The NHS Reconfiguration Formula

No one noticed: the NHS ended up where it started.

When Wes Streeting, the Health and Social Care Secretary, spoke at the NHS ConfedExpo 2025 in Manchester about “our” vision for a new model of NHS care, we couldn't help noticing Wes’s fervent support for NHS reconfiguration.

“So if you need to reconfigure services to cut waiting times, modernise and improve productivity, you will have my support. In fact I’ve had nine reconfigurations cross my desk since becoming Health Secretary,” said Wes.

The TTE office employees are sufficiently long in the tooth to have witnessed several NHS reconfigurations.

In 2002, Strategic Health Authorities (SHAs) were established following the implementation of the Health and Social Care Act 2001.

SHAs in England initially served populations of about 1.5 million. They were responsible for leading the strategic development of the local health service and managing Primary Care Trusts (PCTs). The average size of the 152 PCTs in England was around 330,000 people.

The SHAs were reconfigured from 28 to 10 in 2006. T…