Committee publication · Correspondence · 15 December 2025

Letter from the Permanent Secretary at the Department for Health and Social Care relating to the DHSC-NHSE Transformation programme, 11 December 2025

Summary

The Permanent Secretary of the Department for Health and Social Care updates the Public Accounts Committee on the DHSC-NHSE Transformation Programme, established in March 2025 to manage the integration of NHS England into a restructured Department. The letter outlines joint leadership arrangements, plans to reduce headcount by up to 50% across DHSC, NHSE and ICBs by March 2028 with estimated redundancy costs of £1–1.3bn, and responses to committee questions about ICB functions, redundancies and staff redeployment.

Key findings

Joint leadership structure implemented from 3 November 2025, with co-chaired Joint Executive Team (JET) bridging DHSC and NHSE pending legislation to abolish NHS England.
Headcount reduction target: up to 50% across DHSC, NHSE and ICBs by March 2028, with estimated redundancy exit costs of approximately £1bn–£1.3bn, concentrated in 2025/26 and 2026/27.
Around 18,000 posts to be abolished across DHSC, NHSE and ICBs, generating over £1bn annual savings redirected to frontline care; no cuts to NHS frontline investment.
Voluntary redundancy scheme (VRS) launched by NHSE on 11 November 2025, opening 1 December with closure on 14 December; first exits expected mid-March 2026.
ICBs have no near-term plans to delegate statutory duties; where voluntary redundancy targets are unmet, compulsory redundancy will proceed; redeployment to other public sector employers is limited by legal framework and employee choice.

Tone

Procedural

Topics

public-financenhs-restructuringworkforce-managementpublic-administration

Key actors

Samantha Jones OBE (Permanent Secretary, DHSC), Sir Geoffrey Clifton-Brown (Chair, Public Accounts Committee), Department of Health and Social Care (DHSC), NHS England (NHSE), Integrated Care Boards (ICBs), Sir Jim Mackey, Secretary of State

Notable line

“Rather, it is a fundamental redesign of the centre to streamline priorities and accountability, eliminate duplication and maximise value …”

Key Quotes

“This will not be a simple merger of DHSC and NHSE, where both organisations' current functions are simply added together. Rather, it is a fundamental redesign of the centre to streamline priorities and accountability, eliminate duplication and maximise value, and free up time to focus on delivery.”
— Samantha Jones OBE · Describing the ambitions of the Transformation Programme

“There will be no cuts to NHS or frontline investment; savings will more than cover redundancy costs, and DHSC will remain within its funding settlement.”
— Samantha Jones OBE · On the impact of the 18,000 post abolitions

“The intention is for as many staff as possible to leave via voluntary mechanism over the next two years, with early exits prioritised.”
— Samantha Jones OBE · On staff exit strategy

“ICBs currently have no near-term plans to delegate any of their statutory duties or powers.”
— Samantha Jones OBE · Responding to PAC questions about potential transfer of ICB statutory functions

“Opportunities to redeploy staff to providers will be limited by both the legal framework that supports this, the numbers of displaced staff, our workforce profile, and the limited numbers of vacancies within the NHS across the board.”
— Samantha Jones OBE · On redeployment of staff facing redundancy

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Source · parliament.uk record ↗