By Stephen Ferry, CEO of IEG Group
The ICB landscape is going through an evolution.
There has been a recent wave of ICB mergers and clustering being approved to take place across England, with many mergers taking effect in April 2026, others planned later for April 2027 and work already underway.
For ICBs, these changes bring a chance to reshape governance, align processes, and create new ways to share best CHC practice.
If executed properly, ICB mergers will result in improved efficiency gains by trimming down processes that are not cost effective and deliver mixed results, bringing a strength in collaboration to the sector.
It could result in the delivery of a more cohesive experience for those relying on CHC.
However, for healthcare professionals, patients and their carers, the mergers have left them wondering what these larger ICB footprints will mean for Continuing Healthcare (CHC) service delivery.
Why are ICBs merging?
In March 2025, it was announced that ICBs should reduce their running and programme costs by 50 per cent by December 2025.
To achieve this, many ICBs have agreed to cluster or merge, with two or more ICBs working together across a larger footprint but legally remaining separate organisations.
The restructuring is also part of a broader push to increase ICB capability, and part of the drive to improve efficiency and consistency across the NHS as part of the NHS 10 year plan.
Many smaller ICBs have struggled with differing interpretations of the National Framework for NHS CHC, leading to uneven service provision and outcomes across regions, impacting patients, carers and staff who are left unclear about the next steps of their journey.
Merging and clustering is intended to address this by creating larger, more resilient operating models that can pool expertise, reduce duplication, and deliver a more consistent approach to eligibility assessments and care planning outcomes.
In addition, these mergers are a prime opportunity to invest in foundational digital infrastructure, to truly future-proof this move.
The case for consistent digital systems
One of the clearest benefits of merging ICBs is the chance to align digital infrastructure.
As it stands, the CHC process has historically been beset with issues of long wait times and delayed decision-making that has even led to some patients seeking private care while waiting for a verdict.
For staff, caseloads and the time it takes to interpret complex criteria leads to difficulty in completing timely assessments.
With that in mind, consistent use of digital systems across CHC teams is essential for improving efficiency and ensuring fairness.
When systems vary between regions, or even between teams within the same ICB, it becomes difficult to maintain oversight, audit decisions, and ensure prompt outcomes for patients.
That’s where the opportunity lies for mergers and clustering. Using the same digital tools across the whole region supports standardised assessments and decision-making, greater transparency and auditability, and faster data sharing between professionals, as well as improved tracking of case progression, and more accurate reporting and forecasting.
In a system as complex and sensitive as CHC, where decisions can have life-changing implications for individuals and families, this consistency is not just a technical benefit, it’s a matter of necessity.
Is digital CHC the way forward for ICBs?
As ICBs look to consolidate processes, there are platforms on the market that offer a compelling way to merge whilst realising the NHS’s digital ambitions.
They are designed specifically to support the full CHC journey from checklist to decision.
ICBs can make use of features from integrated case management to real-time reporting dashboards and tools made specifically to ensure good communication between health and care professionals.
This can only be of benefit to the people for whom these services are absolutely essential.
By embedding best digital practice into the system itself, ICBs can use these tools to ensure consistent, transparent, and efficient CHC delivery.
There are ambitious ICBs that are already setting things in motion, setting up central patient access teams to reduce the number of separate administration teams and centralise tasks.
The same process was followed for their finance processes which supported the reduction on head count by using a single end-to-end digital platform where all the data is easily accessible.
The opportunity for digital change is waiting there, with mergers and clustering being the perfect catalyst to support it.
For newly merged ICBs, adopting a common, purpose-built platform can reduce the administrative burden and free up staff to focus on what matters most: the quality and timeliness of care, and that is what matters the most to patients and carers.
The road ahead
The full impact of ICB mergers will take time to unfold, but early indications suggest that when executed with care and clarity, these changes can bring real benefits which will become more realised when progress picks up into next year and beyond.
For professionals in CHC, the priority should be collaboration, learning from each other, standardising what works, and continuing to advocate for the needs of those who rely on this essential service.
Digital CHC platforms are uniquely positioned to support ICBs through this transition.
By providing a single, end-to-end digital solution, they help reduce variation, improve compliance with the National Framework, and streamline the entire CHC process from referral to review.
They enable consistency across teams, faster decision-making, and better visibility for managers, while keeping the patient journey at the centre.
The first wave of mergers and clusters has begun, and as ICBs come together, this is the chance for healthcare leaders to access the digital foundations needed to deliver fairer, faster, and more transparent care at scale.
