UK Prime Minister Announces that NHS England will be abolished
UK Prime Minister Kier Starmer announced yesterday that NHS England will be abolished to “cut bureaucracy” and bring management of England’s health service “back into democratic control”. NHS England will be brought back into the Department of Health and Social Care (DHSC) over the next two years.
The Government aims to remove a “burdensome layer of bureaucracy” and “put an end to the duplication resulting from 2 organisations doing the same job”. In doing so, the intention is to save hundreds of millions of pounds, enabling funds to be channelled towards enhancing patient care, reducing waiting lists and increasing staff salaries. However, exactly how this will be done and what impact this will have on patients, staff and the many partners of the NHS in England, including pharmaceutical companies, is not yet known.
NHS England’s role
NHS England was set up as an arm’s length body as part of the 2012 reforms introduced under the former Conservative-Liberal coalition government in order to give more independence to the NHS in England. Scotland, Wales and Northern Ireland are responsible for their own health systems, and the role of NHS England only impacts England.
The intention was for the DHSC to be responsible for broader health policy, while NHS England’s role was intended to be at the front line of health services, making decisions about the day-to-day operations of the NHS in England.
NHS England receives money from the government and distributes the funds to different parts of the health service in England. It is responsible for administering funding to local integrated care boards, which in turn decide how funding is distributed among service providers (GPs, hospitals, mental health services and community support staff). It is estimated that NHS England distributes around 90% of government health spending in England.
NHS England is also responsible for Health Education England, which oversees workforce, training and education of NHS staff in England, and NHS Digital, which is tasked with design, development and operation of the IT and data services for the NHS in England.
Concerns expressed by the government
This announcement is not wholly unexpected, and the current health minister Wes Streeting recently made it clear that he has concerns about NHS England. In particular, there is a view that in practice, there is a lot of duplication between DHSC and NHS England, and therefore money to be saved. The current health minister is by no means the first to criticise NHS England, as health ministers in previous governments had expressed frustration that their independence from NHS England effectively meant they lacked control over a large part of the health service. Ministers were not comfortable with the level of funding and the size of the body (three times the size of the DHSC) over which they had no direct control.
It has been clear recently that changes would be made, and on 25 February 2025, the Head of NHS England, Amanda Pritchard, announced that she would be stepping down from her role, along with a number of senior managers. Ms Pritchard will be replaced by Dr Penny Dash.
Changes ahead
The key driver for this change appears to be that the government wants to take back control of the NHS, as well as remove excessive bureaucracy and duplication between the role of the DHSC and NHS England. It is expected that roughly half of the roles within NHS England will be cut, leading to costs savings that can be used to provide health services.
The government has acknowledged that while a lot can be done without the need for primary legislation, some new legislation will need to be implemented in order to enact the government’s plan, and they will be working to move this forward “immediately”.
At the time of writing, there have been no details announced about what this will mean in terms of a change or redistribution of NHS funding.
