Agenda item

To provide committee members with an update on the reconfiguration of the NCL and NWL ICB merger.

Sarah Morgan, Chief People Officer opened the item explaining that it was this time a year ago the process began for reducing costs of the ICB by fifty percent and process to merge NWL and NCL as a strategic commissioner. The merger will take place by 1 April 2026 subject to approval by NHS England to create West and North London Integrated Care Board and a £12 billion commissioning budget and 48% of London’s population.

The model ICB blueprint will include continued commissioning for outcomes around strategic commissioning from the workforce perspective and the development of the Neighbourhood Workforce Strategy and work in health. Operating model relationship, need greater caution around this and no gaps within the transition process. The ICB’s role is to commission services for the population and ensure there is strategic direction and this has been an important role. Relationship with providers will be changing especially in terms of holding to account. The Close down board meeting will be on 24March with the merged inaugural meeting on 1 April. The public board meetings in July will cover their Engagement Strategy to shape where they are as an organisation to move forward.

Councillor Revah enquired if change would mean a named relationships with key people for the borough will change? The Councillor expressed concerns about how things will work locally and in response it was explained that it was dependant on the issue for example some issues will be relevant for the ICB whilst others will be the Integrator etc. Councillor Revah requested a list of who would be the key people are once things are established and it was confirmed it could be done. Action.

Councillor White made the comment that if the Integrators will work differently in different boroughs in terms of contacts and the reality will be that some things work better in different boroughs depending on the area. The Chief People Officer concurred that NCL and likewise NWL will have strengths and weaknesses in the way things are done, and the next steps will be to learn from the merged organisation.

Rod Wells, Haringey KONP expressed that from both a patients and governance point of view there needs to be a list of the different responsibilities from April 2026 with the significant changes. Some clarity on responsibility of ICB, Integrators would also be helpful. Rod Wells also enquired if the two JHOSC’s would remain separate to which the Chair confirmed they would be.

Councillor Atolagbe enquired about what work and areas will be compromised as described in the paper. The councillor asked if they had a rough figure of how many would go for voluntary redundancy and would the saving make an impact and then this will be followed by recruitment and what impact would that then have? The Chief People Officer explained that focus will be on statutory requirements but there have been cuts in other areas and recruitment will be from for internal staff from a ringed pool of people. It was explained work was still underway and so they didn’t know where the gaps were. Councillor Connor expressed that Trusts will now essentially be marking their own homework and the Chief People Officer explained that this was already happening. Action: A future paper marking out who has responsibility for various elements between the Trusts, ICB and NHS England will be useful.

Councillor Clarke expressed that’s she was surprised given the meeting of the merged board is to be held on 1 April, knowledge of who will sit on the board is still unavailable. The Chief People Officer explained that there are conversations with the local authorities taking place regarding who will sit on the Board amongst the thirteen boroughs.

Councillor Connor enquired about continuing healthcare funding and different boroughs allocated different amounts and whether the ICB will be allocating all the boroughs the same amount with a one size fits all approach? Sarah Morngan explained that this was an ongoing piece of work looking across the 13 boroughs and how to split it as lead by the Chief Nurse. The Committee heard that they had not worked out the impact of Fair Funding Deal.

The Chair summarised that the JHOSC had an overview but the detail with regards to how the Integrators will work with the Health and Wellbeing Board, how information is fed to the top level to influence the strategic commissioning are amongst the areas the JHOSC will seek further assurance on going forward. Understanding the operational model in more detail will also be key. From the perspective of the JHOSC another key consideration is how we ensure we get the right people into meetings in order to ensure accountability and where the JHOSC sits with the governance structure.

The Chair of the Joint Partnership Board enquired over when budget is being considered for service, if guidelines are used for levelling up or is it a different approach. The Chief Strategy Officer explained that this is the area to come back to, nationally the funding formula is based on deprivation and the core offer for services such a mental health and community services is across the board for all authorities. Following the core offer they will then look at what else can be done for specific communities and hence working with the VCS. Additional funds have also been allocated for hitting waiting lists and A&E targets.