Criteria and enabling conditions for assessing cash-releasing interventions: an evidence review in the context of the NHS ʻthree shifts’

The NHS faces unprecedented financial pressure, requiring the identification of cash-releasing interventions (CRIs). To support evaluation of this, we established five criteria based on relevant frameworks. We conducted an evidence review of published and grey literature (2019–2025), identifying and evaluating CRIs aligned with NHS England's ʻthree shifts’. 186 papers (filtered from 5,175 papers through eight stages) and 151 grey literature documents were assessed against the criteria. No sources contained enough information to determine whether they were cash releasing. There were 332 interventions with potential across community (n = 88), digital (n = 123) and prevention (n = 121), with most requiring 1–5-year implementation. Conditions that would enable cash release were identified. Numerous interventions improved the way that the NHS uses resources. It suggests that the NHS can improve population health and financial sustainability by reallocating resources into higher-value and more cost-effective interventions. Cash release should therefore be a means to improve value for populations, rather an objective itself.