An ICB is a subregional level of NHS administration (and finance) in England.
There are 42, which became entities on 1st July 2022. Before the government decided to introduce ICBs, something called a Clinical Commissioning Group (CCG) did a similar role (though there are important differences).
ICBs usually cover 1-2 million people – i.e. roughly ‘county-sized’.
They formed out of a merger of local CCGs – with local acute and mental health hospitals, ‘community trusts’ and general practices (it is hoped) – and most other aspects of the NHS in England.
The administrative level above ICBs are 7 NHS England Regions, i.e. there are currently (rather illogically) 3-11 ICBs per region.
The NHS in Scotland, Wales and Northern Ireland, works independently from England, so do not have ICBs.
There were 200ish CCGs. They were smaller, covering 150-500k people, i.e. 3-5ish per subregional/county/ICB-sized entity.
Also CCGs acted as a ‘commissioner’ or ‘purchaser’ (i.e. buyer) of healthcare from a ‘provider’ (i.e. seller; hospital, GP, mental and community health for example).
In other words, CCGs were not part of hospitals etc. Whereas for an ICB, the commissioner/purchaser and provider are the same thing.
So. ICBs are partnerships of organisations that provide healthcare to a larger area and population. Their aim is to coordinate services and to plan in a way that improves population health and reduce inequalities between different groups.
They may have advantages as it will lessen competition between hospitals, encourage co-operation, and reduce the tension between groups within the NHS.
In 2025, the government announced the abolition of NHS England. As part of this change, ICBs are being merged to form ‘ICB clusters’. There will be 26, forming on either 1st April 2026, or 1st April 2027.
In this ‘new ICB world’, 35/42 are being merged into 19, and 7/42 are being left alone – making a total of 26.
In the ‘new ICB system’, there will be (more logically) 3-5 ICBs (or clusters) per NHS Region.
[“Yes, it is confusing .. and not very interesting”. Ed]
We have described what is an integrated care board (ICB). Time will tell if they truly integrate and deliver better healthcare.
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