North Central London ICB and North West London ICB are exploring merging as a way to reduce costs.
In a bulletin from the North Central London chief executive, Frances O’Callaghan, it was revealed that NHS England national and regional leaders had ‘indicated their support’ for this ‘direction of travel’ after reviewing the ICBs’ cost savings plans that were submitted at the end of May.
‘This is the start of a journey to explore whether against the backdrop of the cost reductions, there is enough alignment between the two organisations to make a merger viable and attractive,’ Ms O’Callaghan said in the bulletin.
However, she added that conversations were still ‘at an early stage’ and that she knew the news may be ‘unsettling’ and ‘add to the sense of uncertainty in the short-term’.
‘Our options appraisal will consider whether bringing the two organisations together under a shared leadership team could give us the organisational muscle required to deliver in our role as a strategic commissioner and to work within a complex provider landscape for the benefits of circa 4.5m local residents in North London, as well as national and international patients,’ she said.
Merging the two ICBs would make it the largest ICB in the country, with a population of 1.7 million in North Central London and 2.8 million in North West London. That would mean a combined population of 4.5 million.
The next largest ICB would be Greater Manchester, with 3.2 million people, followed by North East and North Cumbria, with 3.2 million.
Many of the ICBs that have announced merging or clustering plans so far have been smaller ICBs, with six of the smallest 10 ICBs announcing 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.
Frimley ICB, which is another ICB serving less than 1 million people 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.’
Healthcare Leader also understands that Bedfordshire, Luton & Milton Keynes (BLMK) ICB is to merge with Cambridgeshire and Peterborough ICB and Hertfordshire.
Previously, it had been reported that the East of England ICBs were considering three different models for their ICB configuration. The option including this merger is model C, which would have the other ICBs as Greater Essex ICB and Norfolk and Suffolk ICB.
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.
