Derby and Derbyshire, Nottingham and Nottinghamshire and Lincolnshire ICBs have announced they are to cluster together as part of plans to cut costs.
It follows moves by ICBs in the East of England and South West regions who revealed similar plans last month.
A spokesperson from Derby & Derbyshire, Nottingham & Nottinghamshire and Lincolnshire ICBs said the cluster plan was the ‘current planning assumption’, and would involve the ICBs sharing teams and operating models.
However, they added this was not a final decision on merging.
The spokesperson said: ‘It is our current planning assumption that Derby & Derbyshire, Nottingham & Nottinghamshire and Lincolnshire ICBs will “cluster” together to develop shared teams and operating models.
‘This is not a final decision about merging the organisations and formalising this mutual intention is a complex process, involving numerous partners and organisations and there are many details to finalise yet.’
This move means that six of the smallest 10 ICBs have now declared plans to cluster. Cornwall and the Isles of Scilly, Bath and North East Somerset, Dorset, Somerset, Gloucestershire and Lincolnshire ICBs all serve less than 1 million people.
The other ICBs serving less than 1 million people are Shropshire, Telford and Wrekin ICB with a population of 519,648, Northamptonshire ICB with 813,203, Frimley ICB with a population of 812,459, and Herefordshire and Worcestershire ICB with 816,242.
Frimley ICB recently told Healthcare Leader that the ICBs across the South East were meeting to explore the ‘potential benefits of aligning plans’.
A spokesperson said: ‘Talks are also taking place with other neighbouring ICBs impacted by possible changes to existing boundaries.’
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.
In May 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.
The chief executive of NHS England, Sir James Mackey, revealed last month that the variation in spend per ICB per head currently ranges from £49 to just less than £21 per head.
ICBs were told to submit plans to meet these cost reductions to their regional teams by 30 May.
Next steps for Bristol ICB
This week, Bristol, North Somerset and South Gloucestershire ICB revealed that they had submitted their plan that involved clustering with Gloucestershire ICB, which included intentions and a headline financial summary. However, it did not include details on specific functions and staffing.
It said they will receive feedback on the plan by the end of June, when they ‘expect formal agreement to cluster, prior to any merger’.
In a statement, it added: ‘Prior to any merger, the current ICBs will continue to be legal entities in their own right. However, NHS England have relaxed the rules on making joint appointments to multiple organisations. The first thing to do will be to appoint a Chair and Chief Executive. We are awaiting national guidance on this process.
‘We will then need to design an Executive structure for the cluster and detailed work will progress on functions and structures. 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 for the people of Bristol, North Somerset and South Gloucestershire now and into the future. We will also need to take into account emerging national and regional models and work closely with providers who may take on some key functions in the future.’
It added that they do not expect to consult staff and teams on structures until August ‘at the earliest’.
Last month, the Suffolk and North East Essex ICB board revealed the East of England’s plans to go from six ICBs in the region to three.
In its board papers, the ICB outlined the difference between clustering and merging. Clustering, it said, would involve making joint senior appointments, forming combined teams and joint committees. However, ICBs would remain separate legal entities, each having to fulfil their statutory functions and manage their financial position.
Merging however, would mean abolishing the ICBs and establishing a new ICB, with a new board and new ICP.
