England’s Hospitals May Cut 100,000 Jobs Amid Cost-Saving Drive

Hospitals in England could cut over 100,000 jobs due to major restructuring and severe cost-saving measures ordered by Health Secretary Wes Streeting and the newly appointed NHS chief executive.

The projected job losses are so significant that NHS leaders have appealed to the Treasury for financial support to cover the estimated £2 billion redundancy bill, arguing that NHS trusts lack the necessary funds.

Sir Jim Mackey, who recently took over as head of NHS England, has instructed the 215 healthcare trusts across England to slash the cost of corporate functions—such as HR, finance, and communications—by 50% by the end of the year.

However, the NHS Confederation, which represents these trusts, warns that such drastic cuts could force trusts to reduce their workforce by 3% to 11%. With 1.37 million people employed across all trusts, this could result in job losses ranging between 41,000 and 150,000.

Matthew Taylor, Chief Executive of the NHS Confederation, described the required savings as “staggering” and cautioned that the financial strain could severely hinder the NHS’s ability to reduce patient waiting times. He urged the Treasury to establish a national redundancy fund, stressing that the cost burden would otherwise overwhelm the already stretched NHS finances.

These concerns surface as Streeting and Mackey prepare to appear before MPs at the Commons Health and Social Care Committee to defend their restructuring plans.

The NHS is bracing for an unparalleled wave of job cuts following Streeting’s move to dissolve NHS England and drastically reduce management roles. Approximately half of NHS England’s 15,300 employees are expected to lose their jobs as the organization merges with the Department of Health and Social Care (DHSC), which itself anticipates staff reductions among its 3,300 personnel. An additional 12,500 positions could be cut from the 42 integrated care boards, which currently employ 25,000 people.

Taylor acknowledged that health leaders understand the nation’s difficult financial context and have already demonstrated efforts to cut deficits. Still, he warned that the speed and scale of the proposed downsizing could jeopardize both performance improvements and essential NHS reforms.

Without Treasury assistance, he said, any anticipated savings could be substantially diminished—or entirely lost—due to the high costs of redundancies.

Some trusts are budgeting up to £12 million each to fund staff redundancies this year, the Confederation revealed. However, others say they cannot afford such programmes and will instead rely on natural staff turnover to reduce headcount.

Concerns mount over the NHS cost-cutting strategy, with experts warning it could backfire and undermine efficiency.

Sarah Woolnough, Chief Executive of the King’s Fund, pointed to research revealing that only 14% of the British public believes the NHS spends its resources efficiently. Despite that perception, she noted that the UK devotes just 1.9% of its health budget to administrative expenses—ranking sixth lowest among 19 comparable nations.

Woolnough emphasized the importance of skilled administrative professionals in supporting frontline healthcare, cautioning: “Efficiency is not just about cutting costs. Skilled back-office staff are essential to ensure clinicians can concentrate on delivering high-quality patient care.”

Thea Stein, head of the Nuffield Trust think tank, echoed that warning. While acknowledging inefficiencies in NHS governance, she urged caution in deciding where cuts should fall. “Corporate staff in trusts include digital experts, analysts, and HR specialists—roles that are vital to improving efficiency and maintaining safe staffing levels,” she said.

Stein, a former NHS trust chief executive, also cited the 2023 Darzi review, commissioned by the current government, which found that previous cuts to oversight bodies in 2013 weakened the NHS’s administrative capacity—changes that later had to be reversed.

Several NHS trusts have recently announced plans to eliminate hundreds of jobs in an effort to meet what NHS Confederation Chief Matthew Taylor described as “demanding” efficiency targets for 2025–26. For instance, trusts covering Portsmouth and the Isle of Wight plan to reduce staff by 798 full-time equivalent roles—about 7% of their total workforce—in a move aimed at saving £39 million, nearly half of their £82 million target, according to the Health Service Journal.

Likewise, the trust managing Bristol’s hospitals has proposed reducing its workforce by 2%, which could result in over 300 job cuts.

NHS England has ordered all 215 trusts to reduce their budgets by 5% this year through “cost improvement programmes,” as the service grapples with a potential £6.6 billion overspend.

A spokesperson for the Department of Health and Social Care said: “We’re working alongside the NHS to implement necessary reforms and ensure the health system delivers for both patients and taxpayers, while also supporting staff.

“Our plan to reintegrate NHS England into the department will reduce duplication and unlock hundreds of millions of pounds for frontline services, ultimately improving care for patients.

“We’re investing an additional £26 billion into health and care, and progress is already evident—over 2 million extra appointments have been delivered seven months ahead of schedule, and waiting lists have been reduced by 193,000 since July.”