NHS England scrapped: what does it mean for community pharmacy?

On 13 March Prime Minister Sir Keir Starmer announced that NHS England (NHSE) will be scrapped and reintegrated into the Department of Health and Social Care (DHSC). 

Starmer said the dissolution of NHSE, as the world’s largest quango, was part of a major reform package aimed at reducing bureaucracy and ensuring resources are directed to frontline healthcare. 

"Work will begin immediately to return many of NHS England’s current functions to the Department," the government confirmed, adding that a longer-term programme would be required to complete the transition. The government believes the changes could generate "hundreds of millions of pounds a year" in savings, which will be reinvested into patient care. 

It was also revealed that integrated care boards (ICBs) have been asked to cut their workforce by 50%, which equates to around 12,500 staff across the health system. 

 

A shift in NHS governance 

Health Secretary Wes Streeting has since defended the decision, stating, "When money is so tight, we can’t justify such a complex bureaucracy with two organisations doing the same job. We need more doers, and fewer checkers." 

"NHS staff are working flat out but the current system sets them up to fail. These changes will support the huge number of capable, innovative, and committed people across the NHS to deliver for patients and taxpayers." 

Streeting also outlined plans to use the NHS’s position as a single-payer system to drive cost savings on procurement and accelerate the adoption of new technologies, alongside a new primary care national medical director role to oversee these reforms. 

The government has yet to clarify how these changes will impact ongoing negotiations between NHSE, DHSC, and Community Pharmacy England (CPE). However, CPE has responded to the announcement, saying they would “continue to make the case for community pharmacy by working closely with whatever new structures and teams the Government deems appropriate in the future.” 

“In the meantime, we remain fully focused on the current Community Pharmacy Contractual Framework negotiations taking place with both NHS England and the Department of Health and Social Care,” they added. 

 

A mixed reception among the uncertainty 

The announcement has sparked mixed reactions from community pharmacy leaders, with many welcoming the move to cut bureaucracy but also wary of how the decision would impact CPCF negotiations and how the government would prioritise investment in frontline services. 

Nick Kaye, Chair of the National Pharmacy Association (NPA), pledged to work with the new government structures but warned that the sector needed urgent investment. 

"Pharmacies are frontline providers that together see more patients every day than any other part of the healthcare system," Kaye said.  

"Ministers have inherited a crisis in pharmacy and need to do everything they can to prevent further damage to pharmacy services – so we hope these changes release much-needed funds for the frontline." 

'We naturally feel for the staff who are affected by this change and we hope the process of reorganisation does not impede progress towards creating the stronger pharmacy network we all want,' he added. 

Likewise, Tase Oputu, Chair of the England Board of the Royal Pharmaceutical Society (RPS), acknowledged the dedication of NHSE staff but urged the government not to lose sight of the pharmacy sector’s needs. 

"It is vital that NHS reforms support the crucial ambition of advancing the role of pharmacists across the NHS," she said. "Fully funded, well-supported pharmacy teams across all sectors are essential for delivering quality patient care." 

Oputu also called for clarity on the transition’s impact on pharmacists, adding, "It’s crucial that pharmacy continues to have representation in the reorganised NHS and that negotiations for the community pharmacy contract remain secure." 

However, some welcomed the dissolution of NHS England, including Derviş Gürol, Director of the Independent Pharmacy Contractor Network: 

“Since 2012, NHSE’s policies have done more harm than good – funding cuts, pharmacy closures, excessive bureaucracy, workforce and medicine supply issues, and an undermining of pharmacy’s role as GP surgeries and hospitals were prioritised." 

Leyla Hannbeck, Chief Executive of the Independent Pharmacies Association (IPA), equally welcomed efforts to cut through the red tape of NHS England, but said the real test of these reforms would be whether they translate into tangible improvements for pharmacy services. 

“Any reforms that reduce bureaucracy and streamline administration in the healthcare system are welcome,” she said. 

“However, the test for these reforms will be whether cost savings can be channelled back into frontline patient care.” 

“The focus of this government must be investing in the "front door" of healthcare and primary care services such as pharmacies, doctors and dentists. A reorganisation of the NHS should prioritise this aim, not distract from it.” 

This was a sentiment shared by Malcolm Harrison, Chief Executive of the Company Chemists' Association (CCA): 

"We support the government’s stated aim of redirecting funding to frontline services, including community pharmacies," Harrison said.  

"After 10 years of cuts and pay freezes, pharmacies are in dire need of a funding uplift." 

Meanwhile, Jay Badenhorst, Director of Pharmacy at the Pharmacists’ Defence Association (PDA), described the announcement as "a dramatic change" with wide-ranging implications for pharmacy practice and employment. 

"With these reforms, it is also a perfect opportunity to have the voice of the workforce during contract negotiations."  

"Making full use of the professional contribution of pharmacists is a critical requirement if the health service is to reach its potential," he continued. 

 

What happens next? 

While the restructuring of NHS England is set to unfold over the coming months, community pharmacy leaders are calling for urgent clarity on how the changes will impact pharmacy funding and services. 

For many, the key question remains whether this is a genuine effort to prioritise patient care or simply another political shake-up that risks further destabilising the sector. 

As Derviş Gürol put it, "Is this a fresh start or just more political chaos?” 

As work begins on implementing the reforms, pharmacy leaders and frontline teams alike will be watching closely to see if the government delivers on its promises – or if community pharmacy will once again be left behind.