Integrated Care Delivery Forum – Spring 2025
How systems can realise the 10-year plan’s community shift
Integrated Care Delivery Forum – Spring 2025
Professor Patrick Vernon, Chair of Birmingham and Solihull ICB, acknowledged the “mixed” impact of ICBs so far, but stressed that significant work had been done to break down silos in the Birmingham and Solihull area. Vernon also pointed out that many of the actions outlined in the model framework are already being delivered through practical ICS working. But with providers facing persistent resource constraints and ICBs set to merge into even larger footprints, progress is likely to remain uneven.
Enhancing the role of strategic commissioning
Strategic commissioning, central to ICSs under the new ICB blueprint, marks a shift from operational oversight to a population health-focused approach. Eisenstadt (Northamptonshire ICB) noted that silos persist due to cultural habits and simpler vertical accountability.
Danielle Oum (Coventry and Warwickshire ICB) said streamlined priorities will accelerate change, with ICBs using purchasing power to improve population health. Victoria Underhill (Optum) added that strategic commissioning enables neighbourhood working through data, tech, and pathway-based planning. Effective integration, all agreed, still happens best at the frontline.
Reform fatigue
Christine O’Connor reminded attendees that reorganisations often disrupt care delivery rather than improve it. While ICSs aim to integrate services, engagement with key partners, especially in social care remains limited.
Nadra Ahmed noted the sector’s exclusion from decision-making despite contributing £68 billion and employing 1.7 million. David Morris (PwC) echoed this, saying true integration is still distant.
Cllr David Fothergill (LGA) stressed the opportunity for joined-up reform, as over 170 councils await reorganisation. He called for collaborative system, place, and neighbourhood-level working to design citizen-centred services.
Optimising financial flow to unlock transformation
Financial flows will be key to enabling this new approach to commissioning and to empowering providers to transform services on the ground. Andrew Moore, Joint Chair of University Hospitals of Northamptonshire NHS Group and University Hospitals of Leicester NHS Trust, highlighted the contrast with the retail sector, where financial and workforce control mechanisms are far stronger. In health and care, however, over-reliance on agency staffing and weak grip on costs make transformation harder to deliver.
Technology remains an underused lever. Alex Crossley, Director of Transformation and Finance at NHS England, called for deeper partnerships with industry and smarter use of tech to overcome persistent productivity challenges. Strategic commissioning must include strategic deployment of digital tools.
A familiar destination despite the new language
There is a risk that ‘strategic commissioning’ turns out to be just commissioning with the word “strategic” tacked on. Policy leaders have a remarkable ability to rename old ideas and repackage them as innovations.
This tendency can frustrate frontline professionals and system leaders alike. Yet, as PPP Chair Stephen Dorrell noted in his closing remarks, it also suggests consistency in the direction of travel that should be built upon. The structures and language may change, but the core goals of integration, prevention, and efficiency remain. The challenge, as ever, is in finally delivering them.