NHS changes briefing 4 April 2025 - BNSSG

Changes to the NHS in BNSSG

1. Update as of 4 April 2025

On 1 April 2025 all NHS Integrated Care Boards (ICBs), Trusts and Foundation Trusts received formal written communication from Sir James Mackey, Chief Executive of NHS England.

The letter, which is published on the NHS England website, sets out further detail regarding expectations on how we will work together through 2025/26 to lay the foundations for reform.

The correspondence acknowledges that ICBs will have a critical role to play as future strategic commissioners in shaping the 10 Year Health Plan. It also recognises that reducing ICB running costs by 50% will be a challenge, but that these reductions will need to be delivered quickly, and that particular consideration should be given to functions where there is duplication.

NHS Bristol, North Somerset and South Gloucestershire ICB Board came together in a board seminar yesterday (Thursday 3 April) to review and discuss the letter and review our current operating model and how it aligns with proposed changes. Our ICB executive team will also be coming together next Wednesday (9 April) to hold further discussions and reflections.

The Chief Executives of the seven ICBs across the South West are also continuing to work together to try and explore how we can align functions and feed into the development and thinking regarding a new operating model for ICBs. As previously stated, although there is no confirmation of mergers, they cannot be ruled out and the recent NHS England letter highlights that cost reductions will in part rely on cross-system arrangements going forward.

2. What next

NHS England are still developing a functional output ‘Blueprint’ for a model ICB and what they believe to be a reasonable running cost per head of the population for ICBs. It is anticipated that this will be shared with ICBs by the end of April.

Once this is received, ICBs will be expected to use this information to create bottom-up plans within the finances available. These plans will need to be ready for sign-off by NHS England Regional Directors by the end of May, with implementation expected within Quarter 3.

We will continue to send an updated briefing and publish this on our website on a fortnightly basis.