NHS England plans to slash around 6,500 jobs—about half its workforce—as part of a sweeping restructuring effort to bring the organization closer to the Department of Health and Social Care (DHSC).
The cuts aim to save £175 million annually by reducing overlap between the two organizations and redirecting resources from central administration to frontline services, according to Health Secretary Wes Streeting.
“We are entering a period of critical transformation for our NHS. With a stronger relationship between the department and NHS England we will all work together to meet the scale of the challenge,” Streeting said.
Leadership Exodus Continues
The announcement comes amid a significant leadership shakeup. Three senior board members—Chief Financial Officer Julian Kelly, Chief Operating Officer Emily Lawson, and Chief Delivery Officer Steve Russell—announced Monday they will step down at the end of March.
These departures follow earlier announcements that Chief Executive Amanda Pritchard and Medical Director Sir Stephen Powis will also leave their positions.
In an email to staff, Pritchard acknowledged the difficult news: “I know this news will be very unsettling. The transition team will develop plans over the coming weeks and we know that colleagues will want this to be completed as soon as possible to provide future certainty.”
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Shifting NHS England’s Role
NHS England was established in 2013 by former Conservative Health Secretary Andrew Lansley to provide greater independence and autonomy from government. The current restructuring signals a reversal of this approach.
Sir Jim Mackey, who will replace Pritchard as interim Chief Executive in April, will lead a transition team tasked with implementing what Pritchard called “radical reform of the size and functions” of NHS England.
Government sources indicate plans to shift resources from central administration to regional health boards. Some job cuts may also occur within the DHSC itself.
Union Concerns
UNISON, the UK’s largest union, has criticized the decision, describing it as a “nightmare” for employees who have already faced numerous reorganizations. The union expressed concerns about the potential impact on patient care and service delivery.
Critics, including UNISON and the NHS Confederation, warn that the rapid pace of change and significant job losses could create further disruption and negatively affect patient services.

Financial Context
The restructuring takes place against the backdrop of a projected £7 billion deficit in the NHS. While the government presents these changes as necessary efficiency measures, healthcare professionals worry about potential consequences for patient waiting times, treatment quality, and overall healthcare delivery.
The transition team faces the challenge of implementing these changes while minimizing disruption to patient care and maintaining staff morale during this period of uncertainty.
FAQ
How many jobs will be cut at NHS England?
NHS England plans to cut approximately 6,500 jobs, which represents about half of its total workforce. These cuts are part of a major restructuring effort aimed at saving £175 million annually.
Why is NHS England cutting so many jobs?
The job cuts are intended to reduce duplication between NHS England and the Department of Health and Social Care (DHSC), streamline operations, and redirect resources from central administration to frontline care. The government aims to bring NHS England closer to the DHSC and address a projected £7 billion deficit in the NHS.
Who will lead NHS England through these changes?
Sir Jim Mackey will take over as interim Chief Executive in April, replacing Amanda Pritchard who has resigned. He will lead a transition team responsible for implementing what’s being described as a “radical reduction and reshaping of the centre with the DHSC.”
Which senior leaders are leaving NHS England?
Several top executives have announced their departures, including Chief Executive Amanda Pritchard, Medical Director Sir Stephen Powis, Chief Financial Officer Julian Kelly, Chief Operating Officer Emily Lawson, and Chief Delivery Officer Steve Russell.
How much money will these cuts save?
The government expects these job cuts to save approximately £175 million per year. This is part of a broader effort to address the NHS’s projected £7 billion deficit.
What concerns have been raised about these cuts?
UNISON and the NHS Confederation have expressed concerns about the rapid pace of change and the potential negative impact on patient care and service delivery. There are worries about the loss of experienced staff and further disruption to already strained services. Staff morale is also a significant concern, with Pritchard acknowledging the changes will be “very unsettling” for employees.