The NHS in England has for most of 2025 been focused on plans to cut spending to fit the limited budget – and this means wiping out a projected £6.6 billion deficit for 2025/26 – almost 4% of its £167bn allocation.
By any previous comparison, this is a very large cutback to make. Barring substantial accountancy manoeuvres the NHS is unlikely to make such changes without many areas suffering significant consequences. But in much of the country, we still know little of what has been cut.
The spring and summer saw a host of local stories on how many jobs were at risk in each area.
In May, an NHS Providers survey of 160 senior figures from 114 trusts found that 47% were cutting services and another 43% were considering doing so; 37% were also cutting clinical as well as non-clinical posts and a further 40% may follow suit; and 26% were closing some services – with 55% more saying they might do so.
But over the summer most of the stories disappeared from local news. Now, as the calendar year draws to a close we know almost no details of what job cuts are planned, which groups of staff are affected – or the likely consequences for patients who need local prompt access to safe and efficient services.
We do know that rather than offer a phased commitment to restore the value of resident doctors’ pay, and take serious action to address the yawning gap in availability of specialist training posts that seems to be leaving up to 20,000 newly qualified doctors unable to find jobs, Wes Streeting has opted instead to plunge the NHS into yet another round of strike action in the run-up to Christmas.
He and other ministers have followed up with a torrent of media quotes vilifying, mocking and abusing not only resident doctors but also GPs – who are not on strike, and continuing to deliver more with less, but are concerned about the imposition of unworkable policies.
Streeting is trying to tough out the resident doctors with silly sound-bites branding them as “the Grinch who stole Christmas,” but can only do this by ignoring the all-too-real prospect of long term unemployment for tens of thousands of would-be doctors, who will be left in the cold well into 2026 and beyond … unless the NHS changes course and gets serious about proper workforce planning, and prioritising British-trained staff for specialist training places.
However resident doctors are far from the only NHS staff who have been left dangling and potentially facing unemployment: the plans (insofar as there are any) to wipe away the £6.6 billion deficit involve mass-scale cuts in jobs at every level. These include:
- scrapping NHS England as a separate body,
- its merger with the Department of Health and Social Care,
- the halving of running costs (and probably staff) in England’s 42 Integrated Care Boards (and merging a number of these to leave just 27 even less local and less accountable ICBs)
- plus further large-scale job losses to tackle threatened deficits in NHS trusts. These are theoretically to be focused on non-clinical staff, although it seems many will also involve clinicians.
The top-level job losses, which were supposed to have been completed by the end of this month, were held back for most of the year by the Treasury’s refusal to cover the costs of redundancy payments, estimated at around £1 billion. But last month Wes Streeting was delighted to tell the NHS Providers conference that a way had been opened up to cover these costs by bringing forward money from next year’s budget. He told the conference:
“we can now bring certainty to people. From today I’m giving ICBs the go ahead and the funding for the voluntary redundancy programs that staff have been waiting for. This will see overall head count cut by 50 percent which will particularly, not exclusively, but particularly, affect roles in corporate services, communications and administration.”
Of course the use of advances from next year’s funding means a further round of spending cuts will be needed next year, to prevent this becoming a fresh deficit: but Streeting does not mention this. And his way of describing the staff whose jobs are being axed also ducks the issue of exactly which jobs are going, and what this will mean in practice.
He is banking on little public understanding of what roles come under “corporate services, communications and administration,” and hoping there will be little or no action by campaigners (or back bench MPs) to resist the coming cuts.
But on closer examination, ‘corporate services and communication’ include delivering effective public consultation on local plans, ensuring meetings allow properly informed and prepared board members to meaningfully discuss relevant plans and issues, delivering prompt and serious responses to complaints and issues raised by patients, the public and local politicians. Administration is an unglamorous term that covers a range of vital functions that enable the complex web of organisations that deliver our NHS to work together, communicate with one another and the outside world, and coordinate plans for the various services in each area.
Nobody can argue that no admin is necessary, and nobody has explained how much of it can be safely cut back, or successfully loaded onto fewer staff without knock-on problems.
The words “not exclusively” are also doing a fair bit of heavy lifting in Wes Streeting’s statement. We know that in many trusts up and down the country the cuts reach well beyond corporate services, communication and admin – with nursing and other clinical jobs and many important non-clinical support roles also being cut back.
Support services that are not delivered by non-clinical staff – for example when fewer staff are employed to clean, serve meals or help move patients and supplies around the hospital – all too often wind up an additional burden and frustration for already hard-pressed clinical staff, and can result in significantly less safe or satisfactory care for patients.
The Lowdown has been working hard to pull together a broader view of what is happening across the country, enabling short-sighted ‘savings’ or ill-judged cutbacks to be challenged before they take place, rather than after damage is done.
But as we have warned, it is becoming more difficult to do so, as Integrated Care Boards become preoccupied with reorganisation or mergers, or opt to take their financial discussions behind closed doors in “private” session. Too many trusts are also apparently doing the same, leaving little if any public access to information on how many of which staff are to be losing their jobs.
Now new figures from NHS England on the financial state of play of trusts, foundation trusts and ICBs across the country have been published, and some of these also give real cause for concern.
While Wes Streeting boasted that “the NHS is in balance, 7 months into the financial year,” this is not the case in every area. The figures reveal that 62 trusts and FTs are forecasting significant (above £10m) deficits by the end of March – adding up to more than £1.9 billion – that are to be covered this year by Deficit Support Funding.
However we already know this funding, which has for years propped up some chronically struggling trusts, is to be phased out, beginning next year, when budgets will be already squeezed by this year’s redundancy payments.
Two trusts facing end-of-year deficits in excess of £20m (West Suffolk Hospital and London’s Royal Free Hospital) have not even been guaranteed Deficit Support Funding, which suggests their situation is likely to worsen in 2026/27.
Forty-two of the trusts expecting significant end-of-year deficits are showing little (below 1%) or no deviation from their financial plans so far, but have still not been able to balance their books, despite all the pressure to do so. The five largest projected end of year deficits are £85m at Mid and South Essex Foundation Trust; £75m at King’s College Hospital; £64.8m at University Hospitals Leicester; £64.2m at East Kent Hospitals; and £57.9m at Northern Care Alliance.
Also worrying are the 16 trusts which are currently running deficits above planned levels that amount to 2% or more of their annual turnover, but still predicting little or no end of year deficit. The worst of these are Salisbury FT (£12.4m adrift, 6.3% of turnover); Royal United Hospitals Bath (£13m, 4.3%); Liverpool Women’s Hospital (£3.4m, 4.1%); Great Western Hospitals (£10.1m, 3.8%); Wirral University Teaching Hospital (£9.4m, 3.7%); and Nottinghamshire Healthcare FT (£12.9m, 3.6%).
Whether these trusts can cut their way back in to balance, and if so what they would have to cut to get there, and by how much is not yet clear – but it seems obvious that the trusts that are even now in some difficulty as the rest of the NHS just about scrapes through are the most likely to feel compelled to make damaging cuts.
Our Lowdown research has provided insights into the implications of the cash cuts underway or coming in the next few months: see our Trusts in Trouble
The picture is a varied one, with options for cuts limited by the requirement of acute trusts to continue to respond to strong demand for emergency services.
It includes cuts in clinical as well as non-clinical posts; trusts making unwise cuts in funding for voluntary sector services such as hospices and specialist clinics; closing beds or wards – as the peak winter pressures loom closer; restricting use of private sector beds; limiting outsourcing to private clinics; slowing down and reducing elective work.
Maybe you know more about some of these, or have details of cutbacks that have not yet been publicised? We invite union activists or campaigners to keep us posted for new developments in the areas we mention, or worrying plans or changes in areas that we have not so far been able to catch up on.
Early information helps build the broadest support for any campaigns to defend local jobs and services, protect safe staffing levels and safeguard our NHS.
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
The NHS in England has for most of 2025 been focused on plans to cut spending to fit the limited budget – and this means wiping out a projected £6.6 billion deficit for 2025/26 – almost 4% of its £167bn allocation.
By any previous comparison, this is a very large cutback to make. Barring substantial accountancy manoeuvres the NHS is unlikely to make such changes without many areas suffering significant consequences. But in much of the country, we still know little of what has been cut.
The spring and summer saw a host of local stories on how many jobs were at risk in each area.
In May, an NHS Providers survey of 160 senior figures from 114 trusts found that 47% were cutting services and another 43% were considering doing so; 37% were also cutting clinical as well as non-clinical posts and a further 40% may follow suit; and 26% were closing some services – with 55% more saying they might do so.
But over the summer most of the stories disappeared from local news. Now, as the calendar year draws to a close we know almost no details of what job cuts are planned, which groups of staff are affected – or the likely consequences for patients who need local prompt access to safe and efficient services.
We do know that rather than offer a phased commitment to restore the value of resident doctors’ pay, and take serious action to address the yawning gap in availability of specialist training posts that seems to be leaving up to 20,000 newly qualified doctors unable to find jobs, Wes Streeting has opted instead to plunge the NHS into yet another round of strike action in the run-up to Christmas.
He and other ministers have followed up with a torrent of media quotes vilifying, mocking and abusing not only resident doctors but also GPs – who are not on strike, and continuing to deliver more with less, but are concerned about the imposition of unworkable policies.
Streeting is trying to tough out the resident doctors with silly sound-bites branding them as “the Grinch who stole Christmas,” but can only do this by ignoring the all-too-real prospect of long term unemployment for tens of thousands of would-be doctors, who will be left in the cold well into 2026 and beyond … unless the NHS changes course and gets serious about proper workforce planning, and prioritising British-trained staff for specialist training places.
However resident doctors are far from the only NHS staff who have been left dangling and potentially facing unemployment: the plans (insofar as there are any) to wipe away the £6.6 billion deficit involve mass-scale cuts in jobs at every level. These include:
The top-level job losses, which were supposed to have been completed by the end of this month, were held back for most of the year by the Treasury’s refusal to cover the costs of redundancy payments, estimated at around £1 billion. But last month Wes Streeting was delighted to tell the NHS Providers conference that a way had been opened up to cover these costs by bringing forward money from next year’s budget. He told the conference:
Of course the use of advances from next year’s funding means a further round of spending cuts will be needed next year, to prevent this becoming a fresh deficit: but Streeting does not mention this. And his way of describing the staff whose jobs are being axed also ducks the issue of exactly which jobs are going, and what this will mean in practice.
He is banking on little public understanding of what roles come under “corporate services, communications and administration,” and hoping there will be little or no action by campaigners (or back bench MPs) to resist the coming cuts.
But on closer examination, ‘corporate services and communication’ include delivering effective public consultation on local plans, ensuring meetings allow properly informed and prepared board members to meaningfully discuss relevant plans and issues, delivering prompt and serious responses to complaints and issues raised by patients, the public and local politicians. Administration is an unglamorous term that covers a range of vital functions that enable the complex web of organisations that deliver our NHS to work together, communicate with one another and the outside world, and coordinate plans for the various services in each area.
Nobody can argue that no admin is necessary, and nobody has explained how much of it can be safely cut back, or successfully loaded onto fewer staff without knock-on problems.
The words “not exclusively” are also doing a fair bit of heavy lifting in Wes Streeting’s statement. We know that in many trusts up and down the country the cuts reach well beyond corporate services, communication and admin – with nursing and other clinical jobs and many important non-clinical support roles also being cut back.
Support services that are not delivered by non-clinical staff – for example when fewer staff are employed to clean, serve meals or help move patients and supplies around the hospital – all too often wind up an additional burden and frustration for already hard-pressed clinical staff, and can result in significantly less safe or satisfactory care for patients.
The Lowdown has been working hard to pull together a broader view of what is happening across the country, enabling short-sighted ‘savings’ or ill-judged cutbacks to be challenged before they take place, rather than after damage is done.
But as we have warned, it is becoming more difficult to do so, as Integrated Care Boards become preoccupied with reorganisation or mergers, or opt to take their financial discussions behind closed doors in “private” session. Too many trusts are also apparently doing the same, leaving little if any public access to information on how many of which staff are to be losing their jobs.
Now new figures from NHS England on the financial state of play of trusts, foundation trusts and ICBs across the country have been published, and some of these also give real cause for concern.
While Wes Streeting boasted that “the NHS is in balance, 7 months into the financial year,” this is not the case in every area. The figures reveal that 62 trusts and FTs are forecasting significant (above £10m) deficits by the end of March – adding up to more than £1.9 billion – that are to be covered this year by Deficit Support Funding.
However we already know this funding, which has for years propped up some chronically struggling trusts, is to be phased out, beginning next year, when budgets will be already squeezed by this year’s redundancy payments.
Two trusts facing end-of-year deficits in excess of £20m (West Suffolk Hospital and London’s Royal Free Hospital) have not even been guaranteed Deficit Support Funding, which suggests their situation is likely to worsen in 2026/27.
Forty-two of the trusts expecting significant end-of-year deficits are showing little (below 1%) or no deviation from their financial plans so far, but have still not been able to balance their books, despite all the pressure to do so. The five largest projected end of year deficits are £85m at Mid and South Essex Foundation Trust; £75m at King’s College Hospital; £64.8m at University Hospitals Leicester; £64.2m at East Kent Hospitals; and £57.9m at Northern Care Alliance.
Also worrying are the 16 trusts which are currently running deficits above planned levels that amount to 2% or more of their annual turnover, but still predicting little or no end of year deficit. The worst of these are Salisbury FT (£12.4m adrift, 6.3% of turnover); Royal United Hospitals Bath (£13m, 4.3%); Liverpool Women’s Hospital (£3.4m, 4.1%); Great Western Hospitals (£10.1m, 3.8%); Wirral University Teaching Hospital (£9.4m, 3.7%); and Nottinghamshire Healthcare FT (£12.9m, 3.6%).
Whether these trusts can cut their way back in to balance, and if so what they would have to cut to get there, and by how much is not yet clear – but it seems obvious that the trusts that are even now in some difficulty as the rest of the NHS just about scrapes through are the most likely to feel compelled to make damaging cuts.
Our Lowdown research has provided insights into the implications of the cash cuts underway or coming in the next few months: see our Trusts in Trouble
The picture is a varied one, with options for cuts limited by the requirement of acute trusts to continue to respond to strong demand for emergency services.
It includes cuts in clinical as well as non-clinical posts; trusts making unwise cuts in funding for voluntary sector services such as hospices and specialist clinics; closing beds or wards – as the peak winter pressures loom closer; restricting use of private sector beds; limiting outsourcing to private clinics; slowing down and reducing elective work.
Maybe you know more about some of these, or have details of cutbacks that have not yet been publicised? We invite union activists or campaigners to keep us posted for new developments in the areas we mention, or worrying plans or changes in areas that we have not so far been able to catch up on.
Early information helps build the broadest support for any campaigns to defend local jobs and services, protect safe staffing levels and safeguard our NHS.
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
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