NHS England abolition: Right direction, but government announcement is tip of the iceberg

Clive Makombera, partner and head of NHS at leading audit, tax and consulting firm RSM UK, comments: 

“The government’s announcement to abolish NHS England is bold on one hand. But for those close to health policy, the decision comes as no surprise. NHSE was on spent time. The nature of what it had become, coupled with the geopolitical and economic pressures that government finds itself under, means a significant shift was urgently needed. 

“Ultimately, whilst change brings uncertainty and sometimes short-term pain, and in this case 9,000 job losses are a lot, the initial direction is the right one – to increase accountability and reduce bureaucracy. The NHSE was intended to improve efficiency but instead created unintended layers of complexity that have not delivered. There now exists a clear opportunity to create a more responsive and agile healthcare system. By reducing administrative layers, we hope resources will be better redeployed towards frontline care, resulting in better outcomes for patients and better collaboration across the wider healthcare ecosystem.  This is key to delivering the ambitious ‘prevention; digital; community’ based pledges set out by government.

“But the PM needs to heed the consequence of previous governments. History tells us that NHSE brought unintended consequences. This announcement is light on detail. Also the volume of redeployed funds for the front line might appear significant, when in fact it’s really just the tip of the iceberg in terms of what’s really needed to make a difference. The total budget for NHS England's administration and programme was at £3.4 billion in the 2023/4 budget, which is around 2% of the total NHS budget.” 

Tom Pugh, UK economist at RSM UK adds: 

“The bigger picture beyond the government’s need to address patient waiting times is important. Productivity in the public sector in general is still almost 7% lower than before the pandemic. In healthcare alone it’s much worse. This is a massive drag on the economy and the public finances and is clearly something the government is hyper-focused on trying to improve. The aim to save £45bn through digital reforms of government departments, especially AI, will impact every government department, not just the NHS. Admittedly, we know the history of big government IT projects, but it looks to me like the government is serious about making much better use of AI and tech across departments and bringing in best practice from the private sector.”