Ministers have admitted they did not assess the impact of axing thousands of NHS managers before pushing ahead, prompting critics to label the move as reckless. The NHS's 42 integrated care boards (ICBs) in England have been ordered to halve their running costs by the end of the year, resulting in approximately 12,500 job losses. This is part of government plans to overhaul the health service, including abolishing NHS England and using savings from management cuts to improve finances and fund frontline care.
Karin Smyth, the minister for NHS reform, conceded in a written parliamentary answer that the Department of Health and Social Care (DHSC) failed to assess the impact of halving ICBs' running costs before approving the move. The admission came in response to a question from Liberal Democrat health spokesperson Helen Morgan, who described the policy as reckless and done on the hoof to please the Treasury.
NHS bosses have called the cuts vandalism, warning that ICBs will be stripped back so much they cannot properly commission services or oversee care quality. Andy Burnham, former health secretary, expressed real concerns about the drastic cuts, which may force ICBs to merge and shrink from 42 to between 23 and 28. The shake-up will distract staff from tackling the NHS's big challenges, he said.
Jon Restell, chief executive of Managers in Partnership, urged health secretary Wes Streeting to pause the frantic pace of reforms, warning that the scale of cuts weakens management capacity, damages services, and undermines morale. The union described the cull as hurried and poorly thought through, noting that the NHS already has one of the lowest proportions of managers globally.
The government's wider NHS shake-up includes NHS England losing half its 15,300 staff, DHSC shedding some of its 3,300 personnel, and trusts deleting tens of thousands of posts. These combined job losses represent a huge risk, according to unions, with the ICB cuts being made before the government has published its 10-year strategy for the NHS.
