Working With ICBs in Mental Health: What Providers Need to Get Right
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Integrated Care Boards (ICBs) now sit at the centre of mental health commissioning, system planning and performance oversight. For providers, working effectively with ICBs is no longer about occasional contract management meetings — it is about operating as a reliable, transparent system partner.
This expectation is closely linked to mental health service models and pathways and underpins requirements around quality, safety and governance. Providers that understand how ICBs function, and how decisions are made across systems, are better positioned to deliver stable services and retain commissioner confidence.
Understanding the role of ICBs in mental health
ICBs are responsible for planning, funding and assuring NHS mental health services at system level. While delivery may sit with Trusts, local authorities or independent providers, the ICB retains overall accountability for outcomes, quality and value for money.
From a provider perspective, this means ICBs are not simply funders — they are strategic partners with a long-term interest in service sustainability, demand management and risk reduction.
What ICBs expect from mental health providers
ICBs consistently expect providers to demonstrate:
- clear operational grip and reliable performance reporting
- early escalation of risks, capacity pressures and safeguarding concerns
- alignment with system priorities and transformation plans
Providers that wait until formal reviews to raise issues are often viewed as higher risk than those who engage openly and early.
Day-to-day engagement and communication
Effective ICB working happens through routine, structured engagement rather than ad-hoc contact. This typically includes:
- regular contract and performance review meetings
- participation in system-wide forums or delivery boards
- named operational and strategic leads on both sides
Clear communication routes reduce duplication and prevent misunderstandings when services are under pressure.
Managing performance and assurance collaboratively
ICBs expect providers to use data as a tool for improvement, not just compliance. This involves sharing:
- activity and access data
- outcomes and recovery indicators
- learning from incidents, complaints and audits
Providers that proactively interpret data and propose corrective actions are typically trusted with greater flexibility.
Escalation and risk management
Mental health systems operate under constant pressure. ICBs expect providers to escalate:
- sustained staffing shortages
- capacity constraints impacting safety
- patterns of increased crisis presentation
Timely escalation enables system-level mitigation rather than reactive intervention.
Why strong ICB relationships matter
Providers with strong ICB relationships are more likely to:
- be involved in service redesign and pilot activity
- retain contracts during system change
- secure commissioner support during periods of instability
Ultimately, effective ICB working underpins service continuity, staff confidence and improved outcomes for people using mental health services.
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