Model Integrated Care Board Blueprint – a first look

NHS England's new Model Integrated Care Board Blueprint was published today by the HSJ, unveiling a significant restructuring plan for the NHS, which centres on the changing role and functions of Integrated Care Boards (“ICBs”). 

The blueprint follows the government's decision to abolish NHS England and merge its functions with those of the Department of Health and Social Care (DHSC) as part of a broader strategy to improve financial performance and redirect resources to frontline care.

ICBs have been asked to utilise the new blueprint to set out their merger plans and reduce their overhead costs by 50% by the end of the year. ICBs are required to submit plans by 30 May detailing how they intend to achieve an operating cost envelope of £18.76 million.

The blueprint sets out transferring many ICB functions to other entities, such as neighbourhood health providers and regional teams. Neighbourhood health providers are a new construct, which for the time being remain undefined. However, the blueprint explains that these bodies are likely to work closely with acutes, including primary care, community, mental health and the voluntary sector.

The blueprint acknowledges that transferring functions alone will not achieve the required cost reductions. ICBs must merge functions to cut duplication and streamline operations. The document suggests a guideline population size of two million within existing NHS regions to foster more cohesive and efficient healthcare delivery across larger populations.

Director of the NHS Confederation’s Integrated Care Systems Network, Sarah Walter, has said that the blueprint sets out a “helpful overview of the future role of ICBs” and provided “much-needed clarity about the proposed future functions in the context of a changing health and care landscape”. 

Transfer of Functions

• Workforce Planning and Emergency Preparedness: Strategic workforce planning, development, education, and training will be transferred to regional teams. Emergency Preparedness, Resilience, and Response (EPRR) and oversight of provider performance will also move to regional teams.
• Primary Care Operations: Responsibility for primary care operations and transformation, including medicines management, estates, and workforce support, will move to neighbourhood health providers.
• Digital Leadership: Digital leadership and transformation will be transferred to providers, while the national team will handle data collection, management, and processing.
• Other Functions: Functions such as medicines optimisation, pathway and service development, estates and infrastructure strategy, green plan and sustainability, and local workforce development and training will be taken over by providers.

Future of ICB Functions

ICBs are being directed to develop and invest in other functions over time. These include strategy and strategic planning – aligned with the ICBs' evolving role in “strategic commissioning” – as well as commissioning services for “neighbourhood health”.

ICBs are also expected to broaden their efforts in areas such as population health management, building partnerships with the voluntary sector and public health bodies, understanding illness prevention and root causes, addressing health inequalities, designing comprehensive care pathways, and commissioning a range of services.

The upcoming NHS 10-Year Health Plan, anticipated for release in June 2025, is expected to outline a transformative vision for England's healthcare system centred on three major shifts: transitioning care from hospitals to community settings, embracing digital technologies, and prioritising prevention over treatment. Further guidance is set to be provided on the development of neighbourhood health centres offering integrated services, the implementation of unified digital patient records accessible via the NHS App, and the exploration of wearable technology for at-home health monitoring.

What does this mean for providers?

For NHS and independent providers that deliver services commissioned by ICBs, change will become the norm in the weeks and months ahead. 

The new activity management provisons in the 2025/6 NHS Standard Contract (which we reported on here: New activity management processes implemented in 2025/6 NHS Standard Contract - Burges Salmon) will require providers to engage closely with ICBs to agree new Indicative Activity Plans for the services that they provide, at the same time that ICBs will see a change in their role and potential consolidation and loss of personel. These changes may mean that securing that engagement will become more difficult in practice.

The responsibility for commissioning certain services will also move in time. Providers will need to form new relationships with the replacement commissioning bodies, including the new neighbourhood health providers, once they are formed. 

The shift in responsibility for digital will also be worth tracking. On the one hand, this may allow digital programmes to align more with local needs and help to fast-track innovation by speeding up decision-making, but it could also increase the risk of increased fragmentation. 

If you have any questions in relation to this article, please contact [email protected] , [email protected] or your usual Burges Salmon contact. 

Article written by Alex Bones (Trainee Solicitor).