Insiders said the uncertainty was damaging morale and ultimately putting patient care at risk. Staff affected by the situation said decisions on key services were being delayed because of the pause in redundancies and designing new structures.<\/p>\n
\u201cThere is no doubt this will cause disruption that affects patients,\u201d one senior manager said. \u201cIt will mean delays in decisions being made. In some areas like safeguarding, which is being really badly affected, it could have serious consequences and is a huge risk for patients.\u201d<\/p>\n
They said that essential services earmarked for cuts or transfers included emergency planning, special educational needs services for children and continuing healthcare decisions \u2014 NHS-funded care packages for patients with serious ongoing medical needs in the community.<\/p>\n
One internal ICB document said the redundancy process was unclear owing to NHS England not agreeing the final structures of the boards and uncertainty about funding. Initially, NHS England had indicated there would be a central pot, but it has since become clear this does not exist, it said.<\/p>\n
In Greater Manchester, there were plans to make 400 staff redundant, with average redundancy costs of \u00a3104,000 each, totalling \u00a341 million. A report to its board said that although NHS England had \u201craised expectations of a centrally funded scheme, no such scheme has been issued\u201d.<\/p>\n
![\"Keir](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/08\/\/f828996e-3b6c-4f93-b9c3-2a599dd9e472.jpg\")
<\/p>\n
Wes Streeting, Rachel Reeves and Sir Keir Starmer pledged to overhaul the NHS<\/p>\n
CHIEF SUNDAY TIMES PHOTOGRAPHER JACK HILL<\/p>\n
Similar plans are being pursued at Cheshire and Merseyside, and at Lancashire and South Cumbria.<\/p>\n
Herefordshire and Worcestershire, with a \u00a32.2 billion budget, plans to cut up to 200 staff, saving \u00a323 million and merging with Coventry and Warwickshire.<\/p>\n
Boards are all aiming to cut their running costs to \u00a318.76 per head of population in their areas. Some have running costs as high as \u00a370 per head.<\/p>\n
The false start for the NHS reforms <\/a>is embarrassing for Labour. It has made fixing the \u201cbroken\u201d NHS a key mission for both Streeting<\/a> and the wider government, which is struggling to show it is delivering on promises made to the electorate.<\/p>\n Streeting promised his plans would make the NHS act faster with less duplication, helping to deliver \u201csavings of hundreds of millions of pounds a year\u201d.<\/p>\n The health secretary has said the measures will slash bureaucracy<\/p>\n CHIEF SUNDAY TIMES PHOTOGRAPHER JACK HILL<\/p>\n Since 2019, corporate costs in the NHS have risen by \u00a31.85 billion, excluding pay and pensions.<\/p>\n In one of his first acts in the job, NHS England\u2019s chief executive, Sir Jim Mackey, told ICBs and NHS hospitals they needed to cut spending because the health service faced a \u00a36.6 billion overspend.<\/p>\n In May, Mackey, who trained as an accountant, told NHS England\u2019s board that changes were needed to cut layers of bureaucracy. But he acknowledged the shake-up was ambitious: \u201cThere is no way of dressing this up \u2014 it\u2019s a really big, complicated, risky change. We are making informed guesses about how things fit together.\u201d<\/p>\n One senior director at a board in southern England said: \u201cIt feels like a total bin fire at the moment.<\/p>\n \u201cI have known for weeks my role will be deleted and we have told other staff they will lose their jobs, and yet we\u2019ve been told the national team is in chaos and there is no funding agreed to pay for it. But they have asked us not to tell the staff, who are all just left in limbo.<\/p>\n \u201cThis whole process is creating so much waste and inefficiency for the NHS<\/a>, which is completely ironic.\u201d<\/p>\n![\"Wes](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/08\/\/31585a1c-abd4-4326-9d03-3a580b10fc87.jpg\")
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