Harness existing expertise and start as soon as possible

Why this matters

With the repeated reorganisation of the commissioning layer of the NHS in recent years - most recently in 2022 with the transition from clinical commissioning groups (CCGs) to ICBs – the institutional knowledge and experience from these reorganisations can be vital to the effective implementation of ICB mergers but risks being lost for ICBs preparing to merge in 2026/27 through ongoing restructures in ICBs. 

What works in practice

Organisational memory linked to previous reorganisations of commissioners has been crucial to effective implementation of these first ICB mergers. ICB staff were able to stand up similar arrangements to the closing down of CCGs and establishment of ICBs, even if the context was different. Strengthening peer support and learning can help mitigate this. 

The short timeframe for delivery also meant that preparing for the transition as soon as possible was important to give themselves the best chance possible of success. 

Advice from ICB leaders

• Regional peer groups and peer support are invaluable for sense-checking approaches throughout the transition.
• Start early on preparations for delivery – even before updated national guidance is shared.