NHS policy and governance

Integrated care boards are entering a period of significant structural change. Following recent direction from NHS England, ICBs are being asked to operate at much lower running costs, while continuing to deliver their statutory responsibilities. By December 2025, ICBs are expected to reduce their running and programme costs by 50 percent. To help achieve this, most systems have already agreed to work in clusters, with further change possible from April 2026. Why ICBs are clu