Recommendation 23

We heard of one element of an ICB that currently has 40 people in place but which will have one person discharging that responsibility from April 2026. We are not convinced that this reorganisation has been thought through properly and resourced adequately, since if ICBs currently do not have the ability or capacity to perform their existing functions, it will be a bigger challenge with 50% fewer staff.48 The planned reduction in resource across all ICBs risks undermining good performing ICBs while limiting the ability of poor performing ICBs to improve.49 NHSE agreed to come back to us with answers to all our questions on ICBs.50 We have heard much that has left us deeply concerned that a 50% reduction in ICB’s workforce will hamper their capacity to carry out both their existing role and any new responsibilities related to frailty. 45 Q 22; Letter from NHS England, 6 November 2025 46 NHS England, Model Integrated Care Board Blueprint 47 Q 22 48 Qq 17-20 49 Qq 17-19 50 Q 23 14