The interim guidance from NHS England lays out how NHS leaders and organisations will operate with their partners in integrated care systems from April 2022


NHS England and NHS Improvement have published Interim guidance on the functions and governance of the integrated care board (ICB).

Following several years of locally led development and based on the recommendations of NHS England and NHS Improvement, the government has set out plans to put integrated care systems (ICSs) on a statutory footing. NHS England and NHS Improvement are publishing guidance and resources to support this transition.

The new interim guidance sets out the headlines for how NHS England will ask NHS leaders and organisations to operate with their partners in ICSs from April 2022, and guidance in respect of what the employment commitment is, its application in practice, and how it affects people.

Key takeaways from the new guidance include:

  • ICBs will be statutory organisations that bring the NHS together locally to improve population health and establish shared strategic priorities within the NHS, connecting to partnerships across the ICS
  • each ICB must be set out its governance and leadership arrangements in a constitution formally approved by NHS England and NHS Improvement
  • while preparations for these new arrangements are being made, all NHS organisations must continue to operate within the current legislative framework retaining any governance mechanisms necessary to maintain operational delivery (including patient safety, quality, and financial performance).

Lou Patten, Chief Executive of NHS Clinical Commissioners and ICS Network lead at the NHS Confederation, commented: ‘The NHS Confederation, including NHS Clinical Commissioners and NHS Employers, has been heavily involved in partnerships with NHS England and NHS Improvement and trade unions via the Social Partnership Forum to develop this new HR technical guidance.

‘We are very grateful for the considerable input of members, and while mindful that central guidance addressing the needs of every system is very difficult to achieve, this has been a really good collaborative effort that seeks to bring clarity as to the way forward.

‘Many senior commissioning leaders face uncertainty themselves regarding their futures, but they are committed to ensuring the effective transfer of staff, teams, and functions to their new ICS-based roles.’

Integrated care systems

ICSs are partnerships of health and care organisations that come together to plan and deliver joined-up services and to improve the health of people who live and work in their area. They exist to achieve four aims:

  1. improve outcomes in population health and healthcare
  2. tackle inequalities in outcomes, experience, and access
  3. enhance productivity and value for money
  4. help the NHS support broader social and economic development.

According to NHS England, collaborating as ICSs will help health and care organisations tackle complex challenges, including improving the health of children and young people, supporting people to stay well and independent, acting sooner to help those with preventable conditions, supporting those with long-term conditions or mental health issues, caring for those with multiple needs as populations age, and getting the best from collective resources so people get care as quickly as possible.