NHS braces for thousands of redundancies

UK Health Secretary Wes Streeting has given the green light to a series of NHS reforms that will see around 18,000 administrative roles abolished, following a deal with the Treasury.

Streeting has promised that the reforms – announced just ahead of the much-anticipated Autumn budget from Chancellor Rachel Reeves – will save £1 billion a year, which will be reinvested into frontline patient care.

The announcement comes after up-to-the-wire negotiations between the Department of Health and Social Care (DHSC) and the Treasury for a £1 billion cash injection to cover the cost of the mass redundancies. It seems that was rebuffed, although Reeves has allowed an overspend this year that will be clawed back in 2026-27.

Many of the jobs will be cut as a result of the Labour government's plan to dismantle NHS England, which was established under the previous Conservative government to handle the budget and day-to-day running of the commissioning side of the health service in England.

Those functions will now be brought into the DHSC, and there will also be sweeping staff reductions at Integrated Care Boards (ICBs), organisations introduced in 2022 that plan health services for local areas.

The ICBs are also being tasked with transforming the NHS into a 'Neighbourhood Health Service', fulfilling two pillars of the NHS 10-year plan, including a shift of care from hospitals into the community and a focus on prevention rather than treatment.

The absorption of NHS England into the DHSC is expected to be completed within two years and end "the duplication of two organisations doing the same job," according to the government. It also said every £1bn saved in red-tape costs is enough to fund an extra 116,000 hip and knee operations.

The announcement has been welcomed by the NHS Confederation, representing commissioning bodies in the NHS, which said it is "a welcome move that provides certainty to NHS leaders who can now go ahead with planned redundancies."

Streeting is expected to tell the NHS Providers' conference in Manchester later today, a gathering of NHS leaders, that the government "is protecting investment in the NHS at the Budget, worth an extra £29 billion to the health service. I want to reassure taxpayers that every penny they are being asked to pay will be spent wisely."

NHS Providers' chief executive Daniel Elkeles said the announcement is "a pragmatic step that means planned redundancies can now go ahead," and "reflects the flexibility of a three-year settlement, allowing some funding to be brought forward in order to generate future savings to go into front-line care."

However, he added: "We must recognise the position of staff affected by these changes – people who have offered commitment and service to the NHS – who face a very uncertain future."

The British Medical Association, meanwhile, said it was concerned about the effect of losing many roles at once from NHS England on the 'shift to prevention', especially in public health and planning, and the impact on all staff losing their livelihoods.

"To suggest these projected savings could fund an extra 116,000 hip and knee operations may well be the case, but we do not have enough surgeons, anaesthetists and other theatre staff, or operating space fit for purpose, to meet existing demand," said BMA chair of council Dr Tom Dolphin.

"We need to see the money spent filling gaps on rotas, creating much-needed training jobs for resident doctors, and restoring the value of staff salaries to show that our worth is recognised."

His comments come ahead of a five-day strike by resident doctors due to start on Friday, as well as the threat of rising prices for medicines used by the NHS.