It’s been 24 hours since Prime Minister Keir Starmer announced the biggest health shake up for decades. It’s safe to say industry experts have some thoughts.
The decision to put an end to NHS England was announced by the Prime Minister whilst he was delivering a speech about reshaping our country’s future in Hull yesterday (Thursday 13th March).
It comes as no surprise that as soon as Labour unveiled their plans, the subject immediately began trending on social media and was snapped up by the media. Now, almost 24 hours later, the announcement is still dominating, and industry experts have had chance to digest and react to the news.
Below, we have piled together some of their thoughts.
Martin Jones MBE, CEO of Home Instead UK & International
‘The decision to abolish NHS England marks a significant shift in how healthcare is structured in this country. While it’s positive to see decisive action being taken, big moves like this create a great deal of uncertainty – especially for those of us in the social care sector. The government must recognize that you cannot fix or reorganize the NHS without addressing social care.
‘And it’s crucial that we focus on the details behind these reforms. Alongside the abolition of NHS England, it’s reported that Integrated Care Boards (ICBs) have been directed to slash their running costs by 50%. This raises serious concerns for homecare providers, as further cuts to local commissioning budgets could exacerbate what the Homecare Association has described as state-sponsored labour exploitation in our sector.
‘ICBs are already struggling. Many NHS commissioners currently purchase homecare at rates that don’t even cover minimum wage plus statutory costs for care workers. The financial strain on providers is worsened by the fact that over 80% of homecare providers report late payment of invoices by the NHS. If ICBs face even deeper budget cuts, we risk seeing homecare providers collapse, care worker pay stagnate, and older people left without essential support.
‘The Prime Minister and his team must set out a detailed plan urgently. Any reform of the NHS must go hand in hand with a robust, well-funded social care strategy – because the two are intrinsically linked. Home care providers, carers, and the people we support need clarity and confidence in the future of care services. We cannot afford delays, and we cannot afford to be an afterthought. We need to see a fully integrated approach, where social care is recognized as an essential pillar of the healthcare system.
‘We call on the government to provide the sector with the long-term vision it needs. The future of care in this country depends on it.’
John Ramsay, Founder and CEO of Social-Ability
‘The decision to abolish NHS England marks a major shift in the management of our health service, but it’s too soon to say what this will look like in practice. While the focus seems to be on cutting bureaucracy and improving frontline care, we cannot afford to overlook social care. It doesn’t come as a shock that, yet again, it has barely been mentioned.
‘The future of social care is in crisis. With dementia cases set to rise by 40% in the next 15 years and an ageing population growing rapidly, the need for a properly funded, well-structured care system has never been greater. Bed blocking remains a crisis, with one in four hospital beds occupied by people with dementia, many of whom could be better cared for in the community or a care home if adequate social care support systems were in place. What will this look like in the new NHS under ‘democratic control’ will this problem be solved once and for all?
‘If we truly want to fix the NHS, we must recognise that health and social care are two sides of the same coin. Where is the announcement and major reform for the social care industry? Investment in social care, including better funding for care homes and staff, would not only improve quality of life for those in need but also ease the growing pressure on our doctors, nurses and frontline services. Social care must be central to the conversation around what this new NHS will be—not an afterthought.’
Hugh Alderwick, Director of Policy at the Health Foundation
‘Abolishing NHS England is a watershed moment in how the English NHS is governed and managed – and ends a 12 year experiment with trying to manage the NHS more independently from ministers.
‘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. Scrapping NHS England completely will cause disruption and divert time and energy of senior leaders at a time when attention should be focused on improving care for patients. It will also eat up the time of ministers, with new legislation likely needed. Expected cuts to local NHS management budgets will add to the disruption and may undermine the NHS’s ability to implement the government’s plans for improving the NHS. Reforming NHS bureaucracy is not the same as reforming patient care – and government must be careful that these changes don’t get in the way.
‘[Our]staff survey shows that the NHS workforce is in a fragile state: four in ten staff report feeling unwell because of work-related stress and a third say they feel burnt out. More than one in four think about leaving their jobs. Improving NHS care and productivity can’t happen without a workforce that is stable, feels well, and able to make improvements.’
Owen Mapley, CEO of CIPFA
‘The NHS has undergone multiple restructurings in recent years, and these latest changes come at a time of huge operational and financial pressures. It is essential that attention is not diverted towards management structures and legislative changes but rather towards frontline improvements.
‘CIPFA hopes that a system traditionally characterised by ‘command and control’ uses these changes to truly empower local system leaders rather than simply change who they report to.
‘Integrated Care Boards have long had the potential to join up local services, centred around a community-first approach to patient care in local systems. But different parts of those systems continue to face fragmented approaches to reform. CIPFA welcomes the commitment to devolve a greater proportion of resources and responsibilities to the frontline and urges the government to fully seize this opportunity to enhance local autonomy and accountability.
‘To be truly effective, these reforms must align with the local government devolution agenda, fostering both cross-government and truly placed based approaches that drive the critical shifts from hospital to community-based care, analogue to digital, and treatment to prevention.
‘While redirecting ‘hundreds of millions of pounds’ in savings to the frontline is a positive step, it falls short of addressing the NHS’s financial sustainability challenge—which the first round of financial planning revealed could be a deficit of approximately £7bn overall for 2025/26.
‘We reiterate our call for a comprehensive review to determine the true scale and root causes of this financial pressure. The NHS funding and financial framework must be adapted to address these challenges and place the system on a sustainable long-term footing.’
Image via Shutterstock
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