NHSE must allow councillors to sit on integrated care boards, says government

Previously, NHSE had issued a draft constitution for ICBs which listed among those “disqualified” from sitting on it “a member of parliament, or member of the London Assembly” and “a member of a local authority in England and Wales”.

Job adverts for ICB chair designates (see attached example), nearly all of whom were appointed last year, stated: “Elected officials including MPs and members of councils are excluded from the NHS ICB chair role.”

NHSE’s integrated care system design framework, issued last summer, was not definitive, but said an ICB’s chair and non-executive members would “normally not hold positions or offices in other health and care organisations within the ICS footprint” and said the ICB member nominated by local authorities “will often be the chief executive of their organisation or in a relevant executive-level local authority role”, rather than a councillor.

Objections were raised in the Lords last month, led by Labour peer Philip Hunt, to the exclusion of councillors, and to the fact NHSE had made the decision and gone ahead with appointments before the Health and Care Bill had been passed by Parliament.

Lord Kamall, the government’s health spokesman in the Lords, said last night: “I have noted the strength of feeling in the house on the issue of, and draft guidance on, elected councillors being appointed to integrated care boards.

“I discussed this matter with NHS England and can confirm that it will revise its draft guidance to remove the proposed blanket exclusion of local authority members sitting on integrated care boards.

“I am informed that, although ICB members from local authorities are normally likely to be officials, local councillors will not be disqualified for selection and appointment to an integrated care board.”

It is unclear exactly what will be permitted or banned once the guidance is revised, but asked by HSJ, NHSE said the latest change would mean it would be possible for councillors to sit as local authority partner members on the ICB board, but would not mean they can become ICB chairs or non-executive members.

ICS Partnership boards — which will set strategies which ICBs must follow, under the Health and Care Bill — are expected to have several councillors, and likely be chaired by one. 

Lord Hunt told HSJ: “I’m delighted that we have reversed this bizarre decision of NHSE to keep councillors off ICBs. But there is no reason why councillors can’t be chairs of ICBs and we will fight this battle at report stage of the bill. If government are serious about integration, local authorities must be full partners with the NHS.”

Rules on governing bodies of clinical commissioning groups, whose powers ICBs are taking over, prevent councillors from being members. However, councillors sat on some primary care and care trust boards, including occasionally as chair, until they were abolished about a decade ago. The last time councillors routinely sat on NHS bodies was the early 1990s on district health authorities.