Integrated Care Boards: Running Costs and Boundary Alignment with Strategic Authorities

(Limited Text - Ministerial Extracts only)

Tuesday 9th September 2025 Written Statements

[The Minister for Secondary Care (Karin Smyth)]

Today I am updating the House on progress towards reducing the running costs of integrated care boards and the Government’s ambition to align the boundaries of integrated care boards and strategic authorities where feasible.

We have committed to reducing the running costs of ICBs and to redirect this funding to frontline services. To deliver this, our “10 Year Health Plan” sets out that ICBs must focus on their role as strategic commissioners, ensuring the best possible value in securing local services that improve population health and reduce inequalities.

In directing ICBs to focus on strategic commissioning, we are reducing duplication of functions that are undertaken by other NHS organisations such as performance management and assurance, freeing up vital resources.

To deliver a reduction in running costs in this financial year, a number of ICBs will cluster together to share leadership and functions; clustering ICBs remain legally separate organisations with their own financial allocations. It will mean that during this financial year the number of ICB senior leadership teams will go from 42 to 26.

In the longer term, there will be fewer, larger ICBs enabling them to harness a shared budget of sufficient size to improve efficiency and reduce running costs. Our ambition is for these ICBs to be coterminous with one or more strategic authorities wherever feasible, a commitment made in the “English Devolution White Paper” and reaffirmed in our “10 Year Health Plan”.

Aligning public service boundaries facilitates service integration, harnesses the opportunities of strategic planning between the NHS and strategic authorities, and supports delivery of a “health in all policies” approach.

I am today announcing the first of these new ICB footprints. These will come into effect on 1 April 2026 and are:

Norfolk and Suffolk ICB

Essex ICB

Hampshire and the Isle of Wight ICB

Surrey and Sussex ICB

North West and North Central London ICB

Thames Valley ICB

Central East ICB (Hertfordshire, Bedfordshire, Luton, Milton Keynes, Cambridgeshire and Peterborough).

In the case of Thames Valley ICB and Central East ICB, we are progressing with these new ICB footprints on the understanding that these may be reviewed in future to allow for alignment with any future strategic authorities, and newly established unitary authorities resulting from local government reorganisation.

Next summer, as local government reform progresses, we plan to decide further ICB mergers and boundary changes to come into effect on 1 April 2027.

The Department of Health and Social Care, alongside NHS England and the Ministry of Housing, Communities and Local Government, will continue to work closely together, and with ICBs and their local partners, to ensure future changes to ICB footprints achieve the best outcomes for patients and citizens. ICB leaders will continue to engage with all local partners, including Members of this House, on the further development of plans, as we stride towards delivering the ambitions set out in our “10 Year Health Plan”.

[HCWS915]