The NHS is undergoing one of its most significant structural transitions in a generation. At this heart of this is the evolution of ICBs into larger, more strategic organisations. As ICBs become leaner, more strategic commissioners, providers like Reed Wellbeing must ensure that preventative services remain accessible, visible and embedded within local pathways during this period of transition and demonstrate our ability not just to provide, but to partner.
The transition is being implemented in phases. An initial set of mergers was confirmed for April 2026, providing early insight into how new system configurations will work. Further mergers are expected to be confirmed in summer 2026, ahead of full implementation by April 2027.
The new model explicitly involves delegating functions “to providers and places”, bringing together NHS, local government and independent/third-sector providers in line with local government boundaries to develop effective place-based service delivery. In many areas, existing boundaries have not fully supported integrated planning across health, social care and community services. The reforms will create more coherent geographies that enable stronger partnership working and more joined-up approaches to improving population health. The aim is to improve the ways local systems tackle health inequalities, shift care out of hospitals and into community settings and improve prevention strategies. ICBs will do this by acting as strategic commissioners, responsible for long-term planning, resource allocation and development of their mix of locally-embedded partners.
How might local mixes of partners best support ICBs during and beyond this transition, and how will their role in delivery evolve?
ICBs will want to ensure their mix of partners, like Reed Wellbeing, can effectively collaborate with primary care networks, community partners and other key stakeholders to ensure that referral pathways are understood and effectively utilised, even as system structures change. Our teams currently attend Protected Learning Time sessions with primary care colleagues, building awareness, strengthening relationships and supporting more effective collaboration across the system. Longer-term, further opportunities to embed co-working practices and communications initiatives will need to be explored to ensure service options, availability and suitability is clearly and consistently understood across these larger geographic regions.
As ICBs streamline their own operational capacity, expectations for waiting list reductions, expanded community-based care and preventative action are increasing.
The risk is a widening gap between strategic ambition and delivery capacity. Partners like Reed Wellbeing, who already deliver interventions like the Healthier You: NHS Diabetes Prevention Programme, can play an important role in addressing this double bind, utilising pre-existing resources and relationships to meet demand. Acting as a capacity multiplier, able to rapidly deploy a trained workforce, establish end-to-end delivery capability and utilise proven, scalable operational models will become a much sought after capability.
The new ICB structure will require strong data analytics and evaluation capabilities to support evidence-based commissioning and outcome tracking, particular as merges take effect. Our existing systems and processes track hundreds of thousands of participants through their health service journeys, providing real-time views of engagement and outcome disparities which is critical for informing long-term strategies as well as immediate impact interventions and pilots for reducing population inequalities. Integrating these data capabilities, and serving as an insights partner, will be another valued capability within ICB’s mix of local providers.
Ultimately, the ICB transformation is going to support more people to access the help they need to improve their health and wellbeing, more quickly and more impactfully. Reed Wellbeing has a strong track record of partnership through change and evolution. We want to continue playing a supportive and collaborative role as ICBs enter this transition, with a shared commitment to delivering better long-term outcomes for patients and enabling them to live longer, healthier lives.