Prime Minister Sir Keir Starmer has unveiled plans to abolish NHS England, the executive body responsible for managing the day-to-day operations of the health service, in a bid to reduce bureaucracy and return control of the NHS to the government.

Delivering a speech in Hull on Thursday, Sir Keir said:

“I can’t in all honesty explain to the British people why they should spend their money on two layers of bureaucracy. That money could and should be spent on nurses, doctors, operations, GP appointments.”

He announced that the management of the NHS will be brought “back into democratic control”, describing the current setup as an inefficient structure that diverts resources away from patient care.

What Does NHS England Do?

NHS England oversees how services are delivered across the country, managing funds, data collection, training, and GP services. While frontline care is delivered by doctors and nurses, NHS England comprises managers and officials who allocate funding and set priorities.

Created with increased autonomy under the Conservative-led reforms in 2012, NHS England was meant to operate at arm’s length from political influence. However, critics have since argued that this distance has hampered reform efforts and accountability.

Why Is NHS England Being Abolished?

Starmer’s Labour government believes the current structure creates unnecessary duplication and inefficiency, and intends to redirect resources to patient-facing services.

Health Secretary Wes Streeting, who has previously advocated for greater ministerial control of the NHS, echoed this sentiment, declaring:

“Today we’re abolishing the biggest quango in the world.”

The move comes amid reports that NHS England’s chief executive Amanda Pritchard is stepping down — a shift that may have paved the way for the government’s bold structural overhaul.

Impact on Patients

Government officials have stressed that patients will not experience changes to their access to NHS services. The NHS will remain free at the point of use, and its existing services will continue uninterrupted.

Further announcements, including funding commitments and plans to improve medicine access, are expected later this year, with a projected 3-4% uplift in NHS funding anticipated for 2026.

Job Cuts and Financial Implications

The government has confirmed that the shake-up will include significant staff reductions, with half of the 15,300 administrative jobs in NHS England and half of the 3,300 Department of Health and Social Care (DHSC) positions working on the NHS to be cut over the next two years.

Mr Streeting claims the cuts will deliver hundreds of millions of pounds in savings, representing around 0.6% of the total NHS workforce.

Reactions Mixed

The announcement has triggered mixed reactions. Thea Stein, Chief Executive of the Nuffield Trust, said:

“The news will be devastating for staff at all levels of NHS England. With public finances under pressure, removing duplication makes sense — but there is a real risk this leads to excessive top-down control from Whitehall, which has historically harmed the NHS.”

Thinktank The Health Foundation called the move a “watershed moment” for the health service, though it warned that structural reform alone won’t address critical issues like waiting lists, social care shortfalls, or long-term NHS sustainability.

As the government embarks on this significant reform, all eyes will be on how effectively the transition is managed — and whether the savings truly translate into better care on the frontline.