Saturday, March 15, 2025
Potential job losses multiply from NHS England
However, the initial estimate of 10,000 job losses as a result of Labour's decision now looks to be an underestimate. The Guardian reports that the jobs cull from the government’s radical restructuring of the NHS will be at least twice as big as previously thought, with other parts of the health service now being downsized too.
The paper says that the staff shakeout caused by NHS England’s abolition and unprecedented cost-cutting elsewhere will mean the number of lost posts will soar from the 10,000 expected to between 20,000 and 30,000:
Many thousands more people who work for the NHS’s 42 integrated care boards (ICBs) in England will see their roles axed, as well as the 10,000 working for NHS England and the Department of Health and Social Care (DHSC) who have already been earmarked to go. ICBs, regional health service bodies which oversee groupings of NHS trusts, employ 25,000 people between them.
Sir Jim Mackey, NHS England’s incoming new chief executive, has told the ICBs to cut their running costs by 50% by the end of the year. “Given ICBs employ 25,000 people, that means that half of them are going to go,” a senior NHS official said. That could lead to 12,500 posts being lost.
In addition, Mackey has also ordered the 220 NHS trusts that provide care across England to cut the number of people working in corporate services, such as HR, finance and communications. That could lead to thousands more officials losing their jobs, insiders say.
Mackey passed on the grim news to ICB and trust leaders in phone calls and meetings this week. He outlined the NHS’s need to undertake budget cuts on a huge scale as part of a “reset” of the service’s finances to help it avoid overspending by the £6.6bn in 2025-26 that initial estimates said was likely.
Mackey, who is succeeding Amanda Pritchard on 1 April but already making key decisions about the NHS’s future, told service bosses that the prospect of such a massive deficit had “scared the living daylights” out of government ministers, the Health Service Journal (HSJ) reported.
Senior figures running ICBs say the order to halve their running costs will make it impossible for them to undertake the full range of their activities, which include funding vaccination programmes, offering blood pressure checks and improving children’s dental health. ICBs have recently finished reducing their budgets by 20% as part of a previous round of cost-saving.
“Operationally, this could be a disaster – 50% on top of what some ICBs have already done is huge. There will definitely be job losses,” said one ICB official.
“In our ICB we have no more ‘fat’ to trim. It’s very difficult to see how, if implemented in a blanket way, this doesn’t lead to service cuts.”
Julian Kelly, NHS England’s outgoing deputy chief executive, told the Commons public accounts committee on Thursday that ICB staff being cut by half was part of the wide-ranging reorganisation of NHS England that Keir Starmer and Wes Streeting, the health secretary, unveiled on Thursday in an announcement that few insiders knew was coming.
Kelly told the cross-party committee, which scrutinises government spending, that reducing NHS England’s staffing by 50% would save £400m a year and that if the staff budget for the 42 ICBs was subjected to a similarly brutal cut that would save a further £750m a year, once the programme of job losses was complete. He did not indicate how many posts could go.
The sheer scale of budget cuts Mackey is pursuing is causing consternation across the NHS. One leader told the HSJ that the size and speed of the cut to ICB running costs was “terrifying” and would cause chaos for the service.
It is not entirely clear is how these cuts will impact on services and on people's health care, especially with the government once more ignoring the need to invest in social care to relive the pressure on hospitals, accident and emergency and the ambulance service.
What is certain is that when Labour won the general election the last thing anybody expected was them laying off 30,000 people in the health service.
