Decision details

Vicky Dutchburn, Interim Accountable Officer, Kirklees Integrated Care Board (ICB), informed the Board that the ICB landscape has been rapidly changing over the last week and the position has evolved since the last update. The Board was reminded that during the previous update, a detailed overview was provided regarding the organisational changes across West Yorkshire and the specific impact that would have for Kirklees.

By way of context, the Board was informed that there are key missions that the government has set out. The first, is that they are looking at the cross governmental work for health, and there is going to be significant changes across the four key elements that deliver health services. These include the Department of Health and Social Care, NHS England, regional bodies, and local ICBs. Recently the 10-year plan for the NHS has been published, and in addition there are reforms for adult social care that have also been included.

The Board was informed that there are three key shifts in care identified within the 10-Year Plan. These include a move from treatment to prevention, which emphasises the importance of neighbourhood-level health initiatives and transitioning care from hospitals into the community; a stronger focus on neighbourhood health as a foundation for integrated care; and the shift from analogue to digital approaches, supporting more efficient and accessible service delivery.

At the previous meeting, the Board was informed of the rapid timeline for designing new structures to support the proposed functions of the ICB. A formal mandate was issued in April 2025, and within approximately eight weeks, the expectation was that draft structures were to be in place and submitted to NHS England on behalf of West Yorkshire. The required milestones were met.

During the process, it was identified that there were four key components requiring change across the wider NHS system. At the time, the only available blueprint for consideration related to expectations for the future ICB. As a result, designing the new structures were undertaken with limited clarity regarding the roles and requirements of emerging regional and national teams. Despite these constraints, draft structures were successfully developed and submitted for West Yorkshire.

Board members may recall that during the last update, attention was drawn to the scale of proposed changes, including a potential staffing reduction of up to 50%, with implementation expected to begin from October 2025.  Concerns were also raised regarding the uncertainty around funding arrangements for any resulting redundancies. The current position with regard to redundancies is that there still remains a lack of funding for any redundancies this year and this is national.   It is clear that it was never planned for national level to fund any redundancies, and it is unlikely that any funding will be coming down, from central to ICBs.  It is expected that this will be funded from within existing resources.

It is recognised that the current financial position makes it unfeasible to implement the required changes within this financial year. This is not unique to Kirklees but reflects the broader position across West Yorkshire. The primary directive from the national team is to meet control totals. As this requirement was issued after the submission of plans for 2025/26, redundancies were not factored into the budget and therefore cannot be actioned this year. However, it is now acknowledged that future planning assumptions for 2026/27 and beyond will need to incorporate this consideration, subject to the confirmed allocation."

The Board was advised that West Yorkshire has taken the decision to pause any formal consultation on staffing reductions or new service configurations until the next financial year. This position has been communicated to the West Yorkshire Board. However, a letter from Sir Jim Mackey issued earlier this week highlighted that discussions with the Treasury are still ongoing and expected to conclude within the next two weeks. As such, there remains a small possibility that the current position may be subject to change.

The Board was informed that, based on the current position that no funding will be made available for redundancies and following a risk-based assessment, staff have now been advised that formal consultation will not begin before April 2026. This is a challenging decision and a difficult message to communicate to staff both within Kirklees and across West Yorkshire. The revised timeline provides an opportunity to better align proposed changes with the evolving functions and structures of the ICB. It also allows for broader and more meaningful engagement at multiple levels, including with the proposed regional teams and their blueprints once these are fully published.

In addition, it also allows the opportunity to put existing resource as in staffing behind some of those priorities that have been identified, for example managing winter.  One of the factors in the original blueprint, was that the regional team were going to be more proactive in delivering winter plans and local ICBs will have the resource to be able to do that. It also means that the expectation to develop three-and five-years strategic plans will also have the full complement of the planning teams to be able to support the delivery of that piece of work.

Communication plans are being revised to reflect the updated timelines. Staff engagement has remained a priority throughout the process, and while regular updates have been provided, it was recognised that weekly or fortnightly briefings were not always appropriate when there was no new information to share. Going forward, the approach will be adjusted to ensure at least monthly meetings are held, maintaining continuity of business-as-usual activity and supporting staff motivation during this period of change.

Written updates will be maintained to all staff, ensuring that staff and partners receive those updates moving forward. There will be regular meetings that have already been put in place with partner organisations and NHS England to ensure that communication flow is maintained, and people feel involved in the work being undertaken.

The Board was informed that two further aspects to note is that future planning requirements include the development of a one-year operational plan, alongside three- and five-year strategic plans. Further guidance is awaited regarding the expected content of these plans. Currently, initial discussions have commenced and working groups are being established with partners to begin gathering the necessary information.

A key focus of this work will be the response to the national 10-Year Plan and the development of the Integrated Neighbourhood Health Plan.  Kirklees already demonstrates strong alignment with this strategic direction, with longstanding efforts to embed integrated neighbourhood health approaches. Examples include the establishment of integrated teams between the local authority and Locala, initiatives to move services from hospital settings into community-based care, and the development of primary care services operating effectively within integrated neighbourhood teams aligned to the Primary Care Network footprint.

This approach is not new but builds upon existing work and further develops it to ensure care is delivered in a preventative, person-centred way. This model has already been embedded within communities, supporting the delivery of high-quality, integrated, and efficient services.

The Board was informed that three areas across West Yorkshire have been successful in joining the National Neighbourhood Health Implementation Programme. A dedicated Board has been established within West Yorkshire to support the dissemination and adoption of learning across the region.  There is clear national guidance outlining the required components of the programme. However, within West Yorkshire, there is a shared understanding that while the overarching concept and some metrics may be consistent across the region, implementation will vary between places. This reflects the distinct characteristics and needs of each local population, which must be appropriately addressed.

Within Kirklees, clear plans are in place for the development of Neighbourhood Health, incorporating the six core service components. These plans have been developed in partnership, with extensive opportunities for engagement with system partners to support further development. While there is a good degree of consistency across the Primary Care Network (PCN) footprints on which these plans are based, the pace of progress varies slightly between areas. However, it is anticipated that by September next year, Operational Integrated Neighbourhood Health Teams will be in place across all nine localities.

The Board was informed about recent organisational changes at Leeds Teaching Hospitals NHS Trust. These changes were introduced in response to ongoing pressures within the Trust and are expected to have a local impact.

RESOLVED:

That Vicky Dutchburn be thanked for providing an update on changes to the Integrated Care Board landscape and will continue to receive timely updates.