Central staff to be cut by 50%

NHSE outgoing chief executive Amanda Pritchard said cuts to the organisation will “now need to go much further” than a move to cut about 2,000 (15 per cent) announced in January.

The cuts will form part of a major restructure of the centre instigated by health and social care secretary Wes Streeting, expected to bring NHSE more closely under the control of the department, and combine some of their teams.

Ms Pritchard said in a note to staff today the plans entailed “looking at ways of radically reducing the size of NHSE that could see the centre decrease by around half”.

It is unclear what level of cuts will be made to DHSC’s civil servants. A DHSC departmental source said the overall size of the centre would shrink by around 50 per cent, and a spokesperson said Mr Streeting “has been clear about the need to reduce the size of central government to put more resource to frontline delivery and to reduce the waste and duplication between the department and NHS England”.

Further details are expected in coming days.

It follows a reduction of about 4-6,000 staff at NHSE in the past two years, and of about 800 at the DHSC — following large expansion at both during the covid pandemic (see charts below).

Ms Pritchard said: “In the last couple of weeks, I have said I believe the time is right for radical reform of the size and functions of the centre to best support local NHS systems and providers to deliver for patients and drive the government’s reform priorities.”

She said Mr Streeting had asked incoming NHSE CEO and chair Sir Jim Mackey and Penny Dash “to lead this work, delivering significant changes in our relationship with DHSC to eradicate duplication”.

A change programme board will be established jointly between NHSE and DHSC, under a lead who has not yet been appointed. They will report to Dr Dash and to DHSC lead non-executive director Alan Milburn, who will co-chair the programme board.

Ms Pritchard added that NHSE will now only recruit in a “very small number of exceptional circumstances”, while all vacancies are now frozen indefinitely.

Sir Jim has been appointed interim NHSE chief executive, expected to stay for up to two years, while Dr Dash has been confirmed as NHSE chair, replacing Richard Meddings.

NHSE chief finance officer Julian Kelly, chief operating officer Dame Emily Lawson, and chief delivery officer Steve Russell are all stepping down at the end of the month.

Despite central staff cuts in the past two years, as of June 2024 the DHSC had 30 per cent more whole-time equivalent staff — including both permanent and temporary — than in January 2020, while NHSE had 14 per cent more, after accounting for mergers with other organisations: