Briefing / Board reporting for integrated care boards (ICBs): considerations for best practice

Since NHS trusts were created in the early 1990s, each NHS body has had to manage its own financial position and report to its own board. Now, the Health and Care Act 2022 has introduced new requirements for NHS bodies to work together to meet joint financial objectives and duties. In some ways, financial reporting will not change as NHS bodies will still need to report to their own board and to the regulators. In other ways, everything will change as decisions will need to be made with a view to their impact on the wider system and the financial impact of those decisions will impact on partner organisations. 

In establishing integrated care partnerships (ICPs), the Act also reflects the fact that healthcare is not provided in a vacuum and the wider system includes local authorities, non-NHS providers and the third sector. This briefing does not consider financial reporting at this level but focuses on the NHS bodies as they will have to achieve financial balance this financial year. 

Cultural change will be required for these organisations to work together to meet their new statutory duties. Organisations that have, until now, been working independently and in competition with one another will need to work together and cooperatively. To achieve this, board members of all the affected bodies will need to forge new working relationships based on openness and honesty.  

Now is the time to consider what information will be required to manage financial performance across organisations and to ensure that information can be collected on a consistent and timely basis from all organisations. This briefing is intended to provide a starting point for those discussions.