ICBs must ‘increasingly look beyond’ traditional healthcare providers in their role as strategic commissioners, NHS England has said in a new framework.
The strategic commissioning framework, published this week, said ICBs should recognise the value that community assets can bring to improving health, wellbeing and health inequalities, and that investment should follow this.
The framework said: ‘To sustain this shift [to neighbourhood health], investment should follow prevention opportunities to focus resources on interventions that deliver long-term health benefits, reduce cost and alleviate pressure on the wider health and care system; with accompanying longer-term outcome measures detailed in the ICB strategy and population health improvement plan.’
It added that where a movement of resource is required, that a ‘clear prioritisation methodology’ should be developed.
‘All partners should be given full transparency on resource movement and for what purpose and a provider impact analysis should be undertaken,’ it said.
‘Transition of funding may need to be over several years. Systems should consider where medium-term financial planning can support the investment decision-making process.’
The framework highlighted the importance of data in strategic commissioning decisions, including the need to insight-led population health management.
‘ICBs should apply a single, consistent system-wide PHM approach to segment and risk stratify populations based on complexity and forecasted resource, using the tools provided by NHS England,’ the framework said.
It added that ICBs should use the Federated Data Platform (FDP) to support this.
Commissioning arrangements
Under the framework, ICBs will be able to commission providers to deliver outcomes, rather than specific services, to give flexibility to providers. They will also be able to give providers a ‘formal role in commissioning decision-making’ if they want.
‘This could involve establishing a committee or sub-committee of the ICB that includes provider representatives, or a joint committee between the ICB and providers,’ the framework said.
However, it added that the success of the different approaches would be ‘highly contingent’ on system maturity, provider skills and capability, accountability and strong relationships.
It added that new capabilities created from upcoming changes to the system, such as commissioning and oversight of the new integrated health organisations (IHO), will be added to the ICB role.
Support for ICBs
A timeline for the new role of ICBs was also outlined, with a requirement to undertake baseline assessments against the framework in March 2026 to ‘inform the development support they need’.
All ICBs will then be expected to adopt the approach outlined in the framework from April, with a development programme to be put in place to support this.
It stipulated that each ICB should be ‘actively developing’ an intelligence function which will be in place by March 2027 to support evaluation.
It said: ‘To support evaluation, each ICB will set an evaluation approach by March 2027, supported by its intelligence function and working with other partners as appropriate.
‘The approach must encompass both quantitative and qualitative data, including feedback from staff (ICB, provider and other partners), communities and people using services.
‘Findings will contribute not only to the ICB’s understanding of the effectiveness of interventions within a local setting but also, through peer learning, the evidence base available to all ICBs. From this ICBs will learn, adapt and grow as confident commissioning organisations.’
It comes as deadlines have also been set for ICBs to submit their five-year plans to deliver the ambitions of the 10 year plan.
Within its Medium term planning framework, NHS England said ICBs will be expected to make their first submissions, which will include a three-year plan, before Christmas. Full five-year plan submissions will then be due in early February, with sign off expected in March.
Key milestones for the strategic commissioning approach
- Strategic commissioning framework released – November 2025
- Strategic commissioning capability toolkit issued – January 2026
- ICB’s development and approval of integrated needs assessment, ICB strategy and population health improvement plan – January 2026
- ICB baseline assessment against the framework carried out – March 2026
- Launch of strategic commissioning development programme – April 2026
Source: NHS England
