Understanding the Role of ICBs in NHS Commissioning and System Leadership
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Integrated Care Boards (ICBs) now sit at the centre of NHS decision-making. For providers delivering NHS-commissioned services, understanding how ICBs operate is essential to maintaining contracts, influencing system priorities and securing future opportunities.
ICBs are not just commissioners in the traditional sense. They are system leaders responsible for aligning NHS organisations, local authorities and providers around shared outcomes.
This sits alongside wider expectations explored in procurement processes and working with commissioners.
What Integrated Care Boards are responsible for
ICBs hold statutory responsibility for:
- Planning and commissioning NHS services
- Managing NHS budgets across their footprint
- Improving population health outcomes
They are accountable for system performance, not individual contracts alone.
How ICBs differ from legacy commissioning models
Unlike previous CCG-led approaches, ICBs:
- Focus on collaboration rather than competition
- Operate across wider geographical footprints
- Expect providers to work across organisational boundaries
This requires a shift in how providers engage.
What this means for commissioned providers
Providers are increasingly assessed on their ability to:
- Align services with system-wide priorities
- Support pathway integration
- Work constructively with multiple partners
Service delivery is judged in a broader system context.
Day-to-day implications for operational teams
Operationally, this often means:
- Greater data and reporting requirements
- More system-level meetings and forums
- Closer scrutiny of outcomes and flow
Providers need internal capacity to manage this engagement.
What good looks like to ICB leaders
Strong providers can clearly articulate:
- How their service supports system objectives
- Where they add value beyond contract minimums
- How they collaborate with partners
This builds trust and long-term confidence.
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