Integrated Care Boards (“ICBs”) are already operating in shadow form. However, Clinical Commissioning Groups have now been formally abolished by the Integrated Care Boards (Establishment) Order 2022 (“the 2022 Order”), which was made under provisions in the Health and Care Act 2022 (“the 2022 Act”). The National Health Service (Areas of Integrated Care Boards: Appointed Day) Regulations 2022 provides that ICBs come into effect from 1 July 2022.
At the same time, keys parts of the National Health Service Act 2006 have been amended to reflect the new duties on ICBs as set out in the NHS 2022/2023 priorities and operational planning guidance. Each Integrated Care System (ICS) will have an Integrated Care Board (ICB), a statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS. When ICBs are legally established, clinical commissioning groups (CCGs) will be abolished.
The NHS England website states that “NHS Digital has been working closely with NHS England and NHS Improvement (NHSE/I) to explore how to apply the changes across digital systems and services, ensuring they’ll continue to run smoothly and supporting the wider health system through the transition phase”.
It remains to be seen how much ICBs will differ from Primary Care Trusts or indeed the Regional Health Authorities that preceded them. They primarily operate as local NHS commissioning bodies although the presence of providers as part of the ICB (as was the case with PCTs) means that they should focus more on integrated care. The jury is clearly out as to whether this is just a further NHS rearrangement that will not deliver any real change on the ground or represents a serious shift towards more holistic and joined up NHS. However, the policies which led to the 2012 Act of running the NHS as near a competitive market as possible and giving GPs a near monopoly of local commissioning power are now consigned to the status of being embarrassing uncles in the family of the new NHS.
Landmark has a specialist team of counsel who are advising on all aspects of the new arrangements. Please contact us if we can assist further on structural changes to the NHS.
David Lock QC is a barrister, has co-authored NHS Law and Practice with Hannah Gibbs and is a visiting professor in practice at the London School of Economics.