ICBs in the North of England hired more staff than those in the South in the 2023/24 financial year, according to an exclusive freedom of information (FOI) investigation.
The FOI request from Healthcare Leader, to which all 42 ICBs responded, asked ICBs to detail the number of hires they had made between when ICBs were first set up in July 2022 and April 2024, and for the 2023/24 financial year.
It found that the 40 ICBs who answered the question had made 8,395 hires between July 2022 to April 2024, 4,082 of which were made during 2023/24.
Those in the North of England had made more hires than those in the South, with Lancashire and South Cumbria, Greater Manchester, Humber and North Yorkshire and Cheshire and Merseyside four out of the top five ICBs for hiring in 2023/24 (see box for details).
| ICB | How many hires has the ICB made over the 2023/24 financial year? |
| Lancashire and South Cumbria | 406 |
| Greater Manchester | 259 |
| Birmingham and Solihull | 226 |
| Humber and North Yorkshire | 223 |
| Cheshire and Merseyside | 201 |
It comes as Greater Manchester was also revealed to have been the ICB that has seen the highest fall in staff numbers across its ICB in 2023-24.
Lancashire and South Cumbria ICB’s chief executive, Kevin Lavery, said their hiring of 406 staff, which is almost half 48%) of its total staff numbers in the 2023/24 financial year, was due to moving roles in-house that had previously been undertaken by the commissioning support unit (CSU).
He said: ‘The rise in the number of staff working for the ICB is largely driven by in-housing a wide range of functions from the CSU, including finance, communications, HR, and customer complaints, and primarily the Transfer of Undertakings (TUPE) of Continuing Healthcare (CHC) staff, which saw 150 staff transferred and other posts recruited to by the ICB.’
However, he added that the move had reduced running costs and that they ‘have clear evidence of the positive impact’.
‘The ICB is continuing to work collaboratively to ensure the NHS funding across Lancashire and South Cumbria provides best value for money and we are focused on improving outcomes for our patients, the public and our staff,’ he said.
A spokesperson for Humber and North Yorkshire ICB also said they had moved some functions in-house and that comparing their May 2024 position with data from the previous year is ‘misleading’ as it would not be comparing ‘like-for-like’.
They said: ‘Over the last 18 months, NHS Humber and North Yorkshire ICB has taken on responsibility for hosting several functions on behalf of other systems as well as in-housing some services previously delivered through other mechanisms. This has led to an increase in staff directly employed by the ICB.’
They added: ‘The ICB is committed to and is in the process of implementing organisational changes necessary to ensure the functions of the organisation are delivered as efficiently as possible, fit for the future, whilst meeting our financial obligations including continuing to operate below the agreed allocation for running costs.’
ICBs have been tasked with cutting their running costs by 30%, with at least 20% of that to be delivered by 2024/25.
Healthcare Leader recently revealed that ICBs have saved £25m through redundancies since they were set up in July 2022.
A spokesperson from Birmingham and Solihull ICB added that it had taken a full review of staffing levels to ensure its structure is ‘fit for purpose within the constraints of reduced running cost allocations’.
‘The results of this review has seen new models now implemented across the organisation, and includes the distribution of ICB staff into our provider collaboratives which ensures commissioning decisions can be made closer to the point of care delivery – an ambition set out within our inception framework,’ they said.
‘Our increase in staff relates, in large part, to our ICB taking on host responsibilities for pharmacy, optometry and dentistry staff from NHS England as part of its delegation of functions, and thanks to efficiencies made elsewhere and in other ways across our organisation, we have been able to continue to recruit to key roles.’
Greater Manchester also referenced the bringing together of 12 separate organisations when the ICB was formed in July 2022 and has since ‘continued to develop into a single, unified organisation’. ‘During this period of ongoing development, enhanced workforce movement has taken place for a wide range of reasons. These have included transferring employees into NHS GM from other NHS bodies and Trusts (post July 2022) which has accounted for over half of the “new hires” during this period,’ the spokesperson said.
The FOI request also asked how many resignations each ICB had over the past financial year (2023-24), which was split more evenly across the country.
In total, there were 2,705 resignations across the 41 ICBs who answered this question, although Sussex ICB added that there was an additional 16 retirements that were not included in its figure.
Greater Manchester ICB had the highest number of resignations (148), followed by West Yorkshire ICB (112) and Bath and North East Somerset ICB (102).
On average ICB resignation numbers represented 11% of their staff list, only Bath and North East Somerset ICB saw resignations above 20% of its total workforce for the financial year (21%).
A spokesperson for Greater Manchester said it had seen a ‘higher level of workforce movement than what would be anticipated for a steady state organisation’.
It said factors that had contributed to this included that Greater Manchester ‘has implemented two mutually agreed resignation schemes, transferred a number of employees into other NHS organisations, a number of fixed term contract arrangements have come to a natural end and a number of employees retired’.
A spokesperson for North West London ICB said: ‘ICBs have been required to reduce their running costs by 30%. Staff costs represent over 90% of our running costs.
‘As one of the largest ICBs in the country, bringing together eight CCGs into a new organisation in July 2022, and creating a new purpose as a new organisation, the NWL ICB will inevitably have one of the largest number of resignations in order to achieve that objective and retain its status as one of the highest performing ICSs.’
West Yorkshire, Bath and North East Somerset and Cheshire and Merseyside have been approached for comment.
The FOI was issued on 2 May and all responses were received by 26 July.
| ICB | How many hires has the ICB made over the 2023/24 financial year? (headcount) | How many resignations have there been in the last financial year (2023/24)? (headcount) |
| Lancashire and South Cumbria | 406 | 53 |
| Greater Manchester | 259 | 148 |
| Birmingham and Solihull | 226 | 80 |
| Humber and North Yorkshire | 223 | 78 |
| Cheshire and Merseyside | 201 | 80 |
| Nottingham and Nottinghamshire | 162 | 82 |
| West Yorkshire | 154 | 112 |
| Hertfordshire and West Essex | 146 | 61 |
| Surrey Heartlands | 128 | 63 |
| North East and North Cumbria | 105 | 80 |
| North West London | 101 | 102 |
| Herefordshire and Worcestershire | 100 | 34 |
| Buckinghamshire, Oxfordshire and Berkshire West | 100 | 64 |
| Norfolk and Waveney | 96 | 82 |
| Coventry and Warwickshire | 91 | 67 |
| South West London | 90 | 75 |
| Sussex | 87 | 72 |
| Bath and North East Somerset, Swindon and Wiltshire | 86 | 102 |
| North East London | 85 | 82 |
| South Yorkshire | 78 | 73 |
| Hampshire and the Isle of Wight | 78 | 89 |
| The Black Country | 76 | 80 |
| Somerset | 76 | 32 |
| Gloucestershire | 75 | 61 |
| Shropshire and Telford and Wrekin | 74 | 25 |
| Cambridgeshire and Peterborough | 73 | 67 |
| South East London | 73 | 59 |
| Dorset | 72 | 62 |
| Mid and South Essex | 70 | 54 |
| Northamptonshire | 68 | 15 |
| Staffordshire and Stoke-on-Trent | 63 | 20 |
| Frimley | 61 | 28 |
| Lincolnshire | 49 | 55 |
| Bristol, North Somerset and South Gloucestershire | 45 | 54 |
| Cornwall and the Isles of Scilly | 44 | 46 |
| Leicester, Leicestershire and Rutland | 42 | 34 |
| Kent and Medway | 36 | 82 |
| Devon | 31 | 89 |
| North Central London | 30 | 60 |
| Derby and Derbyshire | 22 | 60 |
| Bedfordshire, Luton and Milton Keynes | Provided FTE not headcount | 47 |
| Suffolk and North East Essex | Provided FTE not headcount | Provided FTE not headcount |
| Total | 4082 | 2662 |
