Speaking to the Public Accounts Committee (PAC) this morning, Sir Jim acknowledged it was ‘unsatisfactory' that funding for the redundancies had not been factored into the original plans.

ICBs were asked in March 2025 to make cuts of 50% by the end of December 2025 to improve efficiency.

Several ICBs have announced pauses or delays to their redundancy programmes due to lack of funding.

Sir Jim said: ‘The immediate plans were built on a very dramatic, speedy change process that would have required a lot of redundancy costs up front. If that can't be agreed with the Treasury we have had some discussions with ICBs about doing it over a longer time period in a more managed way which is possible but will not get the pace of change and the scale of change that we need in order to deliver our operational imperatives.'

PAC member Labour MP Clive Betts said it was ‘really quite amazing' that deciding how redundancy costs would be met was not agreed at the beginning of the reorganisation process.

Mackey said meeting redundancy costs had been ‘thought of and discussed right at the beginning'.

He said he hoped to be ‘getting closer to resolving the issue' in conversations with the Treasury.

The NHSE chief executive acknowledged the current situation was ‘unsatisfactory' and was causing uncertainty to individual staff members.