What does NHS England do? And why is it being abolished?
The government has announced NHS England will be abolished to "cut bureaucracy" and reform how the National Health Service is run.The changes will not impact anyone's access to the NHS - but Prime Minister Sir Keir Starmer said it would bring management of the health service in England "back into democratic control" and free up money for front-line services. Around 9,000 administrative roles are being cut at NHS England and the Department of Health and Social Care as part of the changes - amounting to roughly half of all roles at the two organisations. As part of Your Voice Your BBC, we asked for your questions on the plans and what they could mean for you - below we have answered them for you.
What does NHS England do?
NHS England is the organisation which leads the health service in England. It was given autonomy by the Conservatives in 2012 with the aim of freeing the health service from interference by politicians.It takes the money provided by the government and funnels it into the different parts of the health service.It has therefore been NHS England's job to translate ministers' priorities into the services people get on the front line.The body is also responsible for things like overseeing training and collecting data, as well as managing GP services.The announcement will not impact how the NHS is structured in other UK regions.
Did this decision come out of the blue?
Within the NHS and Westminster, the writing has been on the wall for NHS England for some months.Even in the latter years of the Tory government, health ministers expressed frustration that they were not in charge of the day-to-day running of the health service.When Labour came into power, it was clear Health Secretary Wes Streeting wanted more control of the NHS and saw a lot of duplication and bureaucracy.NHS England's chief executive Amanda Pritchard recently said she would step down at the end of the March and a number of her senior leadership team have followed suit.In that respect, it was clear there was going to be significant reform - but this is as big a change as you could possibly get at the heart of the NHS management structure.
What is a 'quango' - and why do ministers think 'bureaucracy' is a problem?
These are two words we have heard the government use a lot when setting out these changes.In this context, bureaucracy is a stand-in word for a system that is particularly complicated, or requires excessive amounts of administration, paperwork, regulations or layers of management.Starmer made it clear he thinks this admin is getting in the way of delivering health services.We also heard him describe NHS England as the "world's largest quango" - a term that stands for Quasi-Autonomous Non-Governmental Organisation.
In short, they are bodies like regulators and advisory groups, which are funded by taxpayers but not directly controlled by central government. They do things on behalf of the government, but at an arm's length. They range from big organisations you will have heard of like NHS England, Network Rail and the Environment Agency to smaller ones like the British Film Institute and Gambling Commission. Their numbers have fallen by more than half since 2010 because David Cameron's coalition government abolished nearly 300 - but there are still more than 300 across the UK.Labour has set up more than 20 since winning the election last July, including Great British Energy and Skills England.The total budget for quangos in 2022/23 - when the latest figures were published - was £353bn.
Will local authorities have more control over decision-making and budgets?
It looks likely that some of the responsibilities NHS England currently holds will be devolved down to regional bodies.Jeremy Hunt, the former health secretary, has talked about how he felt NHS England was stifling innovation.One of the arguments being made about NHS reform is that if you move decision-making down to a local level and nearer to patients, it will be local health leaders who are more attuned to the needs of patients in the area making those calls.They will know what local populations need and where the weaknesses are - and that, in theory, could improve services for patients in different parts of the country.
Will this mean an increase in funding to the NHS and better access to medicines?
Thursday's announcement was not about funding - that is expected in the summer.We already know NHS is getting an uplift of about 3-4% next year and we do not yet know what spending will look like beyond that.On access to medicines, it is the National Institute for Health and Care Excellence - which is separate from NHS England - which sets the guidelines on what treatments are judged affordable and cost effective.When a new drug is produced by the pharmaceutical industry, the institute will decide if the NHS can afford it and whether it is better than other drugs that are used.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Times
an hour ago
- Times
The NHS can afford assisted dying, Starmer tells Streeting
Sir Keir Starmer has rebuked his health secretary over the funding of assisted dying as he insisted he was confident the NHS would be able to handle the new law. The prime minister said it was 'his responsibility' to ensure assisted dying could be carried out safely, after Wes Streeting said there was 'no budget' for the service to be introduced. Starmer, who voted in favour of assisted dying, said he was 'confident we've done [the] preparation' needed to ensure it could come into force. Streeting said in a statement to constituents at the weekend that 'setting up this service will take time and money that is in short supply'. He said the process could divert resources from the NHS and other public services.
Business News Wales
2 hours ago
- Business News Wales
Nursing at Wrexham University Ranked Top in UK for Student Satisfaction
Nursing at Wrexham University has been ranked top in the UK for student satisfaction in the Complete University Guide 2026. The Guide has also ranked the institution joint first in the UK – and first in Wales – for graduate prospects in the Nursing subject league table. Wrexham University offers Nursing BN (Hons) courses in Adult Nursing, Children's Nursing and Mental Health Nursing at its Wrexham and St Asaph campuses. Earlier this month, the university celebrated the news that it had been ranked top in Wales for student satisfaction overall in the Guide, as well as joint third in the UK for the same metric – out of 130 higher education institutions. Professor Joe Yates, Vice-Chancellor, said: 'I am thrilled that nursing at Wrexham University has been ranked top in the UK for student satisfaction, as well as joint first in the UK for graduate prospects in the Nursing subject league table, in the Complete University Guide 2026. 'We are enormously proud of our strong reputation for student satisfaction, here at Wrexham – and these latest rankings demonstrate that our staff go above and beyond to support and empower our students in all that they do. 'This recognition speaks directly to the core of our 2030 Vision and Strategy, which is rooted in delivering an exceptional and inclusive student experience, as well as preparing our graduates to thrive in their chosen careers. In professions such as nursing, where compassionate, skilled professionals are in ever-increasing demand, we are proud to be leading the way nationally. 'Congratulations to our nursing colleagues, who work tirelessly to provide an excellent experience for our students.' Some places are available on the University's Adult Nursing and Mental Health Nursing degree courses, which are starting in September. You could be eligible for a fully funded NHS bursary to support your studies, find out more here . Whether you've not quite decided where to study or even if university is right for you, come and see what we have to offer at our next open day, taking place on Friday, August 15, from 10am to 2pm. Book your place here.
The Guardian
2 hours ago
- The Guardian
Starmer pushes back at Streeting doubts over budget for assisted dying
Keir Starmer has insisted the government is prepared to deliver assisted dying legislation 'in all its aspects', pushing back against comments made by his health secretary, Wes Streeting, who claimed there was no budget to implement the new law. Streeting, who was previously a supporter of assisted dying but switched sides last year, said better end of life care was needed to stop terminally ill people feeling as though they had no alternative but to end their own life. Writing on his Facebook page, Streeting cited Gordon Brown's opposition to the move and expressed concerns about the ethics of offering an assisted dying service before significant improvements are made to the NHS. 'The truth is that creating those conditions will take time and money,' he wrote. 'Even with the savings that might come from assisted dying if people take up the service – and it feels uncomfortable talking about savings in this context, to be honest – setting up this service will also take time and money that is in short supply. 'There isn't a budget for this. Politics is about prioritising. It is a daily series of choices and trade-offs. I fear we've made the wrong one.' The prime minister backed the historic measure, which passed the Commons with a majority of 23. MPs were given a free vote. When asked on Wednesday if the bill must be implemented and the budget must be found for the legislation, Starmer told reporters ahead of the Nato summit: 'It is my responsibility to make sure the bill is workable, and that means workable in all its aspects. I'm confident we've done that preparation.' The assisted dying bill, which was formally introduced in the House of Lords for further scrutiny on Monday, gives terminally ill adults in England and Wales with six months to live the legal right to end their lives with medical support. This would be subject to approval by two doctors and a panel including a social worker, senior legal figure and psychiatrist. Kim Leadbeater introduced the legislation as a private member's bill, and the Labour peer Charlie Falconer is expected to lead on the legislation in the Lords. Falconer, who supported Leadbeater's efforts, said peers should not use procedural devices to block the bill. Sign up to First Edition Our morning email breaks down the key stories of the day, telling you what's happening and why it matters after newsletter promotion Leadbeater, the Labour MP for Spen Valley, hopes the bill will get its royal assent by October, allowing the start of a four-year process to formally implement it. Streeting will oversee the implementation of the law, as it will be carried out by the Department of Health and Social Care, although the day-to-day work will be handed over to the care minister, Stephen Kinnock, who backed the bill. Although Streeting's views on assisted dying are well known, he has told allies he will not seek to impede the bill's implementation. Given MPs were allowed to vote according to their conscience rather than along party lines, Starmer had been conscious of not wanting to appear to influence MPs' decisions. He had criticised Streeting for doing so earlier this year.
