The demise of NHS England

NHS England is an arm's-length body of the Department of Health and Social Care (DHSC), meaning it operates independently from direct government control but remains accountable to Parliament and the DHSC. Described as the world's largest quango (quasi-autonomous non-governmental organisation) (Timmins, 2018), NHS England was set up as an independent body in 2013 to manage the commissioning of NHS services, ensuring that patients receive high-quality care. Health is a devolved matter and Scotland, Wales and Northern Ireland do not have an additional layer equivalent to NHS England.

It has been announced that plans are being made to abolish NHS England and to bring the health service under government control. This is a radical reshaping of the NHS in England (Anandaciva, 2025). Ministers are keen to ensure that the management of the health service is brought ‘back into democratic control’ and back at the heart of government (Mason, 2025). Reasons given for abolishing NHS England include a reduction in bureaucracy and a need to deal with unnecessary duplication of activity, with the potential to free up funds to invest in hands-on patient care.