Hospitals across England could axe more than 100,000 jobs as part of a major restructure and severe cost-cutting drive led by Health Secretary Wes Streeting and NHS England’s new chief executive, Sir Jim Mackey.
NHS leaders have warned that the financial impact of these potential redundancies could exceed £2 billion, urging the Treasury to step in and fund the costs.
Without additional support, they argue that trusts will struggle to meet the government’s ambitious savings targets.
Sir Jim Mackey has instructed all 215 NHS trusts in England to halve the costs of their corporate functions – such as HR, finance, and communications – by the end of the year.
The NHS Confederation, representing healthcare trusts, said some organisations estimate they may need to shed between 3% and 11% of their workforce to comply.
Given that the NHS employs approximately 1.37 million people, such cuts could lead to job losses ranging from 41,100 to 150,700 staff members.
Matthew Taylor, chief executive of the NHS Confederation, stressed that the magnitude of the required savings could seriously hamper efforts to reduce long waiting times for patients.
He has called for the creation of a national redundancy fund, warning that trusts are already financially stretched and cannot afford the cost of large-scale job cuts.
The NHS is preparing for an unprecedented wave of redundancies following the government’s decision to dissolve NHS England and drastically cut management roles.
About half of NHS England’s 15,300 staff are expected to lose their jobs as it merges with the Department of Health and Social Care (DHSC), which itself anticipates some redundancies among its 3,300 employees.
Up to 12,500 posts could also be lost across the NHS’s 42 integrated care boards.
Taylor highlighted the risks, noting that unless the Treasury steps in, any potential savings from the reforms could be undermined or even completely wiped out.
Financial stability, he added, is crucial if the NHS is to deliver the government’s forthcoming 10-year health plan.
Some NHS trusts are reportedly budgeting up to £12 million each for redundancy payouts. However, others are opting against formal redundancy programmes, relying instead on natural staff turnover to reduce numbers.
Sarah Woolnough, chief executive of the King’s Fund, pointed out that only 14% of the public believe the NHS spends money efficiently. Nevertheless, the UK dedicates just 1.9% of its health budget to administration, one of the lowest rates among developed nations.
She warned that skilled management and administrative staff are essential to enable frontline workers to deliver high-quality care.
Thea Stein, chief executive of the Nuffield Trust, echoed these concerns. She noted that while there is some duplication and inefficiency within NHS governance, corporate staff such as digital specialists, analysts, and recruiters play a critical role in improving efficiency and maintaining services.
She warned the government to be cautious about where cuts are made, referencing previous rounds of cost-cutting that ultimately weakened NHS performance.
Several NHS trusts have already announced plans to shed hundreds of posts each in an effort to meet efficiency targets for 2025–26. Trusts in Portsmouth and the Isle of Wight plan to cut 798 full-time equivalent roles, or about 7% of their workforce, aiming to save £39 million.
Meanwhile, University Hospitals Bristol is preparing for a 2% reduction in staff, equating to more than 300 job losses.
NHS England has told all 215 trusts to save 5% of their budgets this year through cost improvement programmes, amid concerns the service could overspend by £6.6 billion.
A spokesperson for the Department of Health and Social Care said the government is committed to working with the NHS to deliver the necessary reforms. They stated that bringing NHS England back into the DHSC would eliminate duplication and free up hundreds of millions of pounds for frontline care.
They also pointed to an additional £26 billion investment in health and care services and progress on cutting waiting lists, with 2 million extra appointments delivered and waiting lists reduced by 193,000 since July.
