Workers in the National Health Service, or NHS, in England have been warned to expect major cuts to administrative and management roles under what has been described as a "brutal restructuring" of the free-at-the-point-of-use health service.

Last week, 2,000 job losses were announced, aimed at saving 175 million pounds ($226 million) but the latest measures, which will take the office workforce down from 13,000 to around half that number, have reportedly left workers stunned.

One of the reasons for the cuts is to avoid duplication of roles with workers at the Department of Health and Social Care, or DHSC, which will also be significantly reduced in size through the reforms, allowing Health Secretary Wes Streeting more direct control over NHS performance.

In his first act after being appointed to his post last summer, Streeting made it clear that significant restructuring was a priority, announcing that "from today, the policy of this department is that the NHS is broken".

"When we said during the election campaign that the NHS was going through the biggest crisis in its history, we meant it," he continued. "When we said that patients are being failed on a daily basis, it wasn't political rhetoric, but the daily reality faced by millions. Previous governments have not been willing to admit these simple facts."

Employees were informed of the coming changes in an email from Amanda Pritchard, the outgoing chief executive of NHS England, in which she explained that her successor, Jim Mackey, and the organization's new chair Penny Dash, had been asked to take charge of "radical reform of the size and functions of (central offices)" which will "deliver significant changes in our relationship with DHSC to eradicate duplication".

The email also confirmed that NHS England's chief financial officer, chief operating officer, and chief delivery officer would be leaving.

An unnamed NHS England worker quoted by The Guardian newspaper called the speed of change in the organization "bewildering" and said it had left workers feeling "baffled, unnerved, and fearful".

Matthew Taylor, chief executive of the NHS Confederation, which represents NHS trusts in England, called the changes "the biggest reshaping of the NHS's national architecture in more than a decade", but a spokesperson for the DHSC defended the moves, saying "we are facing enormous challenges with our NHS".

"To tackle these, we need to take radical measures and urgently get the right people working in the right places and stop them being held back by pointless paperwork and inefficiency."

However, Thea Stein, chief executive of the Nuffield Trust health think tank, told The Daily Telegraph that more direct involvement from central government could be counter-productive, rather than encouraging the results the reforms were intended to achieve.

"The government should be careful that this doesn't lead to even more top-down micro-management from Whitehall, which has been the bane of the health service," she said.