The Department of Health and Social Care (DHSC) and NHS England have unveiled a detailed timetable for their function merger, a significant reform aimed at simplifying England's health governance. This initiative, which follows the government's March 2025 announcement to abolish NHS England as an arm’s-length body and integrate its core responsibilities into the DHSC, seeks to eliminate duplication, simplify decision-making, and place the health service under closer government supervision.
The integration roadmap details a managed transition spanning the coming year and into 2027, with staged changes across leadership, legislation, workforce, and corporate systems. Early steps began in November 2025 with the formation of a joint executive team to align policy and delivery. This is complemented by a major restructuring of corporate systems, including an £8 million IT contract awarded in late 2025 to unify the digital infrastructure. While NHS England continues its statutory duties, legislative amendments to the Health and Social Care Act, expected to extend into 2027, will formally abolish the organisation and transfer its functions to the DHSC. A key aspect is the planned significant reduction of central administrative roles which is estimated at around 18,000 posts across the merging bodies, projected to yield long-term savings exceeding £1 billion a year by 2029. Oversight for the process is managed by a dedicated Transformation Oversight Group, co-chaired by non-executive leaders from both organisations, building upon earlier collaborative efforts that began in May 2025.
The reform has sparked debate. Concerns raised by Integrated Care Board leaders and NHS staff focus on the potential for structural upheaval to divert attention from frontline services, create workforce uncertainty, and impact operational continuity. Conversely, proponents argue that integrating NHS England’s functions into the DHSC will reduce bureaucracy, ensure clearer accountability, and better align the service with government objectives, such as addressing waiting lists. However, critics caution that this centralisation risks politicising NHS operational decisions, potentially compromising the balance between evidence-based commissioning and political priorities.
Despite the controversy, the published timetable provides a clear path forward, with key milestones including legislative change, consolidation of executive leadership, IT integration, and workforce redesign, all working toward the goal of a single, coherent health leadership function to improve patient outcomes and system efficiency.
