NHS England’s ‘Radical Reduction’ Could See Number of Central Roles Halved, Say Officials

NHS England said the reorganisation was needed to make the best possible use of taxpayers’ money to support frontline services.

A ward at the Royal Liverpool University Hospital, Liverpool, England, on Oct. 3, 2014.Peter Byrne/PA Wire

Thousands of NHS England central office jobs could be cut as part of plans to reshape and reduce the size of the organisation, officials have announced.

The health service confirmed on Monday that the size of NHS England “will be radically reduced,” and could see the “size of the centre decrease by around half.”

NHS England said the reorganisation was needed to make the best possible use of taxpayers’ money to support frontline services.

Sir James Mackey, who will be taking over as interim NHS chief executive after Amanda Pritchard leaves at the end of March, will set up a transition team within NHS England to lead this “radical reduction and reshaping,” with the Department of Health and Social Care (DHSC).

Chief Executive of the NHS Confederation Matthew Taylor said these changes “represent the biggest reshaping of the NHS’s national architecture in more than a decade.”

“These changes are happening at a scale and pace not anticipated to begin with, but given the huge savings that the NHS needs to make this year it makes sense to reduce areas of duplication at a national level and for the NHS to be led by a leaner centre,” Taylor said.

Period of Transformation

It was not stated how many jobs at NHS England could be cut, but could be in the region of 7,000.

According to data collated for Lord Ara Darzi’s review of the NHS, as of March 2024 NHS England had 15,857 employees and the DHSC 3,185, totalling 19,042 staff. This is down from a peak of around 23,000 in 2022.

The Darzi report found that between 2013 and 2022, the number of staff working at NHS England—including its predecessor organisations which it later absorbed like NHS Digital—increased by more than half, growing from 11,300 to 19,500.

NHS England’s announcement was made as part of the health service’s other changes to its leadership team.

Three senior staff, Chief Financial Officer Julian Kelly, NHS Chief Operating Officer Emily Lawson, and Chief Delivery Officer and National Director for Vaccination and Screening Steve Russell will be leaving their roles in the coming weeks.

This comes as “part of the upcoming changes to the size and function of the centre,” Pritchard said.

Earlier this month, NHS England’s national medical director, Professor Sir Stephen Powis, announced that he would be stepping down from his role in the summer and Pritchard confirmed her departure the week before.

Secretary of State for Health and Social Care Wes Streeting said: “We are entering a period of critical transformation for our NHS. With a stronger relationship between the Department for Health and Social Care and NHS England, we will work together with the speed and urgency needed to meet the scale of the challenge.”

Darzi Review

The massive shakeup comes months after Darzi published his comprehensive review of the NHS in September, where he said that the publicly-funded health service had to make improvements in productivity and efficiency.

The report had detailed that despite record levels of funding, the health service was facing significant challenges, including cancer care in the UK falling behind other countries, waiting times for hospital procedures ballooning in 15 years, and waiting times at A&E causing thousands of extra deaths annually.

Health Secretary Wes Streeting in a file photo on Nov. 13, 2024. Peter Byrne/PA

Responding to the report at the time, Prime Minister Sir Keir Starmer said there would be “no more money“ for the NHS ”without reform.”

“We know working people can’t afford to pay more, so it’s reform or die,” he said.

The prime minister had added that the government’s 10-year plan to reform the health service would create more access to care in the community, improved GP access, more preventative care, and better use of digital services, such as online consultations.

In January, the DHSC unveiled plans to create two million extra medical appointments next year, in a bid to bring down high NHS waiting lists.

The department said up to half a million more appointments are expected to be created in total every year by expanding the use of Community Diagnostic Centres, which will be open seven days a week, 12 hours a day, so that patients can access tests and health checks closer to home and at times more convenient to them.