Health and care sector latest developments

Pioneers of reform: realising a new vision of ICB strategic commissioning

Service reform and ‘strategic commissioning’ may be ‘brought to a standstill’ by steep cuts to integrated care boards, leaders have warned.

An NHS Confederation report shared exclusively with HSJ also comments on slashing ICBs’ running costs in half by October, saying: ’The 50 per cent reduction in running cost allowance for ICBs will need to be managed carefully or it risks bringing to a standstill any efforts by ICBs and their partners to deliver on strategic commissioning and the government’s plans for NHS reform.’

NHS England and the government have in recent months said the future of ICBs is to transform services by working as ‘strategic commissioners’ – a message repeated by NHSE’s new chair and CEO in recent weeks.

The NHS Confederation analysis was commissioned by NHSE before the merger was announced two weeks ago. It looks at how strategic commissioning can be developed in the next two years, drawing on discussions with ICB and other system leaders.

Health and social care secretary Wes Streeting said last year that ICBs would be ‘pioneers of reform’, leading ‘the transformation of care’ through strategic commissioning and a new neighbourhood health service. 

Sarah Walter, integrated care system network director at the NHS Confederation, told HSJ that the cuts — landing only five months after Mr Streeting’s comments — were at odds with the ‘vital role [ICSs] have to play in delivering the government’s three healthcare shifts’.

“Coupled with the inevitable structural changes that will accompany this, the cuts risk jeopardising the government’s reforms,” she said.

“The government and NHS England must now make sure that the core role and function of ICBs is clear before decisions are taken on where the cuts can be made, ensuring that form can follow function. ICSs then need to be supported to deliver on that renewed focus.”

The NHS Confederation report also outlines overhauls of finance, planning, and pathway design needed to make strategic commissioning a success. It will also require better data skills and make leaders less reliant on “looking upward for direction”, it says.

It proposes six ‘shifts’ in commissioning, which echo the three shifts in care proposed by government: 

• Reactive to proactive – Proactively addressing populations’ health needs
• Downstream to upstream – Shifting care towards ‘anticipatory interventions in the community’, with investment following ‘prevention opportunities’
• Competition to collaboration – Replacing ‘organisational silos’ with a partnership with local government and the voluntary, community, and social enterprise sector
• Transactional to transformational – ‘Moving from beyond just managing contracts for episodes of care to transforming services and commissioning services for population cohorts’
• Cost to value – Achieving return on investments, not just managing costs
• Compliance to leadership – Empowering local leaders to lead, innovate, and listen, rather than ‘just looking upwards for instruction’

Weight loss drug faces resistance among ICBs 

The private healthcare company Oviva is facing resistance from ICBs over its online weight-loss drug service, with commissioners arguing the treatment could cost hundreds of millions of pounds annually and potentially ‘bust’ their budgets, HSJ finds.

Under national ‘right to choose’ rules, ICBs must fund NHS treatments from providers with existing contracts, which creates financial challenges as commissioners struggle to manage unexpected costs.

NHS England has allocated only £26 million for weight loss drug treatments in 2025-26, with a fixed budget that won't adjust for actual treatment take up, leaving ICBs to manage additional expenses themselves.

UK experts warn of emerging pathogen threats

UK health experts have identified 24 families of deadly pathogens, including those causing Ebola, plague, and bird flu, that require urgent research due to their biosecurity risk.
 
The UK Health Security Agency (UKHSA) has developed a new tool to highlight viruses and bacteria that lack vaccines, tests, or treatments, especially as climate change alters their spread. It will be updated at least once a year 
 
UKHSA’s chief scientific officer Dr Isabel Oliver stressed the need for investment in disease prevention, particularly as mosquito- and tick-borne viruses expand.
 
The report does not predict the next pandemic but urges preparation. Experts warn that a novel measles-like virus could be far deadlier than COVID-19.
 
The findings serve as a call to action to ensure the UK is better equipped for future outbreaks.

Poorest areas in England linked to five-year drop in life expectancy

Living in England’s poorest communities can shorten your life by nearly five years, according to a new report by the Centre for Ageing Better.
 
The charity warns of a ‘deadly postcode lottery,’ with northern urban areas faring worst. Life expectancy gaps reach ten years for men and eight for women between areas like Blackpool and affluent districts.
 
Campaigners are calling for an older people’s commissioner and urgent government action to tackle deepening health inequalities.

Police warn domestic abusers driving rise in suicide

Police have pledged to investigate more domestic-abuse-linked suicides, as a new report reveals 98 victims in England and Wales died by suspected suicide in 2023–24.
 
According to The Guardian, these deaths have now outnumbered intimate partner killings for a second year. Officers admitted past investigative failures and will now treat more unexpected deaths as potential manslaughter.
 
Campaigners and police leaders stress the need for better awareness of coercive control and stronger agency collaboration to prevent further tragedies.

Three trusts to share chair

Three trusts are set to share a chair as part of their efforts to work more closely together under the Great North Healthcare Alliance.

Gateshead Health Foundation Trust will join Newcastle Hospitals Foundation Trust and Northumbria Healthcare Foundation Trust in the shared arrangement, which is expected to be operational later this year.

The trusts’ council of governors has formally approved the position and it is hoped that a chair will be appointed by the autumn.