Yesterday saw the publication of NHS England and NHS Improvement’s ICS Design Framework. Subject to the passage of legislation, the framework describes how ICSs will be established as statutory bodies, collaborating with their partner organisations to achieve the ambitions of the Long Term Plan.

The basic form of a statutory ICS will comprise an ICS NHS body and an Integrated Care Partnership, the latter formed as a joint committee of the ICS NHS Body and each Local Authority within the ICS footprint with public health functions. Below system level, ICSs will have scope to design placed-based partnerships which best meet local needs, but the framework describes a series of potential models. A model constitution is also to be produced to support ICSs in defining their governance arrangements.

Over the coming days, we will offer our analysis and insight into the proposals. However, based on an initial overview the framework describes many of the key features of the future NHS landscape:-

• The respective roles of the new ICS NHS Body and ICS Partnership.
• The composition of the ICS NHS Body board including non-executives, required executive roles and members drawn from NHS providers, general practice and local authorities.
• The role of trusts as partners of an ICS, including provider collaboratives and delegation of functions to providers.
• Finance and budgets, both at system and place level, including system financial envelopes and shared duties of financial balance across the ICS NHS body and providers.
• Further detail on the proposed NHS provider selection regime.
• Progressive reallocation of commissioning functions from NHS England to ICSs.
• A timeline for transition, including recruitment to senior roles by the end of September 2021, in anticipation of new arrangements commencing in April 2022.

This represents a fundamental reworking of the NHS’s organisational framework, but done in such a way as to preserve the value of what has already been achieved by emerging ICSs.

For a discussion of the implications of the framework for your system or place, please contact Hamza Drabu and Alistair Robertson.