As we come to the closing days of 2019, HSJ reveals its most read stories on integration and system change for the year.

Three new integrated care systems announced

NHS England designated three more integrated care systems in June. These were: Buckinghamshire, Oxfordshire and Berkshire West; The North East and North Cumbria; and South East London. They joined the 14 already existing ICS, leaving 28 sustainability and transformation partnerships remaining.

Two execs step down as mega-merger trusts rebrand

In July, it was revealed the medical and finance chiefs of a board overseeing the mega-merger of three trusts in Essex had stepped down. Basildon and Thurrock University Hospitals Foundation Trust, Southend University Hospital FT and Mid Essex Hospital Services Trust also revealed they would rebrand as Mid and South Essex University Hospitals Group once the merger was completed.

CEO chosen for new mega-trust


Steve Warburton

Also in July, Steve Warburton, incumbent chief executive of Aintree University Hospital Foundation Trust, was picked to lead the provider which was being created through the trust’s merger with Royal Liverpool and Broadgreen University Hospitals Trust. RLBUHT’s chief executive Aidan Kehoe had stepped down earlier in the year. 

Mapped: Sweeping CCG mergers planned for next year

Over the summer, HSJ mapped out the 86 clinical commissioning groups proposing to merge in 2020. 

Plan to break up CCG rejected

Sandwell and West Birmingham GPs rejected a proposal to break-up Birmingham and Solihull CCG in June, with 70 per cent of GP members voting against the proposal. This was despite Birmingham’s local medical committee describing the status quo as a “disaster for West Birmingham GPs”. 

All of England to become ICS by 2021

As part of January’s NHS long-term plan, it was revealed all of England was expected to be covered by ICS by 2021. The document described the systems as “central to the delivery of the long-term plan”.The long-term plan also said nationwide ICS “will typically involve a single [clinical commissioning group] for each ICS area”.

Manchester devo health chief quits

Jon Rouse, DG for social care at DH

Jon Rouse

Jon Rouse, the leader of Greater Manchester’s devolved health and care system, announced in November that he was leaving his post to join a local authority. He became the first chief officer of Greater Manchester Health and Social Care Partnership in 2016. 

Seven CCGs to merge into three under new proposals

In May, it was announced Sussex’s seven CCGs were planning to merge into three. The move would also result in nearby East Surrey CCG moving from Sussex and East Surrey STP to the Surrey Heartlands ICS. 

Batch of CCG mergers approved for next year

A slew of CCGs received the thumbs up to go ahead with their merger plans in October. Although NHS England did not reveal a full list of which mergers had been approved, rejected or delayed, 15 CCGs confirmed to HSJ that their mergers had been given the green light. At least 55 groups had applied for merger approval ahead of a September deadline.

Eight CCGs to merge to make ‘really tricky decisions’

In September, eight CCGs in Lancashire and south Cumbria revealed plans to merge into one organisation. Gary Raphael, executive director of finance and investment for the region’s ICS, said the planned merger would help the area make “some of the really tricky decisions to meet the requirements of the long-term plan”.