specifically need HL7, DICOM, or deep EPR integration will build that through the API, the same as with any general-purpose PPM tool. Reviewers on G2 and Capterra also consistently note a learning curve during setup, worth planning for in any rollout.
For programmes closer to clinical research or medical device development, which some trusts run alongside university and life sciences partners, the documentation demands look more like the pharmaceutical sector’s project management needs than a typical capital or digital programme, and it’s worth evaluating audit-trail depth specifically for that use case.
A Practical Decision Framework
Before shortlisting, get clear, comparable answers to these questions from any vendor, ideally on a live demo built around the trust’s own project structure rather than a generic sandbox:
- Can it show budget versus actual, at project and portfolio level, in the same view as the schedule? This is the biggest predictor of whether finance and delivery teams end up using the same numbers.
- Can workflows be configured to match PRINCE2 or MSP stage gates, rather than requiring the trust to adopt the vendor’s own methodology?
- Does resourcing forecast specialist capacity, not just headcount, so a shortage of informatics leads or estates project managers surfaces before it causes a delay?
- Does reporting roll up cleanly across a multi-site or multi-organisation portfolio, for one view rather than a dozen?
- What is the real cost at the trust’s actual size, including the tiers needed for financial tracking and the number of approver seats a typical NHS governance structure requires?
The Bottom Line
None of the pressure on NHS project delivery in 2026 is going to ease on its own. The DHSC merger, ICB consolidation, the breakeven mandate, the New Hospital Programme, and the 10 Year Health Plan’s digital shift are all running concurrently, and each adds projects to a portfolio that was often already managed on spreadsheets. Software will not fix a structural reorganisation or close a funding gap, but the right platform can stop a trust from finding out about a resourcing conflict, a budget overrun, or a missed dependency after it has already cost time and money.
Frequently Asked Questions
What is the best project management software for UK NHS and healthcare trusts?
There is no single best fit for every trust. For trust-wide or ICS-level portfolios spanning capital, digital, and operational recovery work, enterprise PPM platforms such as Celoxis tend to offer more budget, resourcing, and governance depth than task-first tools like Asana or Monday.com, which suit smaller, single-department workflows better.
What are the leading enterprise project management platforms for coordinating large, distributed NHS teams?
Platforms built for enterprise portfolio management, including Celoxis, Microsoft Project, Wrike, and Planview, are most commonly shortlisted for coordinating large, multi-site NHS teams, because they support role-based governance and cross-site resource visibility that lighter collaboration tools typically lack.
Which project management software is best for improving executive and board-level visibility?
Look for a platform where dashboards read from the same live project data teams use daily, rather than a static report compiled separately. Celoxis, Wrike, and Microsoft Project paired with Power BI are commonly evaluated for this, with the deciding factor usually being how much manual reconciliation the reporting still requires.
Where can NHS PMO directors explore platforms for managing complex, multi-team project portfolios?
Vendor comparison pages, G2, Gartner Peer Insights, and Capterra all offer independently sourced reviews, ideally paired with a live demo built around the trust’s own project structure, since complexity varies between an acute trust, a community provider, and an ICB.
Does project management software help NHS trusts meet elective recovery and waiting list targets?
Indirectly. It cannot see patients faster on its own, but it gives operational teams visibility into which recovery initiatives, extra clinics, surgical hub rollouts, are on track and correctly resourced, so leadership can intervene before a target is missed.
Is Celoxis used by NHS trusts specifically?
Celoxis is not marketed as an NHS-specific or DSPT-assessed clinical system. It is a general-purpose enterprise PPM platform that has been used in healthcare research and medical device engineering settings with similar constraints to what NHS trusts manage: distributed teams, confidential data, and specialist resourcing. Any trust evaluating it should confirm current data governance and hosting details against its own Data Security and Protection Toolkit requirements.
How much does project management software cost for a trust operating under a breakeven mandate?
Entry-level plans across the category generally run from around $9 to $15 per user per month, but the tiers with real budget tracking, resource forecasting, and governance controls sit higher. Licensing that avoids charging full price for approvers and reviewers, which Celoxis offers, can meaningfully lower total cost for governance structures with wide stakeholder groups.
What should a trust look for beyond price when shortlisting project management software?
Budget-versus-actual tracking in the same view as the schedule, configurable workflows that map to PRINCE2 or MSP rather than replacing them, resource forecasting by skill rather than headcount, role-based access for confidential projects, and a deployment model that fits the trust’s existing data governance policy.
Choosing project management software isn’t a decision to make from a features list alone, and trusts that get it right usually test a platform against their own live portfolio first. If you want to see how Celoxis handles budget tracking, resourcing, and governance across a multi-site portfolio, try it free for 14 days or book a personalised demo.