Closure of NHS England shows ambition but risks jeopardising integrated care progress, claims Professor of Management

Prime Minister Sir Keir Starmer has announced the scrapping of NHS England, in a bid to bring the National Health Service (NHS) “back into democratic control”.

Created in 2012, NHS England is the quango that leads the NHS in this country. Its role has involved overseeing funding for the NHS and delivering on its priorities, including effective budgeting for necessary equipment and services.

Although it is not a government department, it uses public funds with sponsorship from the Department of Health and Social Care. Critics have said it promotes unwanted levels of bureaucracy and additional levels of stress and paperwork on staff – as well as rewarding chiefs for failure with large salaries from the public purse.

Amit Nigam, Professor of Management at Bayes Business School, welcomed the move, but urged caution around management of the transition.

“The Government’s goal of streamlining administrative layers in the NHS and focusing expenditure on ways that are closer to its core missions is admirable,” he said.

“Transforming the way healthcare is delivered to incorporate new technologies and move care into the community is also welcome. However, making a series of abrupt changes does have potential to jeopardise these goals in two ways.

“Firstly, closing NHS England and cutting the number of integrated care systems, as well as non-patient facing roles across trusts, risks absorbing too much attention and energy of leaders and remaining staff.

“While these resources are certain to squeezed, organisations must sequence change rather than attempt it all at once. Such a dramatic shift could therefore put the NHS in danger of focusing too heavily on cuts and rapid reorganisation, rather than making shifts in how the care we all need – and the Government wants – is delivered.

“A second way this move could backfire is the ambitious innovation it will require across all levels.

"Systems around the world have been attempting to move care from hospitals towards communities for decades, and innovation involves experimenting with doing things in new ways. This can only happen if there is some slack in the system, such as spare resources, personnel and time to experiment.

“If the overall aim is to deliver better care for the same or less money, making cuts now that leave NHS organisations without this required slack may actually work against that goal in the long term.”

All comments can be attributed to Amit Nigam, Professor of Management at Bayes Business School.