The NHS is facing turmoil as two of its most senior leaders have abruptly stepped down.
Professor Sir Stephen Powis, the most senior doctor in the NHS, announced his departure today, just a week after NHS England Chief Executive Amanda Pritchard resigned following meetings with Health Secretary Wes Streeting.
Sir Stephen, 64, the NHS England’s National Medical Director, will leave the job this summer, adding to the void at the top of the health service.
The news has fuelled speculation that Health Secretary Wes Streeting is pushing for tighter Government control of the health service’s operations in what some have described as a “power grab”.
Sir Stephen Powis
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Amanda Pritchard
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Others believe the Health Secretary is trying to slim down what many believe is the NHS’s “bloated and costly” bureaucracy.
NHS England, an organisation established a decade ago to “lead” the NHS, has faced increasing criticism for swallowing up money in salaries and diverting vital resources away from frontline care.
Recent research by Oxford scientists shows NHS England employs over 10,000 staff.
The scientists, writing on the Substack Trust the Evidence (TTE), also found that between 2022-23, 1,078 people agreed to exit packages costing £79million with 40 of these receiving packages worth £150,000.
The top salary was Amanda Pritchard’s at £260,000. She also received £72,500 in pension contributions.
Between 2022-23, NHS England accounted for £56.4million in “losses and special payments”, the report found.
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NHS England has faced increasing criticism for swallowing up money in salaries and diverting vital resources away from frontline care
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Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine, one of the authors of the report, said: “NHS England has managed to become increasingly bureaucratic and that means taking funding away from front line care.
“It's time for Wes Streeting to consider whether it is fit for purpose. On so many levels the NHS has failed patents, on waiting lists, general practice and emergency departments.
“Money needs to be redirected away from this bloated and costly bureaucracy into patients.
“Many of the functions of NHS England duplicate that of the Department of Health and Social care. It’s time for Wes Streeting to decide which one he wants.”
While health sources stressed Sir Stephen’s departure has been long planned, the timing will leave a gap at the top of the NHS as Streeting plans thousands of job cuts and prepares a ten-year reform strategy.
Pritchard left the institution after Streeting said he wanted a different approach which would put ministers more firmly in control.
Her interim replacement, Sir Jim Mackey, is expected to set out reforms designed to boost falling NHS productivity after Pritchard initially disputed that there was a problem.
The Treasury has been demanding faster NHS efficiency savings to avoid further spending cuts and tax rises as Sir Keir Starmer promises more money for defence. Analysis this week warned of a £13billion gap if the health service falls short of its productivity targets.
Many believe Streeting has been battling for “tighter Whitehall control”, as part of his “vow to fix the 'broken' NHS”.
He insisted he did not ask Amanda Pritchard to quit her NHS England leadership role but her replacement, James Mackey, has been given “a remit to radically reshape” how NHS England works with the Department of Health and Social Care (DHSC).
Critics argue increased ministerial oversight could undermine the autonomy of healthcare professionals and lead to politically motivated decisions that may not align with medical priorities.
Others say that decisive Government intervention is necessary to streamline operations, reduce bureaucratic inefficiencies, and ensure that taxpayer funds are spent effectively to improve patient care.
In a statement, NHS England said: “Professor Sir Stephen Powis, national medical director of NHS England has today announced that he will step down this summer, after over seven years in the role.
“As the most senior doctor within the NHS in England, Professor Powis played a key role in the pandemic response – leading the health service, supporting frontline workers and advising the public on dozens of Government Covid briefings.”
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Prof Sir Stephen Powis said: “It has been an immense privilege to serve as national medical director for the NHS and I am incredibly grateful to have been supported by amazing colleagues working across the NHS to boost the experiences of patients.
“I have always been exceptionally proud to work in the NHS and while stepping down from this role, I remain passionate and committed to improving the health of patients and improving the experience of staff.”
Amanda Pritchard, NHS chief executive, said: “It has been an honour to work alongside Steve - he is a dedicated public servant as well as a brilliant and kind colleague.”
Wes Streeting, Secretary of State for Health and Social Care, said: “Steve has provided outstanding clinical leadership to the NHS over the last seven years, including during the biggest health emergency our country has faced in modern history.”
His knowledge, professionalism, and guidance helped the NHS rise to the challenges created by the pandemic.
“I would like to thank Steve, not only for his pivotal role in the Covid vaccine rollout, but for all his work as medical director, including overseeing the team's work in the creation of the national patient safety strategy.
“Between now and July, I look forward to working with Steve and the new leadership of NHS England under Jim Mackey, as we publish the 10 Year Plan for Health and combine investment with reform to build an NHS fit for the future.”
