NHS England Job Cuts 2025: Who Is Affected & What Happens Next

If you work for the NHS in England, the last few months have probably felt like a steady drumbeat of worrying headlines. The government has announced the abolition of NHS England itself, and with it comes a sweeping plan to cut at least 21,000 posts by 2028, and this article breaks down exactly which jobs are affected, who faces compulsory redundancy, what support packages look like, and what happens next for the thousands of employees caught in the middle.

Total NHS posts to be cut by 2028: At least 21,000 · NHS England staff facing compulsory redundancy: Nearly 1,300 · ICB workforce reduction target: 50% · Budget deficit driving cuts: £1.1 billion

Six key facts, one pattern: the scale of cuts is layered — national headquarters, regional offices, and local health bodies all face separate but overlapping reductions.

What jobs are being cut in NHS England?

In March 2025, Prime Minister Sir Keir Starmer announced plans to abolish NHS England and move its functions into the Department of Health and Social Care (Royal College of Nursing (professional body)). This structural change sets the stage for job losses at multiple levels.

Which roles are affected in NHS England headquarters?

• NHS England’s headquarters in London and regional offices are being wound down.
• Nearly 1,300 staff face compulsory redundancy at NHS England’s regional offices, according to Unite the Union (trade union).
• Women and BAME workers are disproportionately represented in these compulsory redundancy figures, the union reports.

What is the impact on integrated care boards (ICBs)?

• Integrated Care Boards have been told to cut their running costs by half in 2025, per the Royal College of Nursing (professional body).
• The Nuffield Trust (health think tank) reported this 50% workforce reduction target in March 2025.
• Commissioning Support Units were informed in June 2025 that they would no longer exist, the RCN notes.

The implication: the cuts are front-loaded. NHSE headquarters and ICBs are being restructured now, while hospital-level posts will be cut more gradually through to 2028. Staff in regional offices are first in line.

Will NHS England staff be made redundant?

Yes — and the process has already begun. The Treasury gave NHS England the green light to make thousands of staff redundant in November 2025, according to BBC (news outlet).

What is the timeline for redundancies?

• November 2025: Treasury approval secured for a voluntary redundancy model scheme (Royal College of Nursing (professional body)).
• Late 2025: Consultations with trade unions completed in NHS England and Commissioning Support Units (RCN).
• Early December 2025: Staff invited to apply for voluntary redundancy (RCN).
• By April 2026: Nearly 1,300 compulsory redundancy notices issued at NHSE regional offices (Unite the Union (trade union)).
• Mid-March 2026: Approved voluntary redundancies take effect (RCN).

Are compulsory redundancies being used?

• Yes. Unite the Union reports that nearly 1,300 workers at NHS England’s regional offices will be made compulsory redundant (Unite the Union (trade union)).
• Unions including Unite, UNISON, and MiP have raised concerns about the scale and impact of these compulsory cuts.
• Employers affected by the restructuring were required to run a local consultation with trade unions to outline their plans (Royal College of Nursing (professional body)).

“Women and BAME workers are being hit hardest by NHS England’s compulsory redundancies.”

— Unite the Union spokesperson, Unite the Union (trade union)

“At least 21,000 NHS posts are being axed due to a £1.1 billion budget deficit.”

— UNISON report, cited by BBC (news outlet)

Why this matters: The compulsory redundancy process concentrates risk on specific groups. Unite’s data shows women and BAME workers are disproportionately affected — a pattern that raises legal and ethical questions about the restructuring’s equalities impact.

What will happen to NHS England employees?

Staff are being offered several pathways, but none guarantee a seamless transition.

Will employees be transferred to DHSC?

• NHS England’s functions are being merged into the Department of Health and Social Care (Royal College of Nursing (professional body)).
• Some staff may be redeployed to DHSC roles, but the exact number of transfers remains unclear.

What support is available for affected staff?

• Staff may apply for voluntary redundancy or seek redeployment within the NHS.
• The union MiP provides redundancy information for members, including guidance on negotiations.
• The NHS Employers (employer representative body) outlines that employees who obtain suitable alternative employment within four weeks of termination are not entitled to a redundancy payment.
• Pregnant employees and those on maternity, adoption, shared parental, or neonatal leave have enhanced redundancy rights (NHS Employers).

The trade-off: voluntary redundancy offers a known package and a clean break, but redeployment could mean lower pay, a different location, or a role with less responsibility. Staff must decide with limited information about what DHSC roles will actually be available.

What is a typical NHS redundancy package?

NHS redundancy payments follow a contractual formula set by NHS Employers (employer representative body), not just statutory minimums.

How is redundancy pay calculated in the NHS?

• You need at least two years of continuous NHS service to qualify for contractual redundancy pay (NHS Employers).
• The calculation uses a minimum earnings floor of £23,000 and a cap of £80,000 (NHS Employers).
• Payment is based on either 1/12th of annual salary or 4.35 times a week’s pay — whichever is more beneficial (NHS Employers).
• The maximum reckonable service is 24 years (NHS Employers).

What is the value of 20 years of NHS pension?

• For a staff member with 20 years of service at a final salary of, say, £45,000, the redundancy payment could be roughly calculated as: (20 years × 1/12 × £45,000 = £75,000), subject to the £80,000 cap.
• The NHS pension itself is a separate calculation. The value of 20 years of pension contributions depends on the scheme (1995/2008/2015 sections) and final salary at retirement.
• Staff considering voluntary redundancy should request a pension benefit statement from the NHS Business Services Authority before making a decision.

The pattern: NHS contractual redundancy is relatively generous compared to the private sector, but the cap at £80,000 means senior staff with long service may not receive a proportional payout.

Are more than 20,000 NHS posts being axed?

Yes. A UNISON report states that at least 21,000 roles across hospitals and other health facilities will be cut by 2028, as reported by BBC (news outlet).

What is the breakdown of the 21,000 posts?

• The 21,000 figure covers posts across NHS trusts, hospitals, and community health facilities — not just NHSE or ICBs.
• Cuts are driven by a £1.1 billion budget deficit across the NHS, per UNISON.
• The breakdown by role type has not been published in detail, but frontline clinical posts are reportedly less affected than managerial and administrative roles.

Which regions are most affected?

• Regional data is still emerging. NHSE’s regional offices in the North West, Midlands, and South East are among those facing compulsory redundancies.
• ICBs in areas with higher deprivation may face greater pressure because they manage tighter budgets already.

“ICBs have been asked to cut their workforce by 50% — a reduction of this scale has never been attempted before in the NHS’s history.”

— Nuffield Trust analysis, Nuffield Trust (health think tank)

“NHS England has received Treasury approval to make thousands of staff redundant as part of the government’s restructuring plan.”

— BBC News, BBC (news outlet)

What this means: the 21,000 figure is not a target — it’s a floor. If the budget deficit widens or restructuring costs exceed estimates, further cuts are possible. Staff should plan for a reduction at least this large, not smaller.

The gaps in information are not trivial. Without a published breakdown of which roles go where, staff at local trusts cannot plan their next move. That uncertainty itself is a cost of the restructuring.

Frequently asked questions

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For the thousands of NHS England staff facing redundancy, the choice is clear: take a voluntary package now, or face compulsory redundancy with less control over timing. Either way, the restructuring is moving faster than many expected — and the uncertainty around what comes next is the hardest part to plan for.