Amy Humphreys, director of healthcare at The PHA Group, on how to navigate a pivotal moment for healthcare reform.

Keir Starmer’s recent announcement that NHS England (NHSE) is to be abolished, with the health service brought back much more closely under democratic control, came as a surprise.

In hindsight, multiple stories in recent months have highlighted various cuts to the NHSE headcount and a shift towards a leaner operational model. However, such a drastic restructuring was not widely anticipated.

Following this announcement, numerous questions have arisen. Over the 13 years since its creation, NHSE’s brief and scope has become complex and wide ranging. So, what does this shake up mean in practice? What impact will it truly have? How does it fit in with the government’s broader healthcare strategy, and what will the roadmap for the transition period (and beyond) look like?

It remains unclear if the previously announced job cuts were an important first step in laying the foundation of what was to come. Or, if this restructure has been a ‘moving beast’ with updates being communicated as they were decided, rather than a strategic drip feeding.

This presents a significant challenge moving forward for the Department of Health and Social Care (DHSC) communications team.

The task ahead is to convince the public, and other key stakeholders, that the NHSE abolishment is a pivotal moment in the future of the health service. Not a further weakening of the existing structure, but an improvement which will lead to better delivery of frontline care.

Wes Streeting must persuade the public to trust in his vision. The government are not taking a scattergun approach to eradicating bureaucracy. Rather, they are carefully navigating real reform with concrete timelines and tangible steps.

Open and transparent communication will be critical. It will be necessary to acknowledge both the emotional and practical consequences of dismantling NHSE whilst respecting its legacy. At the same time, the government must effectively convey its vision for the future and why this milestone is essential.

With widespread concerns about the fragile state of the NHS, the public could easily perceive NHSE’s dissolution as a huge loss, further weakening an already unstable structure. To counter this, Streeting’s team must present this transition as the beginning of a new chapter – one that leads to improved patient experiences, service delivery, and accessibility for all in need.

At present, however, the rationale behind this decision remains unclear beyond the obvious cost cutting benefits of getting rid of duplicated resource. Whilst financial efficiency is an important message, a careful balance must be struck, particularly when addressing the loss of numerous jobs.

Technically, a narrative based on a redistribution of funds straight to the front line should be a great story to tell, yet the situation is far more complex. For over a decade, NHSE has played a central role in commissioning public health initiatives and providing a clear, consolidated approach to awareness campaigns. Whilst eliminating duplication between NHSE and DHSC teams seems logical, cutting the headcount of these combined teams by 50% and erasing deep institutional knowledge risks undermining national, regional, and demographic-specific campaign effectiveness – an issue likely to raise concerns among both the public and health care professionals.

Healthcare Professionals (HCPs), in particular, must not be overlooked in the DHSC’s communications strategy. Their buy-in is crucial – not only for ensuring operational stability but also for reinforcing public confidence in the reforms. If engaged effectively, HCPs can serve as influential advocates, adding credibility to the government’s strategy.

This group will require consistent and transparent updates, clarity on the roadmap for dismantling NHSE and an upfront approach to addressing potential disruption to services and staffing challenges during the transitional phase.

If managed well, the DHSC can cultivate a trusted group of advocates who will support and amplify key messaging.

Despite these considerations, a significant communications challenge lies ahead. Trust in the future of the health service is already at an all-time low across multiple audience groups.

The abolition of NHSE represents a defining moment in the history of the health service and the government must tread carefully to ensure this transition is perceived as a step toward genuine modernisation – rather than further destabilisation.

By providing open, honest and consistent updates; holding itself accountable for the challenges faced as well as communicating the wins along the way, the government can work to build a compelling narrative of a stronger, brighter and more streamlined NHS for the future, but there is undoubtedly an uphill battle ahead.