The Guidance states that the aim of NHSEI is to minimise uncertainty and ensure employment stability.  This will be guided by the Employment Commitment.  But we are also told that all plans made are subject to the passage of legislation and that we must not pre-empt the passing of legislation but we must get on and plan!  A bit of a conundrum.

Accountability for managing the change will sit with the current ICS and CCG leadership with increasing involvement of the new leaders who may be appointed on a shadow basis pending legislation.  The key action is to ensure there is capacity ready for implementing the new ICS body.  All plans must be agreed with regional NHSEI teams.

The indicative outputs expected of every ICS over the course of the transition period 2021 / 2022 are:

By end Q1 Preparation

  • Update System Development Plans (SDPs) against the key implementation requirements (functions, leadership, capabilities and governance) and identify key support requirements.
  • Develop plans in preparation for managing organisational and people transition, taking into account the anticipated process and timetable, and any potential changes to ICS boundaries and the need to transform functions to support recovery and delivery across the ICS.

By end Q2 Implementation

  • Ensure people currently in ICS Chair, ICS lead or AO roles are well supported and consulted with appropriately.
  • Carry out the agreed national recruitment and selection processes for the ICS NHS body chair and chief executive, in accordance with guidance on competencies and job descriptions issued by NHS England and NHS Improvement. This will reflect the expected new accountabilities and responsibilities of ICS NHS bodies.
  • Confirm appointments to ICS Chair and chief executive. Subject to the progress of the Bill and after the second reading these roles will be confirmed as designate roles.
  • Draft proposed new ICS NHS body MoU arrangements for 2022/23, including ICS operating model and governance arrangements, in line with the NHS England and NHS Improvement model constitution and guidance.
  • Plan for CCG teams to only operate at sub-ICS level where the SDP confirms that the ICS plans to establish a significant place-based function at that footprint.
  • Begin due diligence planning.

By end Q3 Implementation

  • Ensure people in impacted roles are well supported and consulted with appropriately.52 | Integrated Care Systems: design framework
  • Carry out the recruitment and selection processes for designate finance director, medical director, director of nursing and other board level role in the NHS ICS body, using local filling of posts processes.
  • Confirm designate appointments to ICS NHS body finance director, medical director and director of nursing roles and other board and senior level roles.
  • ICS NHS bodies and ICS Partnerships to be ready to operate in shadow form.
  • Engagement on local ICS Constitution and governance arrangements for ICS NHS body and ICS Partnership.

By end Q4 Transition

  • Ensure people in affected roles are consulted and supported.
  • Continue the recruitment and selection processes for all other designate ICS NHS body senior roles, including place-level leaders and non-executive roles, using local filling of posts processes.
  • Confirm designate appointments to any remaining senior ICS roles (in line with our relevant guidance) so that as much of the ICS NHS executive board and other senior leadership is ready (subject to formal decisions on appointments after the legislation is in place/in force).
  • Complete due diligence and preparations for staff and property (assets and liabilities, including contracts) transfers from CCGs and other NHS staff transfers to new ICS NHS body in line with our guidance.
  • Commence engagement and consultation on the transfer with trade unions.
  • Complete preparations to shift our direct commissioning functions to ICS NHS body, where this is agreed from 1 April 2022.
  • Ensure that revised digital, data and financial systems are in place ready for ‘go live’.
  • Submit the ICS NHS body constitution for approval and agree the 2022/23 ICS MoU with NHS England and NHS Improvement, setting out key elements of how the new ICS NHS body and ICS Partnership will operate in the future, in accordance with guidance to be issued by NHS England and NHS Improvement.


If you would like to discuss this topic in more detail, please contact Carly Caton, Partner.

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