The transfer of specialised commissioning services and staff to ICBs has been delayed until next year, NHS leaders have confirmed.
NHS England has written to ICB leaders to say that ‘subject to parliamentary approval’ commissioning functions for programmes including vaccinations, primary care services, and health and justice services will transfer to ICBs from April 2027.
This marks a delay on NHS England’s plans, approved last year, for ICBs to become responsible for commissioning all vaccination services, and most screening services, from next month.
Staff members ‘currently delivering these functions’ will transfer, ‘subject to consultation’, to ICBs in April 2027 as well, the letter added.
The letter, signed by Matthew Style, director general for system development at NHS England and the Department of Health and Social Care (DHSC) and NHS England’s interim director general for finance Elizabeth O’Mahoney, said that they expect ICBs to have the ‘full leadership role’ for commissioning these services through 2026/27 in preparation for the transfer.
Sarah Walter, director of integrated care at the NHS Confederation, said ICBs will need to take on some additional responsibilities for managing these services from April.
She added: ‘For primary care services this will include vaccinations, screening, and child health information, although many ICBs already deliver some of these programmes.
‘However, the reorganisation of ICBs over the past year has affected capacity, and some commissioning expertise – particularly in primary care – has been lost.
‘The delay in transferring additional commissioning staff to ICBs will prolong this challenge and without adequate support from NHSE regional teams, there is a risk that the management of some primary care services could be affected. This may also impact how primary care services are commissioned in future.’
Primary care services were already delegated to ICBs in July 2022 and April 2023 and ‘accountability’ will transfer from NHS England to ICBs subject to legislation from April next year, the letter added.
Pulse PCN’s sister title Pulse has asked NHS England why the transfer has been delayed.
NHSE had previously said that giving ICBs responsibility for commissioning more of the care provided to their population is ‘a key enabler’ for integrating care and improving population health, giving them the flexibility to join up more pathways of care and better align incentives.
The letter added that when NHS England is abolished, DHSC will take over responsibility for commissioning all highly specialised services such as high secure mental health services, all services for the armed forces community, and certain components of screening services that are already commissioned at a national scale.
The DHSC will maintain a national framework of standards, service specifications and clinical commissioning policies to support those services that are set to transfer to ICBs.
It will also maintain the management of national primary care functions including the Performers List for England and national contracts.
The latest update comes after ICBs were urged last year to take a ‘bold’ approach to planning services, including decommissioning services from GP practices and looking ‘beyond traditional healthcare providers’.
A version of this story first appeared in Healthcare Leader’s sister title Pulse.
