Why is NHS England being abolished, and what’s next?
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r535 (Published 17 March 2025) Cite this as: BMJ 2025;388:r535
- Jacqui Wise
- Kent
What is NHS England?
NHS England was created by the Conservative-Liberal Democrat coalition government as part of health secretary Andrew Lansley’s 2012 reforms. It was designed to give operational independence to the NHS, freeing it from day to day political interference. Originally called the NHS Commissioning Board, it was renamed NHS England in 2013. In 2022 it merged with the trust regulator NHS Improvement, and subsequently merged with NHS Digital and Health Education England in 2023, making it a behemoth of an organisation with myriad functions.
What does NHS England do?
NHS England’s key role is deciding how much funding local integrated care boards and trusts are given each year to provide the range of clinical services in their areas, such as GP care. It’s also responsible for ensuring that key waiting time targets, such as the maximum four hour wait for emergency care or the 18 week maximum wait for hospital treatment, are delivered. Sharing good practice, for example through the Getting it Right First Time programme, is another remit, as is coordinating large national programmes such as those for vaccination and screening. Other roles include negotiating commercial arrangements on behalf of the NHS overall, such as the prices of medicines.
Why is the government abolishing it?
The government points to last year’s review into the NHS by Ara Darzi which said the Lansley reorganisation was “disastrous” and created burdensome layers of bureaucracy without any clear lines …
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