Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to ensure that the commissioning of specialised services is not adversely affected by the requirement for integrated care boards to reduce their running costs by 50 per cent.

NHS England has asked the integrated care boards (ICBs) to act primarily as strategic commissioners of health and care services and to reduce the duplication of responsibilities within their structure, to achieve a 50% cost reduction in their running cost allowance.

We expect ICBs to fully deliver on their commissioning responsibilities, including the responsibility to commission some of the specialised services. Furthermore, ICBs have a legal duty to involve patients and their carers and/or representatives in the planning of services, as well as proposals and decisions that have an impact on services. ICBs are required to set out how they plan to execute this duty in their joint forward plans.

NHS England provided additional guidance to ICBs, National Health Service trusts, and NHS foundation trusts on 1 April 2025, where ICBs were tasked with developing plans by the end of May setting out how they will manage their resources to deliver across their priorities.

NHS England will be working closely with ICBs to support the development of these plans, ensuring that their implementation reduces duplication and supports patient care. In his letter to ICBs, Sir Jim Mackay committed to greater transparency and moving back to a fair shares allocation policy over time.