Labour’s radical restructuring of the NHS has led to chaos, according to a union, as a £1 billion cost to implement job cuts has caused a significant halt in the process amid disagreements over who will cover the costs.
The NHS’s 42 integrated care boards (ICBs) in England were originally set to make up to 12,500 of their 25,000 staff redundant by the end of the year as part of the health service’s cost-cutting measures. However, due to the high costs associated with these redundancies, which can go up to £42 million each, a growing number of ICBs have paused their plans to reduce their workforce.
Jon Restell, the chief executive of Managers in Partnership, which represents many ICB staff, stated that “the redundancy bill will be eye-watering and well beyond the means of ICBs, even before their budgets are slashed by up to half. The government will have to pick up the tab.” He also mentioned that his members are increasingly distressed and desperate for answers due to the uncertainty and chaos surrounding the situation.
NHS England is in discussions with the Department of Health and Social Care (DHSC) regarding a plea from ICB leaders for an emergency cash injection from the Treasury to cover severance payments. Planned job cuts have been postponed until these discussions can resolve the uncertainty.
Health unions have expressed concerns that ICB staff are feeling anxious, confused, and stressed due to the uncertainty of their job security, with some even taking time off sick as a result.
In March, NHS England instructed the 42 ICBs to cut their running costs by 50% as part of a plan to “reset” their finances. ICBs were expected to finalize staff redundancies by the end of December. However, many ICBs have paused their redundancy programs because they cannot meet the costs without overspending this year’s budgets.
For example, North East and North Cumbria ICB has delayed its consultation on layoffs due to the projected cost of potential redundancy not being met in the current financial year. Other ICBs covering south-west London, South Yorkshire, West Yorkshire and Humber, and North Yorkshire have also paused their consultation processes for similar reasons.
ICBs in Lincolnshire, Derbyshire, Nottinghamshire, Northamptonshire, and Leicestershire plan to continue shedding personnel during the 2026-27 period, despite the fact that all ICBs’ budgets for the following year assume that workforces will already have been nearly halved.
Tensions surrounding the layoffs have been heightened by claims by ICB leaders that NHS England initially indicated it would cover the costs of redundancies. However, NHS England’s chief executive, Jim Mackey, has denied these claims and stated that “we never said there was a central pot of money” the ICBs could utilize.
In light of the confusion and slow progress, NHS England’s financial reset director, Glen Burley, indicated that “we will have to be flexible” on the directive to ICBs to halve their running costs by the end of 2025.
The DHSC has been approached for comment, while an NHS England spokesperson stated that “ICBs have worked flat out to identify savings that can be reinvested back into patient care, and a number of them have well-developed plans in place for restructuring which we are supporting them with.”
Source: https://www.theguardian.com/society/2025/sep/20/nhs-integrated-care-boards-england-job-cuts-row
