Advice & support

NHS job cuts & system changes: info for members

This page will be updated with the latest developments on the government’s plans to cut jobs in the NHS in England. It also sets out what MiP is doing to support members, how you can get involved and the latest activities from the union nationally and locally.

Planned cuts in the NHS in England

Latest update: 12 September 2025

The government is reorganising the NHS and ordering thousands of job losses throughout the NHS in England by the end of 2025.

This page will give you the latest information on the cuts and is updated regularly. It covers the latest news by sector on the cuts nationally, explains how MiP is challenging them and what your union is doing to support you.

It will also offer information about MiP’s activities locally and what members can do now to support the union and your colleagues.

Read our recently published guide to the consultation process, It’s Your Future, on how you can help yourself and support your colleagues during the re-organisation process.

Not a member yet?

MiP can only support members with workplace issues arising four weeks or more after their join date. If you think the planned cuts might affect you, then it’s important to join now to ensure you’re covered.

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Model Region Blueprint published

The much delayed Model Region Blueprint has been published this week.

The blueprint begins to explain the role of the seven regions in the government’s ongoing restructure of the NHS. The blueprint confirms that the regions will remain the same as the current NHS England regions, however they will have different roles and functions. The regional tier will also be part of the DHSC following the merger of the Department and NHS England.

The blueprint states that the three core functions of the regions are:

  • Strategic leadership: Develop and oversee the implementation of a regional medium-term strategic plan driving delivery and including the regional financial strategy (revenue and capital), service configurations, workforce planning and regional digital strategy.
  • Performance management and oversight: Real-time operational oversight of provider performance and ICB performance and commissioning. Review provider capability self-assessments and ensure local plans are aligned with 10YHP ambitions. Oversee annual performance assessments of ICBs, provide oversight of the transfer of commissioning functions to ICBs and facilitate inter-regional ICB collaboration as needed.
  • Improvement, support and intervention: Oversight and coordination of improvement, spread and scale best practice and innovation, support capability development in providers and ICBs, and facilitate rapid quality reviews. Address challenged performance or organisations, monitor risks and trigger interventions where required. Regions will have access to national improvement expertise to support this work.

The Chief Executives of each region will be accountable for how well their regional system performs, according to the blueprint. Additionally, a new role of ‘regional chair’ will be established, with ‘responsibility for supporting the non-executive directors in
ICBs and NHS providers in their region’.

MiP will be analysing the regional blueprint in further detail over the coming weeks to determine what it will mean for members. Updates that follow will be communicated in a future bulletin and on our website.

National voluntary redundancy scheme

The Treasury has still not confirmed if it will fund redundancies made through the model VR scheme. We understand however that the model scheme has been sent to ICBs with a view of implementing when/if Treasury sign off has been confirmed.

Due to the Treasury’s delay, many ICBs are now reporting they are pausing consultations and pushing redundancies into the new year, past the government’s December 2025 deadline.

NHS England has changed the scheme’s terms after comments from trade unions and employers, made through the national partnership structure, but it is not a formal negotiated agreement. If approved, NHS England will publish FAQs to support use of the scheme’s by individual employers.

MiP and trade union colleagues have raised the issues around the eligibility for voluntary redundancy for staff who have partially retired. It is our view that partially retired staff should have their full reckonable service count towards redundancy payments.

MiP is calling on the government to give employers and unions a mandate to amend the Agenda for Change handbook and consultant contract. This would bring the NHS into line with the civil service.

All NHS employers, including NHS England, ICBs and NHS trusts, will be able to use the scheme if approved by the Treasury. But it will not apply automatically; individual employers can decide whether and when to use the scheme during the 2025-26 financial year. Early and meaningful consultations with local staff sides are therefore very important before launching a scheme.

Updates on the scheme will be posted here.

MiP National Committee statement on Ten Year Health Plan

The Ten Year Health Plan for the NHS in England was published on 3 July 2025.

MiP’s National Committee, elected by our members, has released a statement on the Ten Year Health Plan. You can read the statement in full in the box to the right.

MiP National Committee: statement on 10 Year Health Plan

Read the MiP National Committee’s statement on the 10 Year Health Plan amidst the ongoing job cuts below.

mip nat cttee statement

What we know so far: NHS England and DHSC

The government is abolishing NHS England with remaining staff merging with the Department for Health and Social Care.

NHS England has launched a consultation with trade unions on voluntary redundancy. The consultation period began on 23 July and was originally due to end on 12 September 2025, however this deadline has been extended indefinitely with a new closing date to be communicated by the employer in due course.

Following an NHS England member meeting on 3 September, MiP is putting together a set of FAQs on the consultation which will be sent directly to members.

MiP will submit a joint response to the consultation alongside other health unions. This response will be shared with members following the end of the consultation period.

  • 50% of the total staff of NHS England and DHSC will be cut
  • The DHSC will launch a voluntary exit scheme for civil servants
  • NHS England is now consultation with trade unions over voluntary redundancy
  • All NHS England vacancies are frozen other than in ‘exceptional circumstances’
  • A formal change programme board and team is leading this work, with former regional director Richard Barker as senior responsible officer, reporting to both Sir Jim Mackey and DHSC’s new permanent secretary Samantha Jones
  • Publication of the initial re-design of the national centre has been delayed indefinitely
  • A Joint Partnership Forum has been set up, comprising management and union representatives from both NHS England and DHSC, to engage nationally on organisational change
  • Proposals for the transfer of specialised commissioning functions to 7 ICB Hubs by April 2026 are awaiting submission for board approval. Unions have requested clarification on the status of roles identified to transfer in relation to the headcount reduction requirements and the scope of VR proposals.
  • NHS England will not use a MARS scheme
  • The change process is expected to be completed by October 2026
  • NHS England has paused its consultation for the Recovery Support Programme (RSP) team following concerns raised by trade unions.

MiP and our partner union the FDA are working together to represent members in both NHS England and DHSC. The timelines for the changes and how they may affect individual posts remain unclear. Members must join MiP before the formal change programme starts to qualify for the union’s support.

MiP will write to members directly and update this page, as further information comes in. For MiP Chief Executive Jon Restell’s initial response to the abolition decision please see here.

What we know so far: Integrated Care Boards

The government has told Integrated Care Boards to reduce their running costs by 50% between October and December 2025 and move towards acting ‘primarily as strategic commissioners’.

Delays with Treasury approval on funding redundancy payments has led to many ICBs pausing redundancy programmes until 2026 – past the initial deadline of December 2025. The Treasury has still not confirmed when a decision on centrally funding redundancy payments will be made. HSJ reports

ICBs are also still waiting on further information on responsibilities of the regional tier that is due to take on numerous functions from ICBs. The Model Region Blueprint has now been published, however further clarity is needed on the transfer of roles and functions.

  • NHS England has shared a Model ICB Blueprint with ICBs to guide their planning. Described as a ‘working document’, it outlines which functions will transfer out of ICBs, which will be added or expanded, and which existing functions ICBs will keep.
  • The blueprint says ICBs should reduce spending to an average of £18.76 per head of population across each of the seven English regions, suggesting an overall cut in running costs of less than the 50% first announced.
  • The Blueprint identifies some functions and responsibilities for transfer to providers or into reconfigured regional set-ups.
  • The Model Region Blueprint has now been published and sent to NHS leaders. MiP will be analysing the blueprint to determine how it will impact our members.
  • Regions will be outposts of the DHSC following NHS England’s merger with the Department.
  • Some ICBs have started VR processes for staff at VSM level.
  • Most ICBs have not yet began formal consultations with Agenda for Change staff regarding voluntary redundancy due to insufficient information regarding the new regional tier, the holdout on the model VR scheme and a lack of clarity on what functions will be needed in the new ICB model.

Nationally, unions are raising concerns about:

  • the method and pace of the change demanded, and lack of engagement with staff and unions in planning
  • the scale of cuts expected before reassigning or removing existing functions and accountabilities
  • the risks this creates — including the loss of skills and experience, damage to staff morale, upheaval and uncertainty affecting service delivery.

Members must join MiP before any formal change programme starts to ensure they can access the union’s support.
MiP will write to members directly and update this page when further information is received. For MiP Chief Executive Jon Restell’s initial response to the ICB cuts please see here.

What we know so far: NHS trusts

NHS trusts were told in January to reduce base costs by 1% and make productivity improvements of 4% so the NHS as a whole achieves financial balance in 2025/26. NHS England has since demanded specific cuts to ‘corporate costs’.

Many NHS trusts have started redundancy processes ahead of other employers.

  • NHS trusts must reduce the growth in ‘corporate costs’ since pre-pandemic levels by 50% by the end of 2025.
  • Cuts to corporate services are proceeding at different paces in different employers. Members affected by cuts should contact MiP or your local workplace reps.
  • NHS England will give more details about how these cuts should be made, including guidance on pooling resources at geographical and system level, and will collect monthly corporate cost data
  • Many trusts are undertaking widespread organisational change and proposing job losses to deliver savings this year
  • Trusts are expected to target cuts on non-clinical functions such as HR, communications, estates and finance. NHS England is developing a target operating model for people services, the ‘Transforming People Services’ programme. MiP represents staff side on the programme board.
  • The Chief Nursing Officer for England will advise on reducing unwarranted variation in the number of corporate nursing roles
  • NHS England will talk to unions nationally about new guidance to providers on Wholly Owned Subsidiaries (‘subcos’)

MiP is seeking clarity about these cuts and the associated guidance, both nationally and with local employers. Members must join MiP prior to any formal change programme beginning to ensure they can access union support.

MiP will write to members directly and update this page when further information is received.

What we know so far: Commissioning Support Units

The release of the 10 Year Health Plan has confirmed that Commission Support Units (CSUs) are set to be closed entirely.

A new governance structure has been established to manage the closure of CSUs. The Service Transfer and Closure (STaC) Programme Group will oversee the closure of the four remaining CSUs. MiP and trade union colleagues are seeking engagement from the group through the CSU partnership forum.

CSU consultations with trade unions on voluntary redundancy are expected to begin imminently. Further updates on CSUs will be posted here.

What we know so far: Arm’s Length Bodies

The government has published Penny Dash’s review of health and care regulatory bodies.

The review, which has been accepted by government, proposes:

  • The CQC to remain with changes to its regulatory approach
  • The Health Services Safety Investigation Body (HSSIB) to be absorbed into the CQC but remain a ‘discrete branch within it’
  • The National Quality Board (NQB) to be given enhanced powers and wider scope
  • The Patient Safety Commissioner will be hosted by the MHRA, with some functions also being transferred back to DHSC
  • Healthwatch will be closed with functions transferring back to the DHSC
  • The National Guardian’s Office will be closed with functions transferring to commissioners and providers

The government will put forward legislation where necessary to implement the changes to organisations as a result of the review.

How MiP has responded to the announcements

MiP is strongly opposed to cuts on the scale announced and shocked by the way the news has been delivered – with most staff finding out their jobs could be at risk through announcements made to the media. While structures are not set in stone and many of our members welcome reform, we are clear that cuts are not reforms. If the government wants to truly reform how the NHS works and make it work better, it must outline its plan before cutting thousands of dedicated staff. Form must follow function.

MiP has already written to members at large and at affected organisations. We advise members to make sure you are subscribed to our mailing lists to receive the latest updates. If you are not receiving emails or would like to resubscribe please contact info@miphealth.org.uk.

What action is MiP taking to challenge these cuts?

Your union is taking action to challenge these cuts. Our immediate priority is to get a clearer picture of what the government has planned, particularly what staff will be affected, what functions will go, what processes will be followed to implement reductions and what the future NHS structure will look like. We are actively:

  • Seeking clarity from government and employers on how the cuts will be implemented and under what timeframes consultations will be delivered
  • Raising concerns with ministers and NHS England’s new leadership team directly and through existing partnership working arrangements
  • Engaging with MPs in areas where affected employers are based
  • Raising awareness with policymakers on the role NHS England and ICBs play in our health system
  • Calling on employers to ensure unions and their staff are involved in any change process at the earliest possible stage, including increased facility time for workplace reps
  • Calling for a reset of partnership working to ensure unions and staff are properly engaged before announcing major reforms
  • Pushing back on reported timescales, especially in ICBs, to ensure fair consultation processes can be established and delivered
  • Seeking clarity on what parts of the system are expected to take on additional functions as a result of these cuts and how this will be resourced
  • Working to ensure as many jobs are saved within the system as possible

At this stage, most NHS employers have not started formal redundancy proceedings. That means many questions cannot be answered at this stage. MiP is seeking clarity and will inform members as soon as it is received.

We have written to Health and Social Care Secretary Wes Streeting to raise concerns directly. You can view this letter from the box to the right.

MiP has already hosted a number of member drop-in sessions and meetings to discuss the cuts in more detail. More of these are planned and this page will be updated with upcoming events. In the meantime, please check your email for the latest activity from MiP in your workplace.

What members can do now

Until written notices are presented it’s important to continue carrying on as normal. You may have concerns that you could be at risk, questions about your terms and conditions if transferred to a different employer or what options are on the table if your role is in scope of the cuts. At the moment, it is impossible to answer these as processes have not begun. We understand that this uncertainty creates anxiety, however your union will be there to support you through the process if and when it begins.

MiP will keep members updated on national developments as well as local ones, so please keep checking this page and your emails regularly.

View MiP letter to Wes Streeting MP

MiP has written to the Secretary of State for Health and Social Care Wes Streeting MP directly to raise concerns about the job cuts and system changes.

Read our letter in full.

mip letter to wes streeting mp

Actions for members

Update your membership details

Ensure your details are up-to-date to receive information on the latest developments via email. You can update your details by logging into this website.

Update your details here

Consider becoming a workplace rep

In times like this our workplace reps are needed more than ever. Your union and your colleagues will be relying on you throughout this. You can find out more about the role by visiting the link below.

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Tell colleagues to join now

A union is only as strong as its collective strength. Every member is another voice to challenge these cuts. But they need to join now prior to formal processes starting to access support.

colleagues can join here

Joining when work is going well means your union will be there if you ever need it

MiP can only offer one-to-one support on issues that occur after your first four weeks of membership. Join today to ensure you are protected if you ever need it in the future.

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