Baroness Shawcross-Wolfson

The reference in paragraph 2.84 of the November 2025 Budget refers to the arm's length body review that was launched on 6 April 2025. That review is ongoing. The decision to close NHS England, announced on 13 March 2025, predates the launch of the arm's length bodies (ALB) review.

Departments are developing plans on the size and shape of their workforces as per the financial settlements that were agreed with HMT in the Spending Review and the priorities set by Ministers, including those set out in the Autumn Budget. These plans will take a whole workforce approach based on the cost of civil servants, Contingent Labour, Consultancy and Managed Services.

At an overall Civil Service level, we have set out plans to reduce back office costs by 16% over the next five years, delivering savings of over £2.2 billion a year by 2030 and targeting spending on front line services. The Civil Service is committed to publishing a Civil Service Strategic Workforce Plan this year, which will confirm more details about the plans for our workforce.

The Arm's Length Body Review, formally launched on 7th April 2025 is ongoing, its outcomes will be communicated in due course. Some changes have already been announced such as the closure of NHS England to reduce bureaucracy, make savings and empower NHS staff to deliver better care for patients. Additionally, closures of some ALBs such as the UK Space Agency and its repatriation into DSIT are already underway..

Please see the table below for 2024, 2025 and latest available figures on Civil Service employment sourced from ONS Public Sector Employment Statistics.

*latest available

Each department will take a decision on its future size and shape as per the financial settlements that were agreed with HM Treasury in the Spending Review. These plans will take a whole workforce approach based on the cost of civil servants, Contingent Labour, Consultancy and Managed Services, and will be finalised through the business planning process that is currently underway.

As announced on 6th April 2025, the Government is conducting a full-scale review of arm's-length bodies in order to reduce the duplication of work by public bodies, improve efficiency, reduce unnecessary costs, and improve transparency. This review is ongoing, but some changes have already been announced such as the closure of NHS England to reduce bureaucracy, make savings and empower NHS staff to deliver better care for patients.

The Government has published a comprehensive Regulation Action Plan that sets out our plans to reform the regulatory system to unlock growth, boost innovation and reduce burdens on businesses across key sectors.

One of the key commitments in the Action Plan is the target to cut the administrative burden of regulation on business by 25%, or £5.6bn, by the end of the Parliament. This pledge will save businesses time and money and help create a regulatory environment that is targeted, proportionate, transparent and agile enough to support economic growth.

As announced in the Autumn Budget 2025, the department will lead a review of childcare provision. This review aims to simplify the system for providers and families, improving access and strengthening the impact of government support. The review is expected to take place in 2026, and we will share more information in due course.

Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.

As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.

The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.

Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.

Work has commenced on the Keep Britain Working Vanguard Phase following publication of the review’s final report in November. We are working with Sir Charlie Mayfield, Vanguard employers and regions to mobilise and design this next phase of work and establish effective ways of working. The vanguards will play a pivotal role in shaping how health issues and disabilities are managed in the workplace, building an evidence base and understanding of what works through effective partnership with employers.

As part of the Vanguard Phase, Sir Charlie Mayfield has agreed to establish and lead a Vanguard Taskforce/advisory board in partnership with Department for Work and Pensions, Department for Business and Trade, and Department of Health and Social Care. The Vanguard Taskforce will bring together a group of external experts from various sectors and organisations to provide external advice, and guidance to steer the Keep Britain Working Vanguard Phase. We are currently considering the Terms of Reference and potential membership of the taskforce.

The Workplace Health Intelligence Unit (WHIU) will serve as the central hub for delivery of the whole Vanguard Phase and to drive on-going work. We are currently working to establish the Intelligence Unit within Government and considering options for its design and details of its function. A comprehensive governance framework, incorporating the taskforce, will be established to ensure strategic oversight and accountability of the Unit as it is set up and developed.

Further information on the shape and remit of the Vanguard Taskforce and Workplace Health Intelligence Unit is expected in Spring 2026.

On 11th July 2025, we announced a WorkWell Primary Care Innovation Fund, which offered a portion of £1.5 million of single year funding to each of the fifteen WorkWell pilot sites to test innovative approaches to the fit note within primary care.

The funding is supporting local areas to boost capacity in primary care to provide better work and health support via the fit note process, with the longer term aims of reducing pressure on GPs and improving patients’ work and health outcomes.

Each of the 15 WorkWell Integrated Care Boards has received up to £100,000, with interventions running from October 2025 to March 2026. The locations of the sites are:

Birmingham and Solihull,

Black Country,

Bristol North Somerset and South Gloucestershire (BNSSG),

Cambridgeshire,

Cornwall and Isles of Scilly,

Coventry,

Frimley,

Greater Manchester,

Herefordshire,

Lancashire and South Cumbria,

Leicester, Leicestershire and Rutland (LLR),

North Central London,

North West London,

South Yorkshire, and

Surrey Heartlands.

One of the key aims of the funding is to build the evidence base for how the fit note process within primary care can be improved, and findings will inform future policy development. Most sites are using the funding to test new or additional roles within Primary Care Networks, including social prescribers, work and health coaches, or physiotherapists, to either issue the fit note instead of the GP or provide wraparound work and health support to the fit note recipient.

However, we know that we need to go further. The Keep Britain Working Review was clear that the fit note is ‘not working as intended’ and recommended that we test alternative approaches to the fit note, working with GPs and health services to explore improvements and replacements. We are currently considering how to respond to the Review’s recommendations on the fit note, and we will bring forward more information in due course.

This Government values the input of disabled people and people with health conditions, their representative organisations and people that support them. The Pathways to Work Green Paper launched a consultation which has now concluded. We are considering responses to the consultation.

We also have recently concluded the Access to Work Collaboration Committees, in which we engaged with a range of stakeholders, including disabled people’s organisation representatives and lived experience users, to provide discussion, experience, and challenge to the design of the future Access to Work Scheme.

Whilst the committees have now ended, we will seek opportunity to engage with stakeholders as we move forward with policy development, recognising the value of their input and expertise.

The findings from the consultation and Collaboration Committees will inform the chosen future direction of Access to Work. Once this is established we will set out our plans working closely with stakeholders to ensure an appropriate transition.

The rising number of young people who are not in education, employment or training (NEET) is a crisis of opportunity that demands more action to give them the chance to learn or earn.

To truly address the root causes of youth inactivity, we need a deeper understanding of the barriers that disabled young people and those with health conditions face. The Report will examine the drivers behind the rise in NEET rates and economic inactivity among young disabled people and those with health conditions.

On the 4^th of December my right hon. Friend the Secretary of State for the Department for Health and Social Care launched an Independent Review into Prevalence and Support for Mental Health Conditions, ADHD and Autism.

The review will look to understand the similarities and differences between mental health conditions, ADHD and autism. It will look at prevalence, early intervention and treatment, and the current challenges facing clinical services.

The review will also seek to identify opportunities to provide different models of support and pathways, within and beyond the NHS, that promote prevention and early intervention, supplementing clinical support.