I am today updating the House on the Government’s plans to reform the health system in England, in line with our commitment to deliver a more accountable, productive and patient-focused national health service.
The Government intend to abolish NHS England by March 2027, subject to the will of Parliament. And as we have set out, the role of integrated care boards is also changing. ICBs now have a clear purpose as strategic commissioners, tasked with building a neighbourhood health service focused on preventing illness.
We are doing this to deliver a more streamlined, efficient and strategic centre. The size of the centre has more than doubled since 2010. The 2012 reorganisation of the NHS led to worse care for patients, at soaring costs, leaving taxpayers paying more but getting less. That is why the Government’s ambition remains to reduce staff numbers by up to 50% across the Department of Health and Social Care, NHS England and ICBs. These reductions will be made by March 2028.
Patients will experience better care as we end duplication and slash bureaucracy across the NHS, with around 18,000 posts abolished and more than £1 billion per annum saved by the end of the Parliament. These reforms will also give more power and autonomy to local leaders and systems—stripping away red tape and bureaucracy, and providing more freedom to better deliver health services for their local communities. Today’s announcement comes ahead of next week’s Budget, which will focus on cutting waiting lists, cutting the national debt and cutting the cost of living, and driving more productive and efficient use of taxpayers’ money by rooting out waste in public services.
As set out in our 10-year health plan, we are revitalising the foundation trust model that drove previous improvements in performance, but with the shift from treatment to prevention at its heart. And as our next step in delivering this commitment, I can today update Parliament that eight high-performing trusts will be assessed by NHS England to become the first advanced foundation trusts, based on their record of delivering quality care, strong finances and effective partnerships with staff and local services:
Further waves will follow over the coming years, driving up standards in every community.
This new designation will reward excellence with greater freedom for providers and clinicians to make decisions locally—from how services are organised to how money is spent—so that care can be designed around what works best for local people, not dictated from Whitehall.
On top of this, the best foundation trusts—those embracing the three shifts and demonstrating the strongest partnerships—will also be given the opportunity to hold integrated health organisation contracts. As an IHO, they will hold the whole health budget for a local population, alongside responsibility for improving health outcomes.
From the first wave of advanced foundation trusts, two will go forward as candidates for first wave IHO designation. We will work with these designates to further develop the IHO model, and over time we expect IHOs to become the norm.
All of this adds up to a very different kind of NHS. It marks a fundamental shift: from command and control to collaboration and confidence. It will not happen overnight, but with our investment and modernisation, this Government will rebuild our NHS so that it is there for you when you need it once again.
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