Thousands of administrative and management roles within the NHS in England are set to be cut following an agreement with the Treasury, allowing the health service to temporarily exceed its spending limits to cover redundancy costs. Earlier this year, the government announced plans to remove around 18,000 jobs as part of major reforms, which include bringing NHS England under the Department of Health and reducing local health board staff.

Negotiations had stalled over how to fund the estimated £1 billion cost of the pay-offs, but a compromise has now been reached. The NHS will overspend this year and is expected to make up the shortfall through future savings. Officials stressed that no new funding is being added to the health budget beyond the existing settlement, which includes a £29 billion annual increase above inflation by 2028-29.

Health Secretary Wes Streeting said the changes would streamline management and prioritise front-line care. Speaking ahead of a conference speech, he said patients wanted “fewer layers of bureaucracy” and confirmed efforts were underway to “rebuild the NHS” through efficiency and modernisation.

The reforms aim to save £1 billion annually by the end of the parliament, equivalent to funding more than 100,000 additional hip and knee operations. However, unions have warned that cutting experienced staff could harm patient services and public health programmes.