Peter Collins (Chief Medical Officer, NHS Devon Integrated Care Board) presented an update on the Government’s proposed reforms to NHS England and the restructuring of Integrated Care Boards (ICBs), and discussed:

a)    The Government had signalled its intention in March 2025 to abolish NHS England and restructure the commissioning and organising functions of the health service, including ICBs. This included a requirement for ICBs to reduce their running costs by 33%;

b)    As part of the national specification, smaller ICBs were expected to align and merge with neighbouring systems. NHS England had approved the proposed clustering of Devon, Cornwall and the Isles of Scilly ICBs into a single entity. Work was underway to appoint a new Chair, Chief Executive and Executive Team, and to design the structure of the new organisation;

c)    Restructuring was intended to improve strategic commissioning, with a focus on understanding population needs and holding services to account for delivery. Members were assured that there should be no immediate impact on service delivery for residents, and that the changes were not expected to cause delays in treatment.

In response to questions, the Panel discussed:

d)    There was no expectation of increased funding beyond annual national growth allocations. Devon ICB currently received support funding from NHS England to manage its deficit, but future support was not guaranteed;

e)    The 33% reduction applied to the ICB’s running cost budget, not the total commissioning budget of £3 billion. The running cost budget was calculated nationally at £18.76 per head of population, recently increased to £19 due to inflation. For Devon, Torbay and Plymouth (population approx. 1.24 million), this equated to a running cost budget of approximately £23 million;

f)     Councillors queried the potential for shared services and economies of scale across Devon and Cornwall, including IT, payroll and procurement. It was clarified that the creation of ICBs had not followed a uniform model, and functions varied between systems. This presented an opportunity for ICBs to ensure that the teams were focused on the important matters and that important functions were transferred back to providers in the long term;

g)    Kevin Orford (Chair of Devon ICB) had chosen not to stand for reappointment due to personal reasons. Expressions of interest had been invited for the new Chair of the merged Devon and Cornwall ICB, and an announcement was expected shortly;

h)    Councillor Aspinall commended the staff of the ICB for their hard work and professionalism during the restructuring process, noting the challenges of a 33% reduction in staffing;

i)     Peter Collins offered to return to the Committee at a future meeting to provide further updates and engage with elected members on the implications of the reforms.

The Panel agreed to:

1. Note the update on NHS reforms and restructuring;

2. Request a future update once the new ICB structure and leadership were in place;

3. Thank Peter Collins and the ICB staff for their continued work and commitment during the transition.

Action: Officers to invite Peter Collins to return to the Committee once further details of the ICB merger and leadership appointments are confirmed.