The end of NHS England, and what this means for the HealthTech industry

News of the abolition of NHSE and its impending merger with the Department of Health and Social Care (DHSC) sent shockwaves across the health system. Born out of a desire to streamline decision-making, cut bureaucracy and avoid duplication, the decision was met with both scepticism and a sense that such a bold move could really be the antidote to an NHS on its knees. 

By October 2026, the combined workforce of 17,900 workforce across both NHSE and DHSC will be cut in half, and whilst the Secretary of State will not be drawn on how this will work across the two organisations, we can expect DHSC to emerge more empowered than ever before. Who will survive this period also remains to be seen, but notwithstanding the transformation team which has been appointed to lead the charge, Streeting will want to ensure the department is still staffed with the experience and expertise to guide the health service through this transition. 

National infrastructure will not be the only bodies affected by redundancies either. Lost in the headlines following Streeting’s announcement was the instruction for Integrated Care Boards (ICBs) to cut their operating costs by 50% by the autumn. During a recent Health Committee session, Streeting confirmed ICBs will stay put, adding that they will be key to delivering on the Government’s three shifts, but it is difficult to see how the Government can reconcile this decision without making long-term transformation much more difficult, especially as Streeting admitted in the same session that he had already heard demands from some ICBs to merge.

Amounting to the most significant restructuring in a decade, many are wondering why Streeting pressed the trigger on these reforms at a time of such intense pressure on the health service, characterised by vast waiting lists, financial pressures and a dwindling workforce. The risk of disruption is huge, but arguably more important is getting the health service out of the cycle of decline which has pushed public satisfaction with the NHS to a new low.

But, what does all this mean for suppliers to the NHS, specifically HealthTech innovators? 

I recently attended an ‘In Conversation with Wes Streeting’ event hosted by the Guardian, and if I’d have had the opportunity, I would have asked this very question. When Streeting addressed the Commons, he told MPs the reforms would “get the latest cutting-edge tech into the hands of staff and patients much faster”. He also told the audience the potential of technology was one of the things that made him feel most optimistic about the challenge ahead, whilst conceding that the current environment was not conducive to innovators looking to expand in the UK. 

Whilst it is not yet clear what the procurement landscape will look like, any attempt to streamline the current system will be welcomed. For too long, inefficient and bureaucratic processes, including protracted timelines and red tape, have hindered the adoption of new technologies.  There will also be greater autonomy for local NHS providers and ICBs. National targets and financial constraints remain, but local leaders will be given the flexibility to decide how best to meet the demands of their local population.

There is no denying that there will be disruption in the short-term. As the reforms take shape, it will be more difficult for suppliers to get hold of their contacts, and it will be harder for these people to make firm decisions without knowing if they will still be around to oversee them.  The fate of bodies such as NHS Supply Chain and the Central Commercial Function is also unclear, which further adds to industry’s anxiety over the Government’s direction of travel.

With businesses only now starting to recover after years of instability brought about by the pandemic and conflict, urgent clarity is needed. They will also want to know how this move will dovetail with the Government’s long-term plan for the NHS, Life Sciences Sector Plan and Innovation and Adoption Strategy, all of which are expected imminently. 

Long-term strategising is vital, but stakeholders from across the health service, from patients through to the Health Tech industry, will want to see improvements quickly.  With ministers now able to exert significant political control over the NHS, changes will be made at pace and much will be delivered without the need for primary legislation. 

In his closing remarks, Streeting told the audience that he wants the Government to lead the revolution in technology, not just benefit from it. Taken together, these initiatives demonstrate a Government that is serious about unlocking the potential of the UK’s Health Tech  sector, and there is every possibility that they will be welcomed by the sector once the waters have calmed. 

The next few months will be vital. Amidst the noise and endless speculation, the Health Tech sector must continue to show how it can help deliver the Government’s priorities for the NHS and why it should continue to be a priority area for investment.  drive real results.

Image from Unsplash and Nicolas J LeClerc