News and Insights

What Does Abolishing NHS England Mean and What Are the Implications?

April 2, 2025

Q. What does NHS England do?

Since its creation in 2012, NHS England’s role has evolved but simply put, it is the primary body that sets the priorities for the health service in England, oversees the allocation of taxpayers’ money from central government to local NHS systems and monitors their performance.

It also writes the national contracts that determine how different NHS-funded organisations are paid for the work that they do on behalf of patients and what is required of them when providing these services. For example, NHS England sets the contractual arrangements for nearly 30,000 general practitioners, dentists, community pharmacists and optometrists.

The national body also monitors the performance of nearly 7,000 NHS organisations across England and intervenes to bring about improvements when required.

It also designs and arranges over 80 essential physical and mental health services to support people with rare and complex conditions, as well as healthcare services for members of the armed forces, prisoners, in addition to sexual assault and abuse services.

Crucially, the body also takes a lead on emergency planning and response to major incidents. It took a major role in co-ordinating the health service’s response to the COVID-19 pandemic, including in the delivery of vaccinations.

NHS England has held some of these responsibilities since its creation in 2012. Some roles it has taken on since then, as other national bodies have been absorbed into it. For example, in 2023 NHS England absorbed Health Education England, the national body that oversaw the planning, training and recruitment of the healthcare workforce in England. NHS England has taken over these responsibilities. Other organisations that have become part of NHS England include: NHS Improvement, the NHS Trust Development Authority, NHSX, and NHS Digital.

Q. Is NHS England the same as the NHS?

No. NHS England is the national body responsible for overseeing large parts of the delivery of publicly funded health services in England.

The National Health Service is the name given to the UK’s entire publicly funded healthcare system. The NHS,which was created by an Act of the UK parliament in 1948, is run locally by each of the four UK nations, each with itsown publicly funded budgets, rules and workforce.

In the financial year 2024/25, total government funding for NHS England is £179 billion. Before the creation of NHS England, the delivery of publicly funded healthcare was largely overseen by ministers, with a measure of operational and financial independence granted to certain parts of the system. The most notable example of this limited independence came with the creation of NHS trusts in the early 1990s. These bodies are responsible forrunning individual hospitals or groups of providers.

Q. Why does the UK government want to abolish NHS England?

Announcing the decision to abolish NHS England on 14 March 2025, UK prime minister Sir Keir Starmer explained that his government wants to drive efficiencies within the public sector and empower staff to deliver better care.

The government’s Department of Health and Social Care (DHSC) has said that bringing NHS England’s functions andresponsibilities “back into” the Department will put an end to duplication resulting from two organisations “doing thesame job”.

In its announcement the government argued that the current system penalises hardworking staff at both NHS Englandand the DHSC who “desperately want to improve the lives of patients, but who are being held back by the currentoverly bureaucratic and fragmented system”.

In the short-term, it is clear that part of the rationale for this move is to reduce costs. The UK government has told both NHS England and the 42 Integrated Care Systems (ICSs) that oversee local services that they would be subject to job cuts and financial savings.

When NHS England was created almost 12 years ago, the then-government’s reasoning for the change was to take day-to-day management of the health service out of the hands of “micromanaging” politicians.

Since then successive governments have grown frustrated with NHS England’s performance, and the limited ability they have had from the centre to be able to drive improvement or make wider changes.

Over time this has led to the introduction of new laws designed to give central government greater oversight of NHS England’s functions.

This announcement appears to be keeping in this desire to exercise greater central government control over the way the health service in England functions, with Sir Keir Starmer describing the abolition of NHS England as a move to bring the health service in England “back into democratic control”.

Q. What does this mean for patients?

At this time it is unclear what the impacts of this change will be for patients and the services that they rely on. We await further detail on what the transition of NHS England’s responsibilities back to central government will look like.

What we do know is that around 9,000 administrative roles will be cut from NHS England and the Department of Healthand Social Care as part of these reforms. It is not thought that these changes will directly impact care delivery to patientson the ground.

While both the Prime Minister and Secretary of State for Health and Social Care Wes Streeting have said that abolition willbring more resources to front line health and care, we are yet to see the practical details on how the money will be freed up.

One possibility is that some of the responsibilities currently held by NHS England will move down or become ‘devolved’ to thelocal level. There has been previous discussion in government circles about the benefits of giving greater decision-making powers to local leaders to improve services. The thinking is that they are likely to be better tuned into the needs of their local populations.

Q. What does this mean for the way health services are delivered?

Again, at this early point, we still don’t know what these changes will mean for the delivery of services at either a local or national level. The government has acknowledged that the abolition of NHS England is likely to take time (perhaps up to two years) and that during this time there may be a “risk of disruption”.

The government has pledged that these reforms will not impact access to the NHS, which is mandated to provide most services free at the point of use.

Q. What does this mean for companies working with the NHS?

The health service in England is used to change and reform, which can make it a more challenging environment in which to provide services, technology or medical products.

One of the most likely short-term outcomes for larger companies and start-ups alike from the overhaul of NHS England is that decisions around large multi-year investments are likely to be frozen for at least a few months.

In short, the impact on a company wishing to work with the publicly-funded health sector in England will depend on what kind of product or service the company provides. Life sciences companies and providers of data insights are still likely to find engaged counterparts within the NHS willing to partner.

A key way for commercial partners to spread uptake of their solutions and products is through partnering with local NHS trusts and integrated care boards through fixed-term pilots. These pilots can be crucial for building an evidence base for a solution’s utility, safety and potential return on investment for financial decision makers within the health system.

Given the wider national uncertainty, it is likely that those companies that have already established strong partnerships withlocal NHS bodies should act to strengthen those relationships now.

While the near-term is likely to be difficult, the government has set out its long-term ambition for the health service towork more effectively with suppliers, the life sciences sector in particular, in order to bring economic growth.

Speaking shortly after the Labour Party’s victory in last summer’s UK general election, newly installed Health and SocialCare Secretary Mr Streeting said of his department: “This is no longer simply a public services department. This is an economic growth department…If we can marry our health and social care system with the incredible life science and med tech ecosystem we have in this country, we can be a powerhouse for the life sciences and med tech revolution here in this country and in the world.”

This indicates a greater openness to working with innovative suppliers of technology and therapies in a system that sometimes, fairly or unfairly, has a reputation for raising barriers to the uptake of innovation, rather than lowering them.

Q. What is going to happen next?

At this point it is too soon to know how the abolition of NHS England will take place in practice. It is almost certain thatthe changes will require new laws, so this will likely take some time going through parliament.

How the impact of the decision to abolish NHS England will make itself felt here is still unknown.

Q. How long will this take?

Official statements around the reforms to NHS England and the absorption of its responsibilities into the Department of Health and Social Care have suggested that the transition will take up to two years.

For more information about how health and care services work in Great Britain and Northern Ireland, why not download Finn Partners’ UK Health Group guide to navigating the NHS.