NHS England staff cuts must be about moving capacity from the centre into local systems

Commenting in response to the announcement by NHS England that it intends to reduce the size of its workforce over the coming 18 months, Matthew Taylor, chief executive of the NHS Confederation, said: 

“This is the right move by Amanda Pritchard and her team as we enter a different era for the NHS. With local integrated care systems up and running, we need to devolve more power, control and autonomy to them if they are to succeed. A centre reformed to support systems, rather than control them, is crucial and that requires a different role for NHS England which this announcement rightly signals.

“This is therefore an important next step in creating a centre that enables and empowers local integrated care systems to thrive. Many NHS leaders tell me that they spend too much time looking up in response to the demands of national policymakers and regulators and, as a consequence, they often lack the bandwidth or autonomy to make the changes they want. This important move by NHS England shows they have listened and we look forward to working with them to ensure the new operating model helps deliver on our collective vision for integrated care systems.

“The report we commissioned Professor Sir Chris Ham to undertake for the NHS Confederation earlier this year called for a different role for the centre. In our view, self-improving systems need the right balance of top-down, sideways and bottom-up incentives comprising, principally, political accountability; national strategy and expertise; public service professionalism; a culture of challenge and support; and responsiveness to local partners, communities, patients and the public.

“These planned changes will help move us to a better balanced health and care system. However, we hope these changes are not just about cuts but also about moving capacity from the centre and into local systems.

“Finally, we recognise the significant impact this will have on the individuals affected and trust that they will be engaged and listened to as part of this process.”