Government confirms plan to scrap about 18,000 administrative roles as NHS England is absorbed into the Department of Health and Social Care and local boards halve their headcount.
Treasury deal unlocks NHS redundancies
Thousands of NHS staff in England face redundancy after the government confirmed a deal with the Treasury that lets the health service overspend this year to fund a large job-cutting programme, while keeping overall funding within its existing settlement.
In a press release on November 11 2025, the Department of Health and Social Care (DHSC) said “funding arrangements have been agreed with HM Treasury” and will come from within the current budget, without cutting investment in the NHS frontline.
This agreement allows the NHS to overspend during the current financial year to cover redundancy costs, after months of negotiation between health secretary Wes Streeting and chancellor Rachel Reeves.
18,000 roles to go as integrated care boards shrink
The DHSC says around 18,000 administrative posts will be abolished, mainly across NHS England and the 42 integrated care boards (ICBs) that plan services at local level.
This equates to about half of all ICB staff, as part of a 50% cut to their running costs.
At the same time, NHS England will be brought back into the DHSC within two years, reversing the arm’s-length model created by the 2012 reforms. A March 13 2025 statement to Parliament and the latest DHSC press notice both set out a timetable to complete the abolition of NHS England and its reintegration into the department by 2027.
Ministers argue that cutting management layers and administrative roles will save more than £1 billion a year by the end of the Parliament, money they say will be redirected into frontline care. The DHSC gives one example: each £1 billion saved is enough to fund about 116,000 extra hip and knee operations.
Unions warn of risk to planning, digital and continuing care
While the government insists there will be no reduction in “frontline or backroom” investment, unions and professional bodies say the NHS staff job cuts could weaken vital planning and support functions.
Managers in Partnership (MiP), which represents many senior NHS managers, has been tracking the restructuring. It warns that job losses across integrated care boards, NHS England, and other bodies will affect staff who have already endured a long period of uncertainty.
In comments reported by the Guardian and Digital Health, union leaders say roles at risk include experts in digital transformation, data, and NHS Continuing Healthcare, a package of fully funded long-term care overseen by ICBs under a national framework set by the DHSC.
The British Medical Association has raised similar concerns, telling sector media that large, rapid cuts in NHS England and ICB staff could undermine the government’s ambition to shift toward prevention and community-based services.
NHS Providers and the NHS Confederation, which represent trusts and system leaders, describe the Treasury deal as a pragmatic step that finally gives clarity over redundancies, while stressing the need to support affected staff and protect core functions during the transition.
