Abolishing NHS England: what you need to know (NHS Confederation, 13 March 2025)

Summary

NHS Confederation summarise the developments confirming the abolishment of NHS England.

Content

Key points

• The Secretary of State for Health and Social Care said that NHS England is being "taken back into direct government control". This follows more than a decade of the NHS – via NHS England (formally, the NHS Commissioning Board) – having a degree of operational independence from the government following the 2012 Health and Social Care Act reforms. 
• This process is expected to take place over a two-year period – that is the point at which the Secretary of State for Health and Social Care, Wes Streeting, wants the process to be completed. 
• Wes Streeting has asked NHS England ‘transition’ chief executive, Sir Jim Mackey, to convene a transformation team to guide the process. There will be two clinical directors within this team – one covering primary care and another covering secondary care. 
• The Secretary of State spoke of this move being intended to "liberate" NHS staff and local NHS leaders, "setting them free" from overcentralisation. He also spoke repeatedly of giving local leaders the tools they need to deliver on the government’s three shifts for the NHS. 
• Headcount across both NHS England and the DHSC is expected to be cut by around 50% and it has been reported that the savings could release around £500 million. When combined, the two organisations have a workforce of over 18,000 staff. The Secretary of State would not be drawn at this stage on how this will be cut across the two organisations: this will be worked through by the transformation team. 
• The Secretary of State spoke of this reform being "the biggest decentralisation of power in the history of the NHS", but the implications for frontline NHS organisations are not yet clear. The only clarity we have at this stage is that integrated care boards will need to reduce their running costs by 50% by Q3 2025/26, and that provider trusts will need to make further reductions in their corporate costs.