Model Integrated Care Board Blueprint
The newly released Model Integrated Care Board Blueprint outlines a significant shift in how ICBs will operate within the NHS landscape. The document clarifies the future role of ICBs as “strategic commissioners” focused on population health improvement.
The blueprint positions ICBs primarily as "healthcare payers" responsible for setting evidence-based population health strategies and maximising value from available resources. Core functions include understanding local context through data analytics, developing long-term population health strategies, delivering these strategies through payer functions and resource allocation, and evaluating impact through continuous oversight.
Notably, the document proposes several functional changes, with certain responsibilities growing within ICBs (like population health management, data and analytics), others being selectively retained and adapted, and some transferred to providers or regions over time (digital and technology leadership and transformation, primary care operations and transformation).
Perhaps most interesting is the emerging concept of "neighbourhood health providers" mentioned throughout the blueprint. While details remain limited, this approach might have been influenced by international models.
US Accountable Care Organizations (ACOs) share notable similarities with the proposed neighbourhood health providers: both prioritise population health management, integrated care pathways, and financial accountability for health outcomes.
However, a fundamental distinction is in purchasing authority: ACOs typically have direct purchasing power and financial risk-sharing arrangements with payers, whereas the blueprint clearly separates these functions. Neighbourhood health providers appear focused on service delivery, while ICBs retain the strategic purchasing and commissioning functions. This separation could provide clearer governance but might introduce coordination challenges not present in the ACO model.
Singapore's Regional Health Systems integrate acute and primary care within geographical regions, more closely resembling the blueprint's emphasis on place-based care coordination. We can also see influences from Sweden's healthcare regions which operate with strong local autonomy, New Zealand's Primary Health Organisations with their emphasis on preventative care, and Denmark's healthcare regions which have successfully shifted care from hospitals to primary and community settings. Germany's Gesundes Kinzigtal model, with its focus on prevention and integrated care contracts, also shares similarities with the blueprint's vision.
Digital health technologies will be crucial enablers of the vision set out in the blueprint. Population health management platforms can provide the data analytics capabilities ICBs need for risk stratification and predictive modelling. Interoperable electronic health records will facilitate the longitudinal tracking of patient journeys across care settings that the blueprint prioritises. Remote monitoring solutions can support the shift from hospital to community settings, while AI-powered tools can help identify optimal resource allocation and evaluate intervention outcomes. The explicit mention of the NHS Federated Data Platform as "crucial" underscores the centrality of digital infrastructure in achieving the blueprint's aims.
As we await the 10 Year Health Plan expected next month, this blueprint offers valuable insights into the direction of travel. It’s clear that going forward we’ll need both innovative thinking and pragmatic execution.