Major ICB plans to cut one in six posts

Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board’s proposals would reduce its full-time equivalent posts from 489.6 to 404.  

This is a 17.5 per cent reduction overall, but its executive team could be cut by a third (see table at bottom). Its chief clinical information officer, a joint role with the South East region created last autumn, is among those at risk, HSJ understands.

On the other hand, BOB plans to increase the size of its strategy and partnerships team.

Consultation documents seen by HSJ reveal the ICB would also significantly cut down its functions and delivery to reduce costs, with resources shifted to providers, and the ICB performing a “light-touch co-ordination role” rather than performance management under the new structure.

Consultancy firm Moorhouse is overseeing the consultation, HSJ understands.

NHS England has told ICBs to cut running costs  – most of which is their staff – by 30 per cent by 2025-26, with at least 20 per cent delivered in 2024-25. 

However, BOB ICB needs to “work towards a 40 per cent reduction in total operating costs by redesigning our structure to reflect the budget available”, the documents said, adding its current set-up exceeds its budget by £13.5m.

HSJ understands there are some concerns within the ICB that cutting clinical posts – which they said would be spread across clinical teams – will lead to loss of knowledge and skills.

The ICB is also considering transferring resources to system partners. For example, services for mental health, learning disabilities and vulnerable people could be transferred to provider collaboratives, while “transformation” functions could be transferred to place-based partnerships, with the ICB only being involved when transformation is “truly system-wide”. 

It is aiming to redesign structures and “reduce the size of functions” where possible to focus on core purpose and “stop some functions adding limited value”. 

The ICB will “move from tactical assurance and performance management“ to “focusing on system-wide themes” and “driving strategic improvement”, the documents added. 

BOB ICB told HSJ in a statement that, like other ICBs, it has been “reviewing and redesigning its operating model” by “carefully working through the ICB functions and thinking through at what level of the system they can best be delivered”, such as through developing place-based partnerships and provider collaboratives. 

It continued: “The staff consultation proposes a restructure of BOB ICB and a reduction in posts as part of this programme of work; it is a proposal and subject to change once feedback has been considered.”

The ICB is required to engage trade unions at formal consultation because the change could involve more than 20 redundancies.