Prime Minister Keir Starmer has announced that NHS England will be abolished to bring management of the health service "back into democratic control".
Speaking in Hull today (13), Starmer said: “We're going to cut bureaucracy across the state, focus government on the priorities of working people, shift money to the front line.”
He added that the reform will put “the NHS back at the heart of government where it belongs, freeing it to focus on patients, less bureaucracy, with more money for nurses and NHS refocused on cutting waiting times at your hospital.”
The announcement follows the recent resignation of several NHSE senior leaders, including Amanda Pritchard, chief executive, and Sir Stephen Powis, national medical director.
Speaking in the House of Commons after the PM’s announcement, health secretary Wes Streeting said that NHS England will be brought into the Department of Health and Social Care (DHSC) entirely over the next two years.
“We inherited an NHS going through the worst crisis in its history, so there is no time to waste. We inherited public finances with a £22 billion black hole, so there is no money to waste.”
“The urgency of the crisis means we have to go further and faster to deliver better value for taxpayers and better services for patients.”
Wes Streeting speaking in the House of Commons
On the abolishment of NHSE, Streeting said: “We are putting the final nail in the coffin of the Conservative's disastrous top-down reorganisation of the NHS”, which led to the longest waiting times, lowest patient satisfaction, and most expensive NHS in history.
“We have been left with two large organisations doing the same roles with an enormous amount of duplication.
“It is especially in times like these, when money is tight, that such bloated and inefficient bureaucracy cannot be justified.”
He said that the decision to scrap NHS England would have been taken even if the Conservatives hadn't left “a £22 billion black hole in the public finances.”
"Every pound that is wasted on inefficient bureaucracy in good times or bad is a pound that can't be spent on treating patients faster," he said.
He confirmed that work has already begun to “strip out the duplication” between the two organisations and bring many of NHS England's functions into the department.
He said that these reforms will deliver a much leaner top of the NHS, making significant savings of hundreds of millions of pounds a year, which will flow down to the front line to “cut waiting times faster and deliver our plan for change.”
“By slashing through the layers of red tape and ending the infantilisation of frontline NHS leaders, we will set local NHS providers free to innovate, develop new, productive ways of working and focus on what matters most, delivering better care for patients,” Streeting added.
He reaffirmed the prime minister’s commitment to cutting the number of quangos and stated, “Today, we are abolishing the biggest quango in the world.”
He acknowledged that “change is hard” and there will always be “cautious voices warning you to slow down.”
However, he said the Labor Government will never “duck the hard yards of reform.”
Sir James Mackey will be leading the transformation team as the chief executive of NHS England.
Streeting lauded him, saying: “Jim has an outstanding track record of turning around organisations, balancing the books, driving up productivity and driving down waiting times.”
Sir Mackey is putting in place a new transformation team to drive change, with Dr. Penny Dash joining as the incoming chair.
“I'm delighted to have such a capable leadership team of radical reformers to lead NHS England with me through this transformation,” Streeting added.
Pharmacy sector hopeful for funding uplift
Nick Kaye, chair of the National Pharmacy Association (NPA), is hopeful that the reforms will release much-needed funds for the sector.
He emphasised that pharmacies are frontline providers that see more patients every day than any other part of the healthcare system.
He stated the NPA will work closely with “whatever structures the government establishes” to secure and improve the vital pharmacy services upon which millions of patients rely.
“Ministers have inherited a crisis in pharmacy and need to do everything they can to prevent further damage to pharmacy services - so we hope these changes release much-needed funds for the frontline,” he added.
However, he expressed concern for the staff who are affected by this change and hoped that the process of reorganisation would not impede progress towards creating the stronger pharmacy network.
The Company Chemists’ Association (CCA) has welcomed the government's intention to redirect funding towards frontline services.
CCA chief executive Malcolm Harrison acknowledged that NHS England has played a vital role in leading the NHS through an extremely challenging period, noting that this announcement will be “unsettling for hard-working staff in NHSE.”
However, he said that they support the government’s stated aim of “streamlining decision making and redirecting funding to frontline services, including community pharmacies.”
“After 10 years of cuts and pay freezes, pharmacies are in dire need of a funding uplift,” he added.
Meanwhile, Tase Oputu, RPS England Pharmacy Board Chair, has called on the government to recognise the role of pharmacists amid NHS England abolition.
“There has been real progress in advancing the role of pharmacists across the NHS, and it is vital that planned reforms do not lose sight of this crucial ambition,” she said.
She underscored that “fully funded, well-supported” pharmacy teams across all sectors are essential for delivering quality patient care.”
RPS has asked the government for more details on any proposed transition and its impact on pharmacy colleagues.
Tase noted that medicines are “a fundamental part of the health service and the UK’s life sciences success story,” and urged the government to consider “how to resource and enable pharmacists to help deliver new treatments and support the best use of medicines across the system” as it develops a 10-Year-Health-Plan.
“It’s crucial that pharmacy continues to have representation in the reorganised NHS and that negotiations for the community pharmacy contract remain secure,” she added.
She also acknowledged the hard work of colleagues across NHSE, especially during this “challenging time.”
Community Pharmacy England (CPE) commented that, as the national negotiator, they will continue to advocate for the sector by “working closely with whatever new structures and teams the government deems appropriate in the future.”
“In the meantime, we remain fully focussed on the current CPCF negotiations taking place with both NHS England and the Department of Health and Social Care,” it said.
Dr Leyla Hannbeck, CEO of Independent Pharmacies Association (IPA), said they welcome any reforms that “reduce bureaucracy and streamline administration in the healthcare system.”
However, she noted that the test for these reforms will be “whether the cost savings can be channelled back into frontline patient care.”
She urged the government to focus on investing in “the front door of the healthcare and primary care services, such as pharmacies.”
“A reorganisation of the NHS should prioritise this aim, not distract from it,” she stated.
