A number of ICBs across the country are planning to merge or create new ‘clusters’ in a bid to reduce running costs.
In the East of England, there are plans to reduce the number of ICBs from six to three, although the exact configuration is yet to be confirmed.
Meanwhile, in the South West region, commissioners are looking at forming three ‘clusters’ out of seven ICBs.
In March, the Government announced its intention to abolish NHS England over the next two years in a bid to ‘reduce duplication’, while ICBs were asked to cut their running costs by 50%.
Since then, NHS England has produced a ‘model ICB blueprint’ which would see ICBs hand over some of their existing functions – including ‘primary care operations’ – to new ‘neighbourhood teams’.
The East of England region is considering three different models of configuration (see box), with changes to the footprints of the six existing ICBs:
- Bedfordshire, Luton and Milton Keynes
- Cambridgeshire and Peterborough
- Hertfordshire and West Essex
- Mid and South Essex
- Norfolk and Waveney
- Suffolk and North East Essex
A paper on ICB organisational change by Suffolk and North East Essex ICB was suggested that there were several principles to the redesign, including that each ICB cover at least one million lives and that each ICB could work effectively on neighbourhood transformation.
The board also revealed that NHS England has told ICBs they should be planning to cluster as soon as possible.
It added that there was a difference between clustering and merging, with clustering being ICBs remaining separate legal entities that each have to ensure they individually fulfil their statutory functions and manage their financial position. But it would also include making joint senior appointments, such as chairs and chief executives.
Merging however would require abolishing the ICBs and establishing a new successor ICB, with staff and assets transferring to the new ICB and a new board being appointed.
Three potential models for East of England
Potential Model A
- Norfolk, Suffolk, Cambridgeshire & Peterborough (C&P)
- Greater Essex
- Hertfordshire, Bedfordshire, Luton & Milton Keynes (BLMK)
Potential Model B
- Norfolk & Suffolk
- BLMK & C&P
- Greater Essex & Hertfordshire
Potential Model C
- Norfolk & Suffolk
- BLMK, C&P & Hertfordshire
- Greater Essex.
A spokesperson for Mid and South Essex ICB said: ‘We are working to deliver the requirement set by NHS England to deliver corporate savings of 50%.
‘Together with all ICBs, we have been tasked with ensuring that our running costs (not our spending on delivering front-line services) are the equivalent of £18.76 per head of our patient population, as set by NHS England.’
A spokesperson for Norfolk and Waveney ICB added: ‘As part of the national requirement for ICBs to reduce the running costs by 50%, all ICBs have been asked to reconsider their future delivery models, working with regional NHSE teams to agree a future model that meets the challenges we face today.
‘We have been engaging our colleagues and our key stakeholders on future ICB options, before submitting plans that meet our affordability challenge for agreement by NHSE at the end of May.’
In the South West, Cornwall and the Isles of Scilly ICB and Devon ICB are considering merging, while Bath and North East Somerset, Swindon and Wiltshire ICB, Somerset ICB and Dorset ICB are also considering the move. This would make three ‘clusters’ across the region.
Earlier this month, Bristol, North Somerset and South Gloucestershire and Gloucestershire ICBs also announced they were considering the move.
A spokesperson for Cornwall, Isles of Scilly and Devon ICBs said: ‘All ICBs in England are being asked to significantly reduce running costs and shift to a more strategic role with different responsibilities for us and other parts of our health and care system.
‘This is part of the wider nationally-driven NHS reform programme to reduce management costs and focus more money on the front line.
‘Both Cornwall, Isles of Scilly and Devon ICBs are exploring plans to cluster together. This proposal is still at an early stage and no decisions have been made.’
A spokesperson from Bath and North East Somerset ICB said: ‘BSW, Somerset and Dorset ICBs are exploring plans to cluster together. This proposal is still at an early stage and no decisions have been made.’
A version of this story was first published on our sister title Healthcare Leader.
