The RCN advocates for our members and is committed to ensuring that patient care standards are maintained throughout these changes. Support is available for members impacted by these changes across England. Regular meetings are keeping members updated with all available information and we are working closely with RCN representatives and other unions. We are meeting managers and leaders to advocate for you and are monitoring the impact of these changes closely.
 
You can find the latest information available on this page and it will be updated regularly. You can find information about developments across organisations and access details about RCN activities, support or helpful guidance.

This page will be reviewed regularly. It was last updated on 8 May.

Expand the headings below for more information on each organisation.

The Department for Health and Social Care (DHSC) is a government department responsible for policy on health and adult social care matters in England and oversees the English National Health Service (NHS). 

On 13 March 2025, Prime Minister Sir Keir Starmer announced that NHS England would be absorbed by the DHSC in part of a government bid to bring the health service “back under democratic control” of government ministers. Government has said cuts could be up to 50% across DHSC and NHS England.

A formal change programme board and team have been established to lead this work. A high-level plan for merging NHSE into the DHSC was due at the end of April but has been delayed.

RCN representatives continue to meet with managers in the organisation to advocate for our members and closely monitor the impact of these changes.

Individual RCN support, advice and representation is available for members working in DHSC if needed.

NHS England (NHSE) is an executive non-departmental public body, sponsored by the DHSC. It is not a government department, but it delivers public services with funding from government. It has a wide range of statutory functions, responsibilities and regulatory powers supporting the NHS to deliver effective and high-quality care.

On 13 March 2025 Prime Minister Sir Keir Starmer announced that NHS England will be absorbed by the Department of Health and Social Care in part of a government bid to bring the health service “back under democratic control” of government ministers. Government has said cuts could be up to 50% across DHSC and NHS England.

A formal change programme board and team have been established to lead this work. A high-level plan for merging NHSE into the DHSC was due at the end of April but has been delayed.

The RCN have been holding regular member meetings to provide updates and will publish future dates on the events page.

RCN Representatives continue to meet with managers in the organisation to advocate for our members and closely monitor the impact of these changes.

Individual RCN support, advice and representation is available for members working in NHSE if needed.

Integrated Care Boards (ICBs) are NHS organisations with responsibility for planning health services for their local population. There are 42 ICBs in England.

ICBs manage the local NHS budget and work with local providers of NHS services, such as hospitals and GP practices, to agree a joint five-year plan which outlines how the NHS will contribute to integrated care strategy.

In March 2025, ICBs were told to cut their running costs in half by October – December 2025. This came on top of a reduction in running costs of 20 per cent over the past two years. This announcement came soon after NHSE and the DHSC were told they would be subject to cuts on a similar scale.

Currently ICBs must submit plans for reduced running costs for sign off by 31 May 2025. A recent update on the future of ICBs suggested some functions may transfer to other organisations.

The RCN have been holding regular member meetings to provide updates and will publish future dates on the events page.

There has been recruitment and rapid training of additional RCN Representatives across ICBs to complement the existing representative network. RCN representatives will meet with managers in organisations to advocate for our members and closely monitor the impact of these changes.

Individual RCN support, advice and representation is available for members working in ICBs if needed.

Commissioning Support Units (CSUs) are free-standing NHS organisations that support Integrated Care Boards and other NHS organisations including NHS England with procurement, analysis and commissioning or business support activity. There are four of these organisations operating across England. 

Little information is available about how changes at NHSE and ICBs may impact CSUs.

RCN representatives continue to meet with managers in the organisations to advocate for our members and closely monitor the impact of these changes. 

Individual RCN support, advice and representation is available for members working in CSUs if needed.

Arm’s-length bodies (ALBs) are a specific category of central government public bodies that are administratively classified by the Cabinet Office. There are 23 arm's lengths bodies accountable to the Department of Health and Social Care.

The Cabinet Office has written to all government departments asking them to review their use of ALBs with the potential to close, merge or return some functions to government departments. The move is part of the government's drive to slim down the Civil Service, with a view to saving money and restructuring how the state works.

RCN representatives continue to meet with managers in the organisations where we are recognised to advocate for our members and closely monitor the impact of these reviews.

Individual RCN support, advice and representation is available for members working in ALBs if needed.