Greater Manchester Integrated Care Board is preparing to launch a voluntary redundancy scheme that could see between 350 and 400 jobs go. It is part of a national directive for ICBs to halve their running costs, limit spending to less than £19 per head of population, and focus on strategic commissioning rather than direct management of services.
The scheme is expensive. At an estimated cost of £42 million, it will need to be entirely funded from the ICB’s own budget, with no central government contribution. The plan projects that annual recurrent savings of £29 million will follow, allowing the scheme to pay for itself in around 17 months. In the long run, that could ease financial pressure. In the short term, however, it means finding additional savings elsewhere in the budget for 2025-26 to cover the upfront costs.
The board has been warned that without implementing the scheme this year, the financial stability of the ICB could be at risk, and progress in developing the new organisation could stall until 2026. This raises a difficult balancing act: investing heavily in job cuts now in the hope of securing greater financial sustainability later.
Modelling suggests the average staff member who takes voluntary redundancy will have over 20 years of NHS service and earn more than £55,000 a year. The estimated redundancy cost per person is £104,000, with some long-serving employees reaching the £160,000 cap. Each departure is expected to produce a recurrent saving of about £72,300 annually.
Eligibility will depend on continuous NHS service, with certain roles excluded in the first phase. Staff working in continuing healthcare, medicines optimisation, and IT will be kept out of the voluntary redundancy process for now, reflecting the operational importance of these functions. The ICB has made clear that voluntary departures are the preferred route, but it has not ruled out compulsory redundancies if the savings target cannot be met.
The challenge is that financial models rely on assumptions that may not hold in practice. Savings are only realised if the posts are not refilled and if the work they covered can either be absorbed elsewhere or deemed no longer necessary. In a system already facing high demand, there is a risk that the loss of experienced staff will create gaps that are difficult and costly to manage.
ICBs were designed to streamline commissioning and integrate health and care services more effectively. Reducing headcount may be consistent with that vision, but integration is complex work, requiring skilled teams that can navigate the boundaries between NHS bodies and local authorities. Losing institutional knowledge at speed could undermine the very efficiencies the scheme is meant to achieve.
The pressure to reduce running costs is real. Across the country, ICBs are looking for ways to meet strict financial targets without damaging frontline services. In theory, cutting administrative and management costs should protect clinical budgets. In practice, these roles often play a direct part in planning, coordination, and performance monitoring. Removing too much capacity in these areas risks shifting costs elsewhere in the system, particularly if service problems emerge and need urgent intervention.
Greater Manchester’s plan is bold in its scale and pace. If it delivers as intended, the savings will help stabilise finances and allow the ICB to focus resources on patient care. If it falls short, the costs will have been incurred without the promised benefits, leaving the organisation worse off. The outcome will depend not just on the numbers but on how well the transition is managed, how remaining staff are supported, and whether essential functions can be maintained without adding new pressures.
Cost-cutting is rarely straightforward in the NHS. This scheme offers the prospect of long-term savings but carries risks that cannot be ignored. Success will require transparency, careful planning, and a willingness to adapt if the impact on services proves greater than anticipated.
