Source: Pulse 13.3.25
Today’s big news is the Government’s plan to abolish NHS England, 12 years after its inception, as part of the Prime Minister’s drive to cut bureaucracy. Here, Eliza Parr explores what this shake-up might mean for GPs
Given recent news of NHS England board members stepping down and plans to cut staff by half, Prime Minister Keir Starmer’s announcement this morning may not come as much of a surprise. This is a Government clear on its intentions to reform the NHS and to cut bureaucracy.
But getting rid of NHS England and consolidating management under the Department of Health and Social Care (DHSC) is a pretty seismic change in the way the health service is currently run. And there are some key questions surrounding the decision which will certainly impact general practice.
So, what might this all mean for GPs?
Focus on primary care
There is an argument that bringing NHS policy entirely under Government control will be positive for primary care. Since taking up his role last summer, health secretary Wes Streeting has been emphatic that care and resources need to move away from the acutes and into general practice. The Government-commissioned Darzi report was crystal clear on this point. And many suggested that the recent injection of cash into the 2025/26 GP contract signalled that the Government is serious about investing in general practice.
Former BMA chair and GP Committee chair Dr Chaand Nagpaul says any new management structure within DHSC should have a strong focus on primary care policy, if the Government wants to remain true to its word.
He tells Pulse: ‘If the Government is now taking charge of the NHS, then it needs to implement an organizational arrangement that is true to delivering its own policy, as per the Darzi report, which was unequivocal about the need to both substantially increase investment in and develop general practice and primary care. That’s what I would want to see.’
Primary care professor and GP Professor Sir Sam Everington welcomes the news of NHS England’s abolition for this reason, noting that ‘everything’ Mr Streeting has said indicates he thinks ‘primary care is the solution’.
‘I’ve never known a time when politicians have been so clear about the importance of primary care to solve the problem,’ he tells Pulse.
But he highlights that to drive forward positive change for GP practices, there will need to be ‘a complete connection between the grassroots and the top’.
Dr Rocco Friebel, associate professor of health policy at the London School of Economics, also says this change could ‘refocus’ policies on the NHS frontline – but stresses the need for sufficient capacity to manage this change.
‘Ministers will now have to own the NHS’s day-to-day problems, but they’ll need serious capacity in Whitehall to manage something this complex. If the Labour government gets it right, there’s a real chance to refocus on patients and frontline staff – but if they don’t, it could make an already stretched system even more chaotic.’
So removing a layer of bureaucracy in the management of the NHS could mean that new policies are truer to the Government’s goals – and bolstering general practice is clearly high on Mr Streeting’s agenda. But given that NHSE will be absorbed into DHSC over two years, any improvements won’t be instant.
GP contract and negotiations
Many in the health service may happily wave goodbye to NHS England if it makes their working lives simpler.
GPCE member for Derbyshire and Nottingham Dr Peter Holden says that NHSE’s abolition is ‘probably no bad thing’ as it is a ‘reduction in layers of management’. Indeed, central policy on general practice will surely be simpler if it’s coming from one place instead of two.
Another potential simplification is in GP contract negotiations. For recent contracts, the BMA’s GPCE, which acts on behalf of the profession, has negotiated the contractual arrangements with NHS England, which essentially acts on behalf of the Government. Anything agreed by NHSE ultimately requires ministerial sign-off. By removing this middle layer, negotiations are likely to become simpler (but by no means easy).
To read in full click here for the source article.
