Effective administration is one of the most important parts of healthcare, with effective planning and preparation often making the difference between effective care and poor outcomes. With 42 new integrated care boards looking to work towards building effective systems and infrastructure, there are more and more challenges arising that need to be resolved. Learn more about what integrated care boards are, some of the challenges affecting them and what these challenges mean for healthcare.

What are integrated care boards?

In July 2022, 42 new integrated care boards (or ICBs) were established across the UK. These are statutory NHS organisations that are responsible for planning to meet the health needs of the UK population, including managing the NHS budget in the area and arranging for healthcare provision across the region. ICBs work closely with local authorities, integrated care partnerships and providers to improve healthcare outcomes and deliver a more efficient NHS service for patients.

What are the biggest challenges for integrated care boards?

Having been assembled relatively recently, ICBs are still facing a range of challenges in their operations. Some of the main issues that ICBs are facing in their procurement work include:


One of the most significant constraints that the NHS deals with is its budget. Due to the political environment and a drive to recover public funds after the high spending of the pandemic era, budgets are becoming tighter and inflation is further adding to the strain. ICBs are increasingly looking for the balance between investing in healthcare outcomes and staying within budgets. Effectively managing budgets means that staff remain happy, procurement isn’t an issue and infrastructure is in good condition, improving the area’s performance.

NHS England is responsible for determining allocations of financial resources to integrated care boards (ICBs) from April 2023. Total annual budgets given to ICBs cover the majority of NHS spending. Capital allocations will be topped-up by £300 million nationally, with this funding prioritised for systems that deliver agreed budgets in 2022/23. ICBs and NHS primary and secondary care providers are expected to work together to plan and deliver a balanced net system financial position in collaboration with other ICS partners.

Check here: NHS core allocations to Integrated Care Boards (ICBs) 2022/23

Local population demands

As set out in the recently published Operating Framework, NHS England will continue to support the local NHS (integrated care boards (ICBs) and providers) to deliver their objectives and publish information on progress against the key objectives set out in the NHS Long Term Plan. Different populations all have unique demands. For example, a university town with a high population of young people has fewer long-term health challenges to resolve than a seaside resort with a high population of older residents. These new organisations need to adapt quickly to build a comprehensive understanding of the local population before adapting to their needs and providing a bespoke healthcare solution for the region that they work in. Adapting quickly provides better healthcare outcomes more quickly, saving lives through the provision of more appropriate treatment.


A ‘power struggle’ between the NHS and the local authorities would destroy the value of having an integrated care system. Hospitals should no longer work independently and local authorities should be fully integrated at all levels of an ICS. Several of the larger ICS could have the challenge of working with multiple local authorities and the structure needs to work for all of them. Improving collaboration and coordination with the local community means that the ICB responds to major local events more effectively and people are happier with the way healthcare services integrate with the region. It is important to understand how ICSs create effective and value-adding local partnerships across health and government, not focusing on process but on delivering outcomes for populations.

The potential of integrated care boards

In spite of all of the challenges integrated care boards face, ICBs have a lot of potential for achieving their goals. The first of these goals is improving healthcare outcomes in the community, through the provision of effective care that patients can rely on. One of the core tenets of this is a greater focus on equality, and ensuring that everyone has the healthcare that they require in that specific community. This means not leaving communities behind, whether due to their wealth, ethnicity, age, or geographical location. ICBs mean that each individual region gets the targeted support that it needs to thrive.

Integrated care system (or ICS) goals go beyond simply improving healthcare performances whilst working within a budget, with some of the targets being more complex. This includes offering tailored support for people with long-term conditions affecting them, supporting elderly people with long-term conditions in remaining as independent as possible and improving the health of young people (which is a long term investment in itself).

Can integrated care boards succeed?

Given the range of challenges that integrated care boards face, there are some people who question the ICB model. However, with enough time, attention and investment, there are plenty of opportunities for the model to demonstrate its use in a modern healthcare system.


  • Carolina Duran

    Carolina Duran, VP of Marketing at ELCOM, joined ELCOM in May 2016 to lead the company's marketing team and implement a robust and efficient strategy to secure brand positioning and growth in the UK and internationally. ELCOM is a global Supply Chain Technology Provider which praised itself for making procurement smarter, more connected, and transparent.

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