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The chief executive and senior leaders departing, yet another restructure and now this week the wholesale abolition of NHS England, the health service’s national leadership body.
Was this all part of a fortnight-long comms plan from the government; one of successive news cycles of ‘cutting red tape’ and ‘getting a grip’ on the state, through a series of major announcements?
The Government would like you to think so, but with a bit of digging, probably not.
The resignation of Amanda Pritchard, the outgoing chief executive, was done on her own terms. Likewise the departures of fellow members of her NHS England board, at least one of whom had given notice at the turn of the year.
Then the full abolition of the national commissioning body announced by the Prime Minister as part of a package of measures to reform the civil service was very much a surprise to most people it affects – and contrary to a lot of the messaging from government in previous months.
The net result of these disjointed announcements has been a degree of confusion and mixed messages about what was actually happening within the top tier of NHS leadership.
That uncertainty was ended with a thud as the Prime Minister made NHS reform the centre of his public services improvement announcements on Thursday.
The Government will no doubt be pleased with their coverage: reducing the number of managers, administrative staff and quangos is always going to go down well, particularly when the leader of the opposition and a former Tory health minister give their blessing.
But reputationally, Starmer might be storing up problems.
The trade-off of Government being seen to be brave, accountable and responsible for more of the state, through abolishing intermediary bodies, is that these organisations can act as a shock absorber for ministers.
When inevitably there are problems – whether in the health service, transport or elsewhere – ministers have benefitted from being able to share the blame with the administrators.
Now, in the NHS, the most political non-political organisation in the country, that option has been taken away and there is no doubt where the buck will stop.
What’s more, while the decision to abolish the NHS’ managerial body is intended to give full control of the health service to the Secretary of State, in reality the levers of power are widely distributed across the thousands of local, frontline care organisations of the NHS.
The result of this genuinely brave political decision, in media management terms, is that the government owns all the risk and only a share of the ability to do anything about it.
When ministers are on the Today programme being asked why the NHS is going through its inevitable next difficult winter period, there is only so long they will be able to point to the failure of NHS managers.
James Mole, former Head of Media and Deputy Director of Communications at NHS England, is Director of Healthcare Communications at Hanover and is part of our Executive Media Unit - created to help CEOs and leaders engage with the full breadth of today’s media landscape.