Comment EDITOR’S COMMENTwith LOUISE FRAMPTON THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


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The end of the road for NHS England


At the time of writing this, the government has announced that NHS England is to be abolished. NHS England will be brought back into the Department of Health and Social Care (DHSC), “to put an end to the duplication resulting from two organisations doing the same job”, in the words of the government. Health and Social Care Secretary, Wes Streeting, commented that: “We need more doers and


fewer checkers, which is why I’m devolving resources and responsibilities to the NHS frontline.” Responding to the announcement that NHS England will be abolished, Hugh Alderwick,


Director of Policy at the Health Foundation, said: “There is some logic in bringing the workings of NHS England and the government more closely together – for example, to help provide clarity to the health service on priorities for improvement. And – in reality – it is impossible to take politics out of the NHS. But history tells us that rejigging NHS organisations is hugely distracting and rarely delivers the benefits politicians expect.” Nuffield Trust Chief Executive, Thea Stein, said: “With the public finances under extraordinary


pressure, it makes sense to remove the duplication and bureaucracy that exists currently – and patients and the public are probably not going to shed many tears over the shifting of power from an arm’s-length body into central government. But profound problems facing the NHS remain: how to meet growing patient need in the face of spiralling waiting lists and how to invest in care closer to home with the NHS’s wider finances already underwater and social care reform in the long grass. It is not immediately clear that rearranging the locus of the power at the top will make a huge and immediate difference to these issues, which ultimately will be how patients and the public judge the government. Furthermore, the government should be careful that this doesn’t lead to even more top-down micro-management of local services from Whitehall, which has been the bane of the health service. NHS England was set up to take the politics out of the NHS, but today politics has taken out NHS England.” Sarah Woolnough, Chief Executive of The King’s Fund, added: “The most important question is


how will the abolition of NHS England make it easier for people to get a GP appointment, shorten waits for planned care and improve people’s health? That hasn’t yet been set out – ministers will need to explain how the prize will be worth the price.” It remains to be seen whether this becomes a major distraction or creates a leaner NHS


– certainly, a move closer to top-down control means the buck will firmly stop with Ministers. However, let’s not forget that there is also a human cost to this decision – thousands of people have lost their jobs, yet the language around the announcement has been brutal. The Department of Health’s own headline read: ‘World’s largest quango scrapped under reforms to put patients first’ – the implication being that NHS England have ‘not put patients first’, a comment that will sting for the many experts employed by NHS England, who have worked as healthcare professionals delivering care to patients on the frontline of the NHS. The subsequent media coverage has referred to NHS England staff as ‘pen pushers’ – these are the same people who helped guide the country through some of the most challenging times during the pandemic, helping to save lives. Whatever one’s views on the decision to close the doors on NHS England, the announcement


could have, and should have, been handled with more compassion. As UNISON general secretary Christina McAnea points out: “The way the news of the axing has been handled is nothing short of shambolic. It could surely have been managed in a more sympathetic way. Thousands of expert staff will be left wondering what their future holds. Wherever possible, their valuable skills must be redeployed and used to the benefit of the reformed NHS and patients.”


louiseframpton@stepcomms.com Get in touch and give us your views, email me:


April 2025 I www.clinicalservicesjournal.com 5


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