DHSC and NHS England: Organisational Update

Wednesday 4th November 2026 Written Statements

[The Secretary of State for Health and Social Care (Yvette Cooper)]

Over the summer I reviewed the Department of Health and Social Care’s reform plans, the legislation and the work underway across the Department and NHS England to deliver the vision set out in the 10-year health plan. I have been clear that our focus must remain on the health and care of patients and communities across the country, and on supporting the staff who deliver those services.

On 1 April 2027, subject to the passage of the Health Bill, we will bring NHS England back into the Department of Health and Social Care. As set out in the 10-year health plan, we cannot continue with two parallel national organisations carrying out so many overlapping and unco-ordinated functions. This is particularly important as we strengthen partnerships and integration between the NHS and social care, and shift more care into the community and towards prevention.

As we devolve power out to the frontline, the new DHSC must transform into a streamlined and agile organisation executing a core set of national functions effectively. The national centre should offer local areas a single vision, clarity on the future strategy, and a set of national priorities and minimum standards. It should also oversee the execution of a sophisticated and clear rules-based system that rewards success, co-ordinates an overall improvement offer and intervenes where performance falls short.

Before the 2012 reforms, most of these functions sat within the Department of Health. This included the period between 2006 and 2012, when the NHS achieved its strongest performance and public satisfaction levels. Our future model will therefore draw on that experience of effective national leadership and delivery, while reflecting the needs of today’s health and care system.

We will maintain the crucial role of the NHS chief executive and establish an NHS Group within DHSC, focused on NHS operational delivery and working alongside the Department’s other core responsibilities, including policy development, social care and public health.

The vast majority of NHSE’s current national delivery functions will transfer into the NHS Group. Elsewhere, we will bring together existing DHSC and NHSE expertise in combined teams, strengthening our ability to bring policy makers together with operational service delivery experts across a range of issues. This will be particularly important for areas such as neighbourhood health, where delivery depends on close working between the NHS, social care, other Government partners and the voluntary sector.

I want to see greater devolution to local organisations and communities, alongside closer alignment between the NHS, social care, MSAs—mayoral strategic authorities—and local councils.

We will therefore continue work and consultation on how boundaries, partnerships and the alignment of powers should evolve across regions, MSAs and local areas.

NHS regional teams will support this transition, given their knowledge of local circumstances, communities and patients needed to support performance improvement. These teams will not transfer into DHSC on 1 April 2027.

To support the continuing work of the seven existing regional teams, we will establish a transitional special health authority. It will be accountable directly to the Secretary of State for Health and Social Care, through the NHS Group within the Department.

The transitional special health authority will not exercise national functions. Its purpose is to support existing regional teams, allowing them to remain close to the frontline organisations they support, rather than being centralised within the Department. We have agreed that this should be a temporary arrangement that will support the transition towards a more devolved model.

This can be achieved within the existing legislative framework and does not require amendments to the Health Bill. The legislation already provides for the establishment of the special health authority and for relevant functions of the Secretary of State to be conferred.

I also believe that decisions about care must be informed by the experiences of patients and the public. That is why I have chosen to retain and strengthen Healthwatch, and why the Department will soon appoint a new Patient Experience Director. This role will support patients and families who have experienced harm and injustice, listen to their concerns and help them get answers.

Alongside the voices of patients and families, we must draw more fully on the expertise of those who provide care. I will therefore establish the first clinical council, bringing together a small group of senior clinicians to strengthen clinical leadership across the system and advise Ministers on the NHS’s major clinical priorities. Their experience of treating patients and improving services will directly inform our decisions.

These reforms must help us get back to what the NHS does best: caring for people when they need it most. That is the purpose behind every target and every plan—not changing structures for their own sake, but so that patients get timely care and families get the support they need.

[HCWS447]