Changes to the NHS in Bristol, North Somerset and South Gloucestershire

21 March 2025

This update provides an overview of everything we know to date, based on the changes announced nationally.

Overview

Government announcements during the week of 10 March 2025 mean significant changes for the Department of Health and Social Care and many NHS organisations.

On 12 March 2025, it was announced that all integrated care boards, including NHS Bristol, North Somerset and South Gloucestershire ICB, would have to reduce their running costs by 50%.

Impact on NHS Bristol, Somerset and South Gloucestershire Integrated Care Board

All integrated care boards have been told to reduce their running costs by 50%. The timescale we have been given is that changes need to be made by the third quarter of 2025/26 (October to December 2025). This is a cut of 50% on top of the 30% which we have already delivered, as instructed in 2023.

We understand a new operating model, which should give a clearer picture of the role and remit of integrated care boards moving forward, will be published soon. It is expected that ICBs will have a particular focus on strategic commissioning and reducing our responsibilities with regards to provider oversight.

We have put all external recruitment on pause while we gather further details about the nature of the change we will be undertaking. As you can imagine, the announcement has had a significant impact on our hard-working and committed teams, who are focussing on delivering our Joint Forward Plan after the disruption caused by recent restructure to effect the 30% cut. We are currently reviewing all programmes and areas of work to establish what needs to continue and what can be paused during this time as we wait to learn what a new ICB and its function is going to be.

The Chief Executives of the seven ICBs across the South West are working together to try and explore how we can align functions and work together to support the thinking for the development of the new operating model for ICBs. Although there is no confirmation of mergers, they cannot be ruled out.

NHS Bristol, North Somerset and South Gloucestershire ICB has been focussed on delivering services within our allocation, commissioning high quality services for patients and getting value for taxpayers.

We are proud to say that we have delivered a balanced budget this year and are committed to doing the same in 2025/26. Our team is regularly singled out for its best practice and we know the NHS must live within its means and realise the changes underpinning the 10 Year Health Plan to make it fit for the future.

Our track record of success stands as testimony to the fact that we are ready to take on more responsibility and we want to play a role in sharing our best practice and defining the future of efficient and effective healthcare for our local communities.

Impact on other organisations

NHS England and the Department of Health and Social Care

The Government has said NHS England is being ‘taken back into direct government control’.
This follows more than a decade of the NHS – via NHS England (formally, the NHS Commissioning Board) – having a degree of operational independence from the government following the 2012 Health and Social Care Act reforms.
This process is expected to take place over a two-year period although exact timescales are unclear.
Headcount across both NHS England and the Department of Health and Social Care is expected to be cut by around 50% and it has been reported that the savings could release around £500 million.
Combined, the two organisations have a workforce of over 18,000 staff, which the Secretary of State says is double what it was in 2010 when waiting times were shorter and patient satisfaction was higher.
On 17 March, NHS England named a new executive team to lead the transition. Elizabeth O’Mahony, formerly South West Regional Director at NHS England, has been appointed national Chief Financial Officer.

Providers

Nationally, provider trusts will need to make further reductions in their corporate costs.
Trusts have been told to reduce corporate services budgets, cutting back any increase since the pandemic by 50%. Specifics have not been defined, but this is expected to cover corporate functions like HR, finance, and communications.
Trusts should be transferring support staff to subsidiary companies, which can allow providers to employ new staff off NHS pay scales and terms and conditions, and typically cover cleaning, facilities management, and staff such as porters.

What next

We will publish further developments on our website every 2 weeks.