Integrated Care Boards (ICBs) are responsible for planning, commissioning and managing local NHS budgets and services. In 2025, NHS England (NHSE) announced 50% reductions in running costs for ICBs to become more efficient. Headcount reductions would also be made, with steps being taken to merge and cluster ICBs to reduce their total number. These measures are part of wider reforms, including plans to merge NHSE into the Department of Health and Social Care (DHSC) by April 2027. Government expects to abolish 18,000 administrative posts across DHSC, NHSE and ICBs, and to save £1bn/yr by the end of the Parliament.
The PAC has a long-standing interest in the delivery of NHS reform, and has questioned officials multiple times since the reforms were announced on the future role of ICBs, the timetable for changes, and the arrangements for funding redundancies. The PAC’s 2026 report on supporting people with frailty outside hospitals expressed deep concerns that the changes DHSC and NHSE are making to ICB responsibilities are insufficiently thought through and resourced. The report noted that ICBs have an important role in the future NHS, but expressed diminishing confidence that they will be able to perform this role effectively.
In autumn 2026, the National Audit Office (NAO) publishes its report on restructuring ICBs, examining the planned changes to them.
Proceeding from the NAO’s report, the PAC will hear from senior DHSC and NHSE officials, with likely topics including the impact of the oncoming changes to ICBs’ performance and capability to deliver on their responsibilities; progress in making the changes and management of staff reductions; and government’s oversight of whether the restructure is increasing efficiency.
The Committee will welcome written evidence on these issues in due course.
Please look at the requirements for written evidence submissions and note that the Committee cannot accept material as evidence that is published elsewhere. The Committee decides what information to publish and how. You can request anonymity or confidentiality when you send evidence, but it is for the Committee to say whether it will agree.It may treat submissions confidentially, even where you have not requested this.
Please note that the Committee’s inquiry cannot assist with individual cases. If you need help with an individual problem you are having, you may wish to read the information on Parliament’s website about who you can contact with different issues.