NHS England confirms first two trusts to become integrated health organisations

Two trusts have been confirmed by NHS England as the first two integrated health organisations (IHO).

Northamptonshire Healthcare NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust have been designated as eligible to hold an IHO contract.

The two trusts will work with NHS England and commissioners to co-develop the model during 2026/27, with the first arrangements expected to go live in 2027.

Last week, Pulse revealed that GP leaders in one area withdrew support for the local IHO model, as they said it was unlikely GP practices would be on ‘equal footing’ with trusts.

NHS England previously announced that trusts will have commissioning responsibilities for primary care under the Government’s new neighbourhood health model, as they will be eligible to hold IHO contracts as described in the 10-year health plan.

IHO contracts will hold the whole health budget ‘for a defined population’. Under the model, ICBs will contract a single IHO for an area, and the IHO will then contract a number of multi-neighbourhood providers, each of which will work with multiple single neighbourhood providers.

NHS England has recently launched a consultation on neighbourhood contracts, which said that where IHO contracts are established, the contract holder will ‘take on responsibility for resource allocation and service planning’ for the whole care pathway.

It also said that hospital trusts looking to take on IHO contract must demonstrate a good working relationship with primary care.

NHS England wrote separately to the chairs and chief executives at the trusts and ICB in Northamptonshire and Northumbria to confirm the move.

Both letters, signed by NHS England’s deputy chief executive (interim) Glen Burley and respective regional directors, said: ‘This is a significant achievement and recognises the significant progress that has been made, in partnership with your ICB and system partners, to develop the strategy, orientation and infrastructure that will be required to take on responsibility for planning, resource allocation and delivery across the care pathway.’

But NHS England also said that it will work with the trusts to ‘develop a roadmap’ towards the arrangements of mature IHOs.

The letters said: ‘We recognise that, as a first wave IHO candidate, your work to develop a local model has sat alongside work to co-develop an IHO policy framework nationally.

‘We have taken a developmental approach to designation in this first wave and will continue to work with you to develop a roadmap towards mature IHO arrangements ahead of an IHO contract going live in 2027.

‘We will carry out a risk-based approach to contract assurance prior to the start of any IHO contract.

‘Given the developmental approach to this first designation wave, some capabilities may be tested in greater detail as part of this assurance process.’

The letters said that the ‘defining characteristic’ of the contract holders will be taking on responsibility for improving outcomes across a defined population.

‘This represents a shift to a population focus, requiring trusts to take on leadership for population health improvement, lead beyond organisational boundaries and manage additional financial and clinical risk,’ they added.

Northumbria Healthcare NHS Foundation Trust chief executive Dr Birju Bartoli, said: ‘It’s good news for our patients, staff and local communities for our local area to be given the opportunity to really join up health services in a way the benefits local people.

‘This is just the first step in what will be a long journey and the detail of what this means will emerge as we work closely with local partners to really understand what benefits we can realise for patients, the wider NHS and care services.’

Northamptonshire ICB chief executive Toby Sanders said: ‘This opportunity allows us to explore new ways of organising services around people’s needs, with a stronger focus on prevention, reducing inequalities and improving population health.

‘The overall aim is for people to experience care as one journey, not as separate organisations.’

He added: ‘The ICB remains committed to working alongside NHFT [Northamptonshire Healthcare NHS Foundation Trust], primary care, local authorities, voluntary sector partners and local communities as we develop the next phase together.’

Both Northamptonshire and Northumbria were given advanced foundation trust status earlier this year.

A version of the story was first published on Pulse’s sister title Healthcare Leader.