NHS Trusts: Subsidiary Companies
The question
To ask the Secretary of State for Health and Social Care, what action will be taken against NHS Trusts that do not follow guidance from NHS England around proposals to consider the formation of a subco.
Answered by Karin Smyth
Outsourcing transactions which involve the creation of new subsidiaries, or material changes to existing subsidiaries, including any proposals in the North West, are reportable to NHS England for review in line with its published subsidiary transaction guidance.
NHS England wrote to the sector on 26 September 2025 to highlight a change in national policy on subsidiaries given concerns about transferring National Health Service staff into new organisations, which is seen as undermining the concept of a single NHS workforce.
NHS England will shortly consult on updating the subsidiary transaction guidance to confirm that subsidiaries involving the transfer of NHS staff will now only be approved in a limited number of circumstances, and only where there is clear local union support and protection of NHS terms and conditions, including pension access.
All subsidiary transaction proposals involving the transfer of NHS staff are paused while NHS England undertakes this consultation, unless they are supported by local unions. This includes any proposals in the North West.
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