So, as we are all aware NHS Integrated Care Boards (ICBs) are undergoing significant changes as part of a broader NHS restructuring initiative aimed at improving efficiency, enhancing local healthcare delivery, reducing costs, and enhancing local healthcare delivery to address some of the significant challenges the NHS is facing.

What do ICB’s do?

ICB’s put the budget and decision making into the hands of local partnerships who will work with local communities to decide how best to design and deliver efficient services that meet local needs and avoid duplication. helping people stay healthy and well, delivering more joined-up, convenient care, and better supporting marginalised or disadvantaged groups.

The plan is merging several ICB’s changing the number of ICB’s will change from the present number of 42 to around 26.

1. Delegation of Commissioning Functions

NHS England is transferring additional commissioning responsibilities to ICBs to enable more localised service design and integration and an adaptable approach to the needs of the community:

• • Specialised Services: From April 2025, ICBs will assume full responsibility for commissioning 70 specialised services, encompassing a £14 billion annual budget. This move aims to shift from siloed service delivery to a more strategic, population-based approach hopefully eradicating the postcode lottery.
  • Vaccinations, Screening, and Child Health Information Services (CHIS): Delegation of these services is planned for April 2026, allowing ICBs to tailor public health initiatives to local needs.

2. Financial Constraints and Operational Challenges

ICBs are facing stringent financial targets amid a backdrop of NHS deficits.

• • Cost Reduction Targets: ICBs are required to reduce operating costs by 50% by the end of 2025, potentially leading to significant job cuts across NHS England, the Department of Health and Social Care, and NHS trusts.
  • Financial Planning: The NHS is under pressure to achieve a 4% improvement in productivity and a 1% reduction in cost base, with a focus on reducing spending on non-frontline staff.

3. Structural Reorganisation

The government’s plan to abolish NHS England and integrate its functions into the Department of Health and Social Care is set to be completed within two years. This restructuring aims to eliminate duplication of resources and responsibilities, potentially leading to further job reductions.

4. Enhanced Local Control and Accountability

Proposed changes to the NHS Standard Contract for 2025/26 are designed to grant ICBs greater authority in managing healthcare delivery

• • Activity Management: ICBs will have the option to set indicative activity plans and activity management plans if none have been agreed with providers, allowing for more direct oversight of service delivery.
  • Performance Targets: ICBs will have the authority to set minimum waiting times for services, enhancing their ability to meet local healthcare

5. Focus on Strategic Commissioning

ICBs are transitioning to a strategic commissioning role.

• • Workforce Planning: Investing in strategic commissioning functions, including analytics, strategy, market management, and contracting.
  • Integrated Service Delivery: Collaborating with local providers to design and deliver services that meet the specific needs of their populations.

These changes reflect a significant shift towards localised, strategic healthcare planning, though they also present challenges related to financial constraints and organisational restructuring.

At Hallam Medical, we are committed to staying at the forefront of healthcare service delivery by leveraging our extensive experience and embracing innovative solutions such as digital platforms and remote working. We remain closely connected to our clients, actively engaging with them to understand their evolving needs and future service plans. This ongoing collaboration ensures that we continue to provide responsive, forward-thinking support that aligns with the changing landscape of healthcare delivery.