NHS England accounts reveal spike in ‘agreed departures’

NHS England and the commissioning system it is responsible for notched up more than 8,000 “agreed departures” and compulsory redundancies in 2025-26, a massive hike on the combined figure for the previous year.  

The health quango, which is being merged back into the Department of Health and Social Care under plans set out by the Starmer government last year, spent £534.1m on exits across its “consolidated group” in the last financial year, its latest accounts reveal. 

In November last year, then-health secretary Wes Streeting told parliament that 18,000 roles would go across NHSE, DHSC and Integrated Care Boards by March 2028, in a move expected to save £1bn a year by 2029. The latest figures suggest almost half of the anticipated departures had been achieved by the end of March.  

According to NHSE’s annual report and accounts for 2025-26, the consolidated group – which brings together NHSE, ICBs and government-owned company Supply Chain Coordination Ltd – racked up 7,578 agreed departures and 585 compulsory redundancies in the financial year. The figures compare with just 342 agreed departures and 549 compulsory redundancies in 2024-25. 

The £534.1m price tag for the 2025-26 departures stands in contrast with the previous year’s figure of £42.9m. 

NHSE accounted for 107 of the compulsory redundancies and 2,872 other agreed departures in 2025-26. Compulsory redundancy numbers were actually higher the previous year (165) but agreed departures were tiny by comparison (8). 

According to the annual report and accounts, published yesterday, NHSE directly employed 15,569 staff as of 31 March this year – or 14,088.8 full-time equivalent staff.  

The document said a further 1,733 people were “engaged in an off-payroll capacity”, including agency staff and secondees. It added that recruitment restrictions were put in place in March this year as part of moves to reduce headcount and that there were 2,995 vacancies as of that month. 

NHSE and Commissioning Support Units, which assist ICBs, registered a significant increase in consultancy spending in the last financial year – up by more than 50% from £16.8m in 2024-25 to £25.4m in 2025-26. 

Across the wider consolidated group, consultancy spend also increased, but by a less dramatic proportion: from £48.4m to £52.6m (8.6%).

The annual report notes the steps so-far taken to implement the merger of NHSE back into DHSC, a move that will be legally underpinned by the health bill, which was introduced to parliament in May and is due to enter the report stage next week. “NHS England is working closely with DHSC to prepare for this transition, with legal transfer planned for April 2027 subject to parliamentary approval,” it says. 

Writing in her foreword to the report and accounts, NHSE chair Dr Penny Dash said the document told “a story of meaningful progress”, but acknowledged the pressures associated with the organisation’s looming abolition. 

“I know that it has been another challenging year for colleagues, particularly those in Integrated Care Boards and NHS England as we navigate significant change,” she said.  

“I continue to be impressed by the hard work and commitment I see and hope we will be in a more stable position over the next year. 

“The progress captured in this report is a tribute to our brilliant and professional workforce. I am grateful to every member of staff who has contributed to it, and I remain committed to an NHS that serves patients and communities with the care and compassion they deserve – and in which our staff feel genuinely valued and supported.” 

The annual report and accounts show that former NHSE chief executive Amanda Pritchard received pay in lieu of notice bracketed at £105,000-£110,000 in 2025-26 and a further payment of £5,000-£10,000 in lieu of annual leave.  

Pritchard announced her departure from NHSE in February 2025, a couple of weeks ahead of official confirmation that the organisation would be abolished. Her full salary for 2024-25 was bracketed at £265,000-£270,000. 

The NHSE annual report and accounts also detail a £330,000 “special severance payment” made with HM Treasury approval to “settle an employment related claim”. 

The accounts do not name the recipient, but state: “Settlement was agreed to conclude the employment relationship mitigating the risk of ongoing litigation and associated financial impacts.”