Integrated care boards (ICBs) have been told to cut their running costs to £18.76 per head of population.

This will include all ICB running costs and programme pay, but will exclude pharmacy, ophthalmic and dental (POD) services and specialised commissioning delegation.

It comes as draft documents have circulated outlining how ICBs might delegate some functions to neighbourhood health teams.

The cost savings must be achieved by the end of Q3 in 2025/26, the document said.

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And ICBs must submit their plans to do so to regional leads by 5pm on 30 May 2025.

The blueprint, initially published by the Health Service Journal, said it had been developed with a group of ICB leaders from across the country to provide a ‘consistent understanding of the future role and functions of ICBs’.

However the document, which NHS England confirmed to Pulse PCN had been shared across the ICBs, is a draft only and will be updated based on feedback, according to an NHS England spokesperson.

It also stated that it has been published ‘without the corresponding picture of what neighbourhood health will look like or the role of the centre or regional teams’.

‘Given the pace at which this work has been developed over recent weeks, our initial focus has been system led design. We are now sharing it more widely for discussion and refinement and will be setting up engagement discussions over the coming weeks,’ the document said.

It set out the functions that will be retained, expanded and transferred from ICBs in the coming months. It suggested that primary care operations and transformation, including primary care, medicines management, estates and workforce support would be transferred to neighbourhood health providers.

However, the commissioning of neighbourhood health will remain a function of ICBs and is one that will grow over time, as will the role of health inequalities and inclusion expertise.

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The document said ICBs will hold the ‘capacity and capability to routinely disaggregate population and performance data to surface health inequalities, generate actionable insights, drive evidence informed interventions and build intelligence to guide future commissioning and resource allocation decisions’.

Glen Burley, NHS England financial reset director and accountability director, said the draft blueprint was 'the first step in a joint programme of work to reshape the focus, role and functions of ICBs'.

And he said it was linked to NHSE's work to reshape regions, the centre and the operating model more generally.

'There is still much more work to do but we are sharing the blueprint to help ICBs design their future state and develop their plans to achieve the 50% reduction in running costs,' he said.

NHS England confirmed that the draft document would be updated with further details based on feedback.

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'We are seeking to reduce the management costs of the NHS so that more money can be spent on the frontline. This won’t be achieved by simply moving functions to different organisations – instead ICBs need to be working together to merge functions to cut duplication as part of their plans to make significant cost savings,' Mr Burley added.

A version of this article was first published on our sister title Pulse PCN.