Complete guide to NHS Integrated Care Systems (ICS) in the UK — ICS structure, ICB governance, provider collaboratives, place-based partnerships, population health management, and ICS software.
There are 42 ICSs in England, each serving 1-3 million people. ICSs control £170 billion of NHS funding. Hospitals must align their strategy with ICS priorities to secure funding and thrive in the new system.
ICS Structure
| Component | Role | Accountability |
|---|---|---|
| Integrated Care Partnership (ICP) | Broad partnership including local councils | Sets health and care strategy |
| Integrated Care Board (ICB) | Statutory NHS body, controls budget | Accountable to NHS England |
| Place-based partnerships | Local level (borough/district) | Delivers integrated care locally |
| Provider collaboratives | Groups of NHS trusts | Delivers services at scale |
| Primary Care Networks (PCNs) | Groups of GP practices | Delivers primary care at neighbourhood level |
| Health and Wellbeing Boards | Local authority statutory body | Sets local health priorities |
ICS Priorities for Hospitals
- Population health management: Manage health of attributed population, not just episodes of care
- Health inequalities: Reduce disparities in access, outcomes, and experience
- Integration: Coordinate care across primary, secondary, community, and social care
- Financial sustainability: Deliver services within ICS budget allocation
- Workforce planning: Plan workforce across ICS, not just individual trusts
- Digital transformation: Shared care records, interoperable systems, NHS App
- Prevention: Shift focus from treatment to prevention and early intervention
- Net zero carbon: Contribute to ICS carbon reduction targets
How Hospitals Must Adapt to ICS
| Old Model | ICS Model | What Hospitals Must Do |
|---|---|---|
| Individual trust strategy | ICS-wide strategy | Align trust strategy with ICS priorities |
| Activity-based payment | Population-based budget | Focus on prevention and efficiency |
| Siloed services | Integrated services | Partner with community and social care |
| Compete with other trusts | Collaborate via provider collaboratives | Share resources and standardise |
| Own patient data | Shared care records | Share data across ICS via FHIR APIs |
| Individual workforce | ICS workforce planning | Share staff, rotations, training |
Frequently Asked Questions
- What is an NHS Integrated Care System (ICS)?
- An ICS is a partnership of NHS organisations and local councils that plan and deliver health and care services across a region. There are 42 ICSs in England, each serving 1-3 million people. ICSs aim to integrate care, improve population health, reduce inequalities, and improve financial sustainability.
- What is an Integrated Care Board (ICB)?
- An ICB is the statutory NHS body within each ICS that controls the NHS budget and commissions services. ICBs replaced CCGs (Clinical Commissioning Groups) in July 2022. Each ICB has a chair, CEO, and board including local authority representatives. ICBs are accountable to NHS England.
- What are provider collaboratives?
- Provider collaboratives are groups of NHS trusts working together at ICS or sub-regional level to deliver services more effectively. They may manage a service line across multiple trusts (e.g., specialised mental health, cancer). Provider collaboratives enable resource sharing, standardisation, and economies of scale.