I am writing to provide all colleagues with an update in terms of local ICB changes; obviously colleagues will be receiving updates but their content appears somewhat circumloquacious. However, in one way this is justified; given the obvious potential implications for colleagues working in ICBs, a degree of sensitivity is appropriate and no formal decisions have yet been made. This is not an easy time to be working within an ICB yet colleagues there continue to be expected to undertake a complicated set of responsibilities.
As far as the LMC understands it local plans are as follows, with the caveat that these have yet to be approved by NHS England. However, ICBs are pre-marking their own homework and only submitting what they expect to be “greenlighted”.
Frimley ICB is being abolished: the substantial part of the ICB, East Berkshire, is being incorporated into Berkshire, Oxfordshire and Buckinghamshire ICB [BOB] which currently covers West but not East Berkshire. The two ICBs already share the same Chair. Farnham and Surrey Heath, currently a “Place” within the ICB, but which are geographically within the administrative County of Surrey, are to be incorporated into Surrey Heartlands ICB.
The LMC understands the ideology is not to describe a merger taking place, but instead that a new ICB represents unification and the creation of a new organisation. Indeed one ICB Chair stated in a somewhat, it might be thought, grandiose way that:
“This is a pivotal moment for our system. We are […] seizing the opportunity to design a new organisation that can act as an incubator for new models of integrated care”.
NHS Sussex and Surrey Heartlands ICBs have submitted plans to become one ICB. A single ICB covering both the current NHS Sussex and the County of Surrey will be coterminus with the three LMCs, Surrey and East and West Sussex, which will create opportunities for more harmonised commissioning arrangements for GPs in these areas. However, in terms of the ICB functions, clearly there will be significant retrenchment, the outcome of which will only become apparent later this year.
In London there remains a rumour that of the five current ICBs, South West and South East London ICBs may unify. However, I believe this is on the less likely end of the reality scale. A definitive decision once again lies with NHS England.
On a wider England perspective it appears the current 42 ICBs will reduce to, probably, between 25 – 30, with a dramatic change in their workforce, responsibilities and functions. An insight into what might happen is contained within the accompanying document [Model Integrated Care Board: BluePrint]. This should be considered faction – a genre in which real events are used as a basis for a fictional narrative. Obviously as more emerges in terms of ICB changes I will update further. Like many colleagues, the LMC is also hoping to separate reality from myth in terms of “Neighbourhoods” but that will require more investigation.