Agenda item

The Board will receive an update on the current position of the Integrated Care Board.

The Chief Executive at Leicester, Leicestershire and Rutland Integrated Care Board (ICB) gave an update to the Health and Wellbeing Board. The following was noted:

·       A presentation was given providing an overview of the significant changes taking place across Integrated Care Boards nationally. It was noted that two main factors were driving this change. Firstly, at a national level, NHS England had set out a clear vision for the future focus of the NHS, with a shift from analogue to digital delivery and an emphasis on understanding local populations and how services were performing. The role of ICBs across the country was being reshaped to focus on improvement, value, and the effective use of resources, enabling providers and voluntary sector organisations to work more effectively across systems.

·       The Government had required all ICBs to reduce running costs and corporate resources, not in relation to healthcare provision but to operational budgets. The local system covering Leicester, Leicestershire and Rutland, together with Northamptonshire, was expected to achieve around a one third reduction. This would be supported by more streamlined structures, improved efficiency, and a shift towards strategic commissioning.

·       There were currently eleven ICBs across the East Midlands, and all had reached similar conclusions that in order to remain viable and operate effectively, they would need to work in partnership with neighbouring systems. This would include clustering arrangements between two or more ICBs to share expertise and align workstreams.

·       Work was underway to develop single leadership and governance arrangements across these new structures, while maintaining a strong focus on neighbourhoods and places to ensure that local needs continued to be addressed. It was emphasised that the next twelve to eighteen months would be a period of transition, with systems responding to national requirements while maintaining strong local relationships and delegating as much responsibility as possible to place-based work.

·       The intention was to bring together leadership teams to guide the development and delivery of this new model. There remained some uncertainty regarding timelines and national funding, but there was a strong commitment to ensuring that Leicester and its local partners retained a clear focus within the wider arrangements.

In discussion with Members it was noted that:

·       That this was the start of a wider journey and that further discussions would be required as the proposals developed. Concerns were expressed about the size and diversity of the proposed cluster and the potential impact on Leicester residents. Members stressed that the city’s voice needed to be clearly heard and recognised within the new arrangements.

·       Members asked whether the new cluster would have a single leadership team and how the unique health needs of Leicester would be represented. Questions were also raised about whether the Health and Wellbeing Board would have a role in shaping the structure and direction of the cluster.

·       It was explained that work was taking place to bring together the boards of the two ICBs to appoint a chair and leadership group made up of executive and non-executive members. Although leadership structures would be streamlined, the funding allocations and statutory responsibilities for each ICB would remain separate, ensuring that the needs of each local population continued to be reflected. The changes were described as a partnership approach rather than a formal merger, with the aim of identifying where efficiencies could sensibly be achieved while maintaining a strong local focus.

·       Members were advised that the Health and Wellbeing Board would continue to play a role within the new arrangements, working alongside other place-based partnerships across the wider cluster geography to shape and manage priorities. The starting point would remain local, built from neighbourhood and place level upwards, with efficiency changes only where appropriate.

·       It was highlighted that regular engagement was already taking place across work programmes, including children’s services, healthy weight, and other cross-boundary issues, where collaboration with neighbouring areas could bring benefits.

·       Members acknowledged the strong commitment of staff working across the system to support their local populations and emphasised the importance of maintaining this focus throughout the period of change.