NHS England is being axed in a bid to cut red tape and save ‘hundreds of millions of pounds a year’ that will instead be ploughed back into frontline NHS services, Prime Minister Keir Starmer has announced today.
ICBs have also been asked to lose half of their workforce, it has emerged.
NHS England will be brought back into the Department of Health and Social Care (DHSC) ‘to put an end to the duplication resulting from two organisations doing the same job’, the Government has said.
It described the current system as penalising ‘hardworking staff at NHS England and the DHSC who desperately want to improve the lives of patients’ but are being stifled by bureaucracy and fragmented processes.
The announcement comes only days after plans were revealed to reduce NHS England’s workforce by ‘around half’ and that three of its board members – chief financial officer Julian Kelly, chief operating officer Emily Lawson and chief delivery officer and national director for vaccination Steve Russell – would be stepping down at the end of March.
Ministers have promised that these latest reforms to deliver ‘a more efficient, leaner centre’ will help to bring about ‘significant savings of hundreds of millions of pounds a year, which will be reinvested in frontline services to cut waiting times’.
The changes will also give more power and autonomy to local leaders and systems – so they have more freedom ‘to tailor provision to meet local needs’, the Government said.
NHS England was originally set up in 2012 as part of former Conservative health secretary Andrew Lansley’s reforms, which he said at the time aimed to ‘take the politics and politicians out of day-to-day management of the NHS’.
Known then as the NHS Commissioning Board, it was intended to be an independent body with executive powers and responsibilities.
However, health and social care secretary Wes Streeting said today that the 2012 reorganisation was ‘disastrous’ and has ‘led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history’.
‘When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same jobs. We need more doers, and fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline’, he also said.
‘NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative and committed people across the NHS to deliver for patients and taxpayers.’
The reforms will be led by Sir Jim Mackey, who will be taking over as transition CEO of NHS England and Dr Penny Dash, incoming chair of NHS England.
Dr Dash said she will be working with former health minister Alan Milburn to lead the bringing together of NHS England’s functions with the DHSC, with the programme to begin immediately. It will be managed hand in hand with the Government’s priorities to cut waiting times and responsibly manage finances.
‘I am committed to working with Jim, the board and wider colleagues at NHS England to ensure we start 25/26 in the strongest possible position to support the wider NHS to deliver consistently high-quality care for patients and value for money for taxpayers,’ Dr Dash said.
Sir James Mackey said integrating the two organisations is needed to ‘deliver the biggest bang for our buck for patients, as we look to implement the three big shifts – analogue to digital, sickness to prevention, and hospital to community – and build an NHS fit for the future.’
The Institute of General Practice Management (IGPM) has said any move to replace NHS England must be driven by a clear, credible plan and not just be a top-down reorganisation.
‘Practice managers are already working under immense pressure and wholesale structural reform without meaningful engagement risks further disruption’, its directors warned.
They added that the changes need to ‘deliver real improvements in access, staffing and support for general practice’.
‘The IGPM stands ready to engage but we will continue to champion the need for pragmatic, workable solutions for those running services on the ground,’ they also said.
Meanwhile, ICBs have been asked to cut their workforce by 50%, which equates to around 12,500 staff across the health system, according to chief financial officer at NHS England Julian Kelly.
Speaking to the House of Commons Public Accounts Committee (PAC) this morning, before it was announced NHS England is being abolished, Mr Kelly said Sir James Mackey ‘has asked ICBs to look at how they can reduce their size by 50%.’
He confirmed this would ‘require a redundancy scheme to achieve that scale of change’.
When asked what difference staffing cuts across ICBs would mean in monetary terms, Mr Kelly said: ‘ICBs…currently employ around 25,000 people. If you reduce their staff by around 50% you would be achieving around £700-£750m of savings on an annualised basis, once fully delivered.’
He clarified that this number is made up administrative roles, not providing frontline services, adding that he was only informed about the decision yesterday.
When asked about what it would mean for already efficient ICBs, Mr Kelly said that detail would be in the 10-year plan.
He said: ‘Somebody’s going to have to be working out exactly what is the relationship between, not just the Department [DHSC] and NHS England, but NHS England and ICBs, and what are the expectations on providers as well as ICBs and I think that detail will become clear as the secretary of state, the department and the NHS team finalise the 10 year plan.’
Parts of this article were first published in our sister publication Healthcare Leader
