We wanted to provide a further update on organisational development affecting NHS Integrated Care Boards (ICBs) and how this impacts on Gloucestershire.

As we shared in a background briefing on 12 May, we have provisionally chosen a preferred cluster partner – Bristol, North Somerset and South Gloucestershire ICB.

We were required to develop and submit a high-level plan to the regional NHS England team by the end of May. This sets out NHS Gloucestershire ICB’s intentions (mirroring a submission from Bristol, North Somerset and South Gloucestershire ICB) and a headline financial summary.  It does not include detail on specific functions and staffing at this stage.

It was based on an assumption that a decision on our preferred clustering option would be made and implemented by the autumn and that we would formally merge by 1 April 2026, although due to considerations such as local authority boundary changes this could be April 2027.

It included:

  • an introduction to Gloucestershire – a brief summary covering demographics and health needs.
  • information on the options appraisal and how we arrived at our preferred option of clustering with BNSSG (including the intention to meet the running cost requirement of £18.76 per head). Our previous briefing on 12 May described the process and design criteria.
  • summary information on partner engagement to date and what they have told us is important to them such as the value of Place based working and community partnerships for services and support, acknowledging the direction of local government reorganisation, the potential for skills development and maintaining Gloucestershire’s financial integrity (both Gloucestershire and BNSSG delivered their financial plans for 2024/2025).
  • headline risks associated with the roadmap timescales. This includes transition for services (including potential transfer of some services), maintaining financial stability, the importance of engagement and involvement of staff through change, continuing engagement with stakeholders, the need for clarity on the process for appointing Chair, CEO and other senior appointments and confirmation of support arrangements for Voluntary and Compulsory redundancy schemes.
  • transition arrangements (to support the above).

Next steps

NHS England regional team will work with us to test the assumptions in our submission before an overall South West plan is submitted to the national team for review and moderation.

Our current understanding is that we will receive feedback by the end of June, when we expect formal agreement to cluster, prior to any merger.

Prior to any merger, the current ICBs will continue to be legal entities in their own right. However, NHS England have relaxed the rules on making joint appointments to multiple organisations. The first thing to do will be to appoint a Chair and Chief Executive. We are awaiting national guidance on this process.

We will then need to design an Executive structure for the cluster and detailed work will progress on functions and structures. We will continue to work with teams as we formulate plans and we will want to ensure we get things right and we have the best possible arrangements in place for the people of Gloucestershire now and into the future. We will also need to take into account emerging national and regional models and work closely with providers who may take on some key functions in the future.

While the overall pace of change is rapid, these changes will take time. We do not expect to be able to consult staff and teams on structures until August at the earliest.

As a leadership team, we will remain focused on delivering the best possible outcomes for our population and for our dedicated staff and teams working in Gloucestershire.

We remain committed to maintaining and developing our strong partnerships with all local stakeholders, during and beyond this period of transition.

We will continue to keep you informed of developments in the weeks ahead.