National Announcement – Recap
As part of the announcements last week, NHS England will be abolished and will be fully integrated into the Department of Health and Social Care (DHSC). The size of Integrated Care Boards (ICBs) will also be reduced by around 50 per cent, affecting both running and programme costs, although we do not have clarity on this yet. These reductions are, we understand, required by the start of quarter three (October 2025). It is understood that Trusts will also be required to reduce managerial costs, including corporate services and clinical posts that are not patient facing.
The NHS operating model is being clarified, but we do know that a key focus for ICBs will be strategic commissioning.
ICB CEOs across the South East met this week and agreed the benefit of all six ICBs working collaboratively, particularly with regards to the reduction requirements announced last week. Key headlines from the meeting included:
- We collectively acknowledge this is an uncertain time for our colleagues working within ICBs and, therefore, we are committed to working quickly together, designing potential ways forward, complementary, with the national direction of the vision and functions of ICBs.
- We will describe an approach, which includes collaboration of ICBs and a re-arranging how we work - only by doing both will the changes required be delivered.
- We will define options for consideration by chairs, boards, NHSE and our senior leadership teams in ICBs.
- We acknowledge that to deliver the 50 per cent reduction required, we need to propose radical options which will be best shaped by our own teams and look at solutions across the ICBs.
- We acknowledge that, in some cases, our language and descriptions of our functions currently vary between and within ICBs, so we need to review this to establish a collective understanding and collective language/descriptions.
How will we approach this at BOB ICB?
Structure of the ICB Transformation Programme to reshape the ICB
An ICB Transformation Programme Board has been set up with Chief Officers, with Interim Director of Organisational Development (Joe Smart) and Associate Director of Communications and Engagement (Sarah Adair) in attendance. This programme group will meet on a weekly basis.
This group will be supported by a senior leaders group convened by Joe and Sarah; this is currently in the design stages but will be discussed at the new BOB ICB Senior Leaders Network next week and further details will be shared with staff on how you can get involved and shape work as it progresses.
Working with you
We recognise that these changes will raise questions and concerns. We are committed to maintaining open lines of communication with you and will provide regular updates as more information becomes available and as we move through the programme of work to respond to the Government's ask.
We have listened and taken on board all the feedback given about the previous change programme and we are responding to the feedback presented in the 2024 staff survey. In recognition of your feedback, we have developed three ‘design principles’ to help guide us in these uncertain times. They are:
1. Over communicate – we will share as much information as we can, as soon as we can and make sure information is accessible in a range of places and formats.
2. Focus on wellbeing – we will look after ourselves and our teams, and use face to face events such as team meetings to check in and support each other.
3. Co-design the future - as much as possible with staff in the ICB, we will involve as many people as we can in the future design of the ICB.
An extraordinary meeting of the Staff Partnership Forum (SPF) will be held on Friday (21/3) to discuss the programme approach and how we engage with staff representatives and the wider staff group.
We will reinstate bi-monthly staff briefings and will have a regular email newsletter. We will design our staff communication and engagement with input from staff. Feedback from Monday's all staff briefing and the internal communications survey will inform the approach.
Recruitment
As the announcements were made the ICB paused all recruitment. The Executive Team has now established several principles for recruitment during the ICB transformation process starting right away.
- First, all new recruitment must be approved by the Establishment Control Panel.
- Roles will only be filled under very exceptional circumstances and with full agreement from the Executive Team.
- Offers already made to prospective employees will be withdrawn unless the role is deemed business critical, and the start date is within two weeks.
- In addition, all planned interviews are to be cancelled unless they fall under specific exceptions.
- Essential roles within Continuing Health Care that are patient-facing and could prevent further costs to the BOB health and care system will still be appointed.
- Similar considerations will be made for roles within Medicines Management on an individual basis.
- The Thames Valley Cancer Alliance has been instructed by NHSE to pause all recruitment activities, pending clarification from NHSE.
- There will be a focus on interim or fixed-term cover for business-critical roles, as agreed by the Executive Team through organisational change meetings.
- Wherever possible, a partnership approach should be taken to cover vacancies, such as collaborating with other ICBs and system partner organisations.
- Decisions regarding roles currently out for recruitment will be communicated to the recruiting manager by the relevant Chief Officer.
- It is also noted that individual candidates may now choose not to accept offers due to the current circumstances.
If you are in the process of recruiting please read more detail on the principles, and template communication to be used with candidates in this document.
Staff Zone
The Staff Zone has a new webpage called 'ICB Transformation Programme' here:
ICB Transformation Programme | BOB ICB
It will be kept up to date with key information and documents relating to the Transformation Programme, including links to the All Staff Briefing Teams recordings and slide decks.
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