NHS England is set to undergo an unprecedented transformation, with half of its workforce and a significant portion of its senior management team facing redundancy as part of a radical overhaul led by its new chief executive.
The organisation’s workforce will be slashed from 13,000 to approximately 6,500, with entire teams being disbanded to cut costs and eliminate “duplication” with officials at the Department of Health and Social Care (DHSC).
Staff members have expressed shock at the scale of the redundancies, which go far beyond the previously announced 2,000 job cuts intended to save £175 million.
As part of this restructuring, the DHSC will also see reductions in staff numbers, albeit on a much smaller scale, as it moves towards closer integration with NHS England from April.
The changes will significantly enhance the authority of Health Secretary Wes Streeting, granting him greater oversight of NHS England’s operational management.
Matthew Taylor, Chief Executive of the NHS Confederation, described the overhaul as “the most significant restructuring of the NHS’s national framework in over a decade.”
Outgoing NHS England Chief Executive Amanda Pritchard informed staff of the extensive downsizing in an internal email, confirming that the initiative was driven by Streeting.
She revealed that incoming Chief Executive Jim Mackey and newly appointed Chair Dr Penny Dash have been tasked with leading a “radical reform” of NHS England and DHSC’s headquarters in London, aimed at eliminating redundancy and streamlining operations.
Pritchard, who announced her resignation two weeks ago following discussions with Streeting, will step down at the end of the month.
A designated “transition team” comprising DHSC and NHS England officials will oversee the restructuring, reporting directly to Dash and Alan Milburn, the former Labour Health Secretary who has been appointed as the DHSC’s lead non-executive director.
“The restructuring could see NHS England’s central workforce reduced by around 50%,” Pritchard stated, acknowledging the “unsettling” impact of the changes and the uncertainty they bring to staff.
Additionally, senior executives including Deputy Chief Executive and Finance Chief Julian Kelly, Chief Operating Officer Emily Lawson, and Chief Delivery Officer Steve Russell will also depart this month, along with National Medical Director Professor Sir Stephen Powis, who announced his resignation last week.
An NHS England insider remarked, “Staff anticipated changes, but not to this extent. Many feel bewildered and anxious about the rapid departure of key figures like Emily Lawson, Julian Kelly, and Steve Russell.”
Streeting has been transparent about his intent to exert greater ministerial control over NHS England, which has maintained semi-autonomous status since former Health Secretary Andrew Lansley’s NHS reforms in 2012.
Recent reports by The Guardian revealed that thousands of positions within NHS England were set to be eliminated, with Mackey planning a comprehensive overhaul of senior leadership.
More high-profile exits are expected as NHS England faces a projected budget shortfall of £6.6 billion for the 2025/26 financial year.
Mackey and Pritchard recently cautioned NHS leaders that a “fundamental reset of the financial framework” is necessary to stabilise the organisation’s finances.
