NHS England has rated the leadership performance of integrated care boards (ICBs), praising some for strong collaboration and governance while flagging areas for improvement in others.
The assessment is part of NHS England’s annual performance review for 2024/25. It measured ICB performance across five key areas: system leadership and governance; improving population health and healthcare; reducing inequalities; productivity and value for money; and enhancing social value.
Only one — Suffolk and North East Essex ICB — was upgraded to segment 1 (high performing) of the NHS Oversight Framework in Q4 2024/25, with NHS England citing ‘excellent leadership, strong governance and a track record of collaboration’.
Several ICBs were recognised for effective partnership working, while others were flagged as needing to strengthen relationships across their systems in the report published on 17 December.
Nottingham and Nottinghamshire, South Yorkshire, Gloucestershire, Somerset, South West London, North East London and North East and North Cumbria ICBs were recognised for the strength of their collaborative and partnership working.
And Frimley ICB was mentioned for its leadership of system transformation programme while national interest in Birmingham and Solihull’s integrated care approach was noted.
However, NHS England said some ICBs must improve partnership working.
Cambridgeshire and Peterborough was among those listed, with Surrey Heartlands noted as needing to do more to achieve its ambitions of a collaborative approach between trusts.
Strengthening external relationships was also identified as an area for improvement for Leicester, Leicestershire and Rutland, Mid and South Essex, and Kent and Medway ICBs.
Financial performance remains a significant concern for several ICBs, said the report.
It described Lancashire and South Cumbria ICB as having had ‘a very challenged year’ and the ICB has been working with the recovery support programme (RSP).
NHS England listed a number of ICBs in RSP that were making progress but still had work to do. These include Hampshire and Isle of Wight, which entered the RSP in 2023, Devon, and Shropshire, Telford and Wrekin ICBs.
And it said financial grip and control in Staffordshire and Stoke-on-Trent remains a challenge, with actions taken so far proving less effective than hoped.
The leadership assessments come amid major structural change for ICBs following NHS England’s instructions last March to cut their workforce by 50% by October 2025.
Since then, they have gone through a range of changes to meet this requirement, including plans to cluster or merge.
