Bristol, North Somerset and South Gloucestershire (BNSSG) ICB has revealed plans to merge with Gloucestershire ICB as part of efforts to make cuts to the system.
In a statement, BNSSG ICB said it plans to ‘cluster’ with Gloucestershire ICB later this year, with a view to a formal merger from April 2026 or April 2027, once any changes to local authority boundaries have been settled.
The ICB said there had been a transition group established with other ICBs in the south west of England, supported by the regional team at NHS England, and that BNSSG’s executive team had also established a transition group that meets weekly.
It said discussions on these groups had ‘progressed’ on the potential for joint working through ICB ‘cluster arrangements’.
It said: ‘This is because we will be required to work on larger footprints in the future to meet our strategic commissioning responsibilities set out in the Model ICB blueprint and our running cost reductions.
‘As an ICB executive transition group, we have been looking at various options, including across different geographies.’
As a result of those discussions, it said the provisional view was for BNSSG ICB to cluster with Gloucestershire ICB later this year.
‘At a meeting of south west ICB and regional leaders on Wednesday, further discussions took place on the potential shape of ICBs for the future across the region, using a detailed design criteria to help ensure alignment with the Model ICB blueprint,’ it said.
‘We can now confirm that following those discussions, the provisional view is for Bristol, North Somerset and South Gloucestershire Integrated Care Board to cluster with Gloucestershire Integrated Care Board.’
It added that these plans to cluster would be included in the ICB plans that need to be submitted to regional teams by 30 May.
BNSSG and Gloucestershire ICBs have respective population sizes of 1,059,770 and 675,447, meaning their combined population would be 1,735,217.
The update added that further work would be done this summer on ICB functions and structures, while working with regional colleagues.
‘We will continue to work with teams as we formulate plans and we will want to ensure we get things right and we have the best possible arrangements in place,’ it said.
It comes after Gloucestershire ICB’s chief executive, Mary Hutton, announced her retirement from the role in December, with an intention to step down in spring 2025.
ICBs were told in March they must cut their running costs by around 50% by October 2025 and to focus on reducing duplication when making cuts.
Last week it was revealed that the ICB running cost envelope will be reduced to £18.76 per head, and that this target must be reached by the end of Q3 in 2025/26.
Assessing ICBs
NHS England has this week opened a consultation on the NHS Performance Assessment Framework, which also has a deadline of 30 May.
Details of the performance framework were revealed to the NHS England board at the end of March, suggesting that ICBs were to be ‘segmented’ from July.
However, the consultation proposal has amended this previous framework to reduce the number of metrics that calculate a segment decision, and made them focused on short term priorities.
It said this was due to the ‘fundamental shifts in operating context in the last 12 months with a reappraisal of the role of ICBs and the centre as well as any changes set out in the upcoming NHS 10 Year Plan’.
It added: ‘We believe it is appropriate to clarify the focus of oversight for 2025/26 to fewer core measures that align with these priorities as well as a high-level view of quality of care. This will allow the NHS to focus this year on the stated recovery priorities.
‘Longer-term transformation measures that align to the NHS 10 Year Plan and the redefined roles of ICBs and the centre will be introduced from 2026/27.’
Director of the NHS Confederation’s ICS Network, Sarah Walter, responded to the consultation: ‘This framework sets out a series of proposals to try to address the significant operational and fiscal challenges facing the health service. Our members will welcome fewer targets, something which we have been calling for consistently to minimise the bureaucratic burden when applying the performance regime.
‘But it is vital that we strike the right balance right between recovery and reform – dropping targets could result in NHS performance being assessed purely on ‘here and now’ metrics such as A&E waiting times or waiting lists. This could leave out measures that would judge how successfully the NHS is implementing the reforms necessary to put it on a sustainable long-term footing.’
She added that it was important that the short timescale on consulting and finalising ‘does not create unintended consequences for staff and patients’.
‘We also have concerns about the proposals to hold ICBs accountable for all the organisations in their system while providers are not held to account for the part they have to play in system performance. This calls into question the ability of systems to achieve the three shifts,’ she said.
