NEW YORK – The UK government's decision to abolish NHS England by bringing its operations under the direct control of the UK Department of Health and Social Care has been met with cautious optimism by companies and organizations that could be affected by the reorganization.
UK Prime Minister Keir Starmer announced last week his plans to scrap the body, a dozen years after it was established to lead the National Health Service in England. The delivery of healthcare in the UK is federated, and the NHS is led by similar bodies in Wales, Scotland, and Northern Ireland. No similar plans have been announced in the other three UK countries.
In a March 13 speech before Parliament, UK Health and Social Care Secretary Wes Streeting laid out the rationale for the decision, stating that the government had "inherited an NHS going through the worst crisis in its history." He cited a September 2024 report published by Lord Ara Darzi which attributed the NHS's issues to the 2012 reorganization that led to the establishment of NHS England, calling it a "calamity without international precedent." More than 300 new NHS organizations were created, he added, leaving the UK drowning in complex bureaucracy.
Streeting noted that the staff at NHS England and DHSC had doubled in the past decade, and that the budget for NHS England's staff and administrative costs is now £2 billion ($2.6 billion). The government's decision is to now turn NHS England and DHSC into one organization, starting by eliminating tasks where the two bodies overlap. In two years, NHS England will be brought into the DHSC completely, Streeting said.
The decision to streamline NHS England and DHSC was broadly welcomed by the British In Vitro Diagnostics Association, which represents test manufacturers in the country. Paul Fisher, director of policy and programs at BIVDA, noted that the IVD sector plays a "key part" in the UK healthcare system and estimated that about three-quarters of clinical decisions are supported by diagnostics.
He pointed out that the Starmer government has introduced a 10-Year Health Plan for UK healthcare centered on "three shifts," including moving healthcare from analog to digital technology, providing care in communities rather than in hospitals, and reorienting from a system that treats sickness to one focused on prevention.
"Diagnostics are particularly well suited to moving from sickness to prevention and moving treatment from hospital to home," said Fisher. However, he said that making new tests available for use within the NHS is constrained by bureaucracy as it insists on large amounts of data to vet any new diagnostics before implementing them, and the NHS’s complex structure means that companies often need to liaise with the body at multiple points of contact. Because of this, the decision to streamline the operations of NHS England and DHSC could prove beneficial.
"The abolition of NHS England is broadly welcomed," said Fisher. "Removal of duplicate functions, freeing up of resources, and allowing a focus on delivery are all positive steps." He noted that one concern is that the restructuring could distract from operations, as the NHS adjusts to changes. But considering the body was set up in 2013, Fisher said that BIVDA does not anticipate major challenges. "As long as the government focuses on adoption, regulation, and innovation, we are fully supportive of the plan to merge NHSE into DHSC," he said.
That sentiment is shared by some others in the sector. Adrian Smith, CEO of Oxford Gene Technology, said that the planned abolition of NHS England won't likely have a direct effect on the firm. Based in Kidlington, outside of Oxford, OGT sells fluorescence in situ hybridization probes, microarray, and next-generation sequencing products for research and clinical use.
But Smith also said the reorganization could have potential negative consequences if not managed well. "As with any major change program within healthcare systems around the world, a restructure of this magnitude could result in uncertainty and delays, which could impact patient services," he said.
The same thoughts were echoed by Michelle Mitchell, Cancer Research UK's chief executive. "Nearly one in two of us will be diagnosed with cancer during our lifetimes," Mitchell said. "It's essential that improving the lives of cancer patients is a top priority for the UK government, and this change must not impact efforts toward achieving that ambition," she said.
Mitchell added that the London-based cancer research organization will continue to work with DHSC and NHS England on a National Cancer Plan for England. The UK government announced plans to develop the effort, aligned with its 10-Year Plan for healthcare, last month.
Mitchell said that the envisioned National Cancer Plan for England will be "vital to cutting waiting lists, preventing cancer cases, and fixing [the NHS] as a whole."
According to Mark Street-Docherty, CEO at Global Access Diagnostics, it is not yet clear what the overall impact of the abolition of NHS England will have on the diagnostics industry.
"It largely depends on what the future combined entity will look like," said Street-Docherty, who held similar management roles at IVD firms Elucigene, Rosa Biotech, and MicrosensDx. While the resulting entity that results from the combination of DHSC and NHS England will have less employees and potentially less capacity, it might be nimbler when it comes to adopting new technologies, policies, and practices, he said.
Street-Docherty also said that it will be important to see how the 15 Health Innovation Networks established by NHS England will be managed going forward. These networks act as innovation arms of the NHS and support the adoption of new technologies across the healthcare system. Continued effective management of the HINs will be "key to the success of innovative technology update and deployment," he said.
Another diagnostic service that might be affected by the abolition of NHS England is the NHS Genomic Medicine Service. NHS England in 2022 published a five-year-plan on implementing genomics into the British healthcare system, and the Genomic Medicine Service, introduced in 2018, has played a core role in accomplishing that. Genomics England, a company set up by DHSC, has been a partner for NHS England in managing the NHS Genomic Medicine Service.
A spokesperson for Genomics England declined to comment on whether the plan to scuttle NHS England will impact the Genomic Medicine Service. NHS England referred a request seeking comment to DHSC, which did not respond by deadline.