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NHS England consultation on policy change regarding subsidiaries

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By Sara Meyer & Tim Gooder

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Published 13 October 2025

Overview

NHS England has published an open letter to NHS Foundation Trust and NHS Trust chairs, directors and executives stating that it intends to change national policy guidance regarding the transfer of NHS staff to new subsidiary organisations.

 

Facts

The use of subsidiary organisations to deliver NHS services is generally intended to deliver financial savings and tax efficiencies. It has, however, been criticised by trade unions on the basis that it risks undermining the principle of a single NHS workforce, since subsidiaries can employ new staff on non-NHS terms and conditions without access to the NHS pension.

NHS England states in the open letter that it intends to change national policy in light of these concerns. It has committed to amending national guidance so that new subsidiaries involving the transfer of NHS staff will now only be approved in limited circumstances, and only where there is clear union support and protection of NHS terms and conditions, including pension access.

 

What does this mean for employers?

The letter confirms that NHS England will shortly consult on these changes, and that proposals involving the transfer of NHS staff currently under review will be paused with immediate effect while consultation takes place, unless they are supported by local unions. Employers with relevant proposals currently under review can speak to their usual DAC Beachcroft contact for advice.

Update on an important change in national policy regarding subsidiaries

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