Integrated care boards

An integrated care board (ICB) is the NHS body that plans and pays for most health services for the population of its area in England. There are 42 of them, each covering one integrated care system. ICBs took over from the old clinical commissioning groups. They hold the budget, agree contracts with hospitals, community services, mental health providers and GP practices, and are accountable for how well local health services perform.

What an ICB does

An ICB’s main job is commissioning: deciding what services the area needs, buying them from providers and checking they deliver. It agrees the annual contracts with NHS trusts, holds the GP, pharmacy, dental and optometry contracts that have been delegated to it, and pays for individual care packages such as NHS continuing healthcare.

ICBs also set the strategy for their system. Each one sits alongside an integrated care partnership with local councils, so that health and social care plans line up. Board members include representatives of local trusts, GPs and councils, as well as executive directors employed by the ICB.

Jobs in an ICB

ICBs employ people in roles you will not find on a hospital ward. Typical jobs include:

• commissioning managers and contract managers
• finance, from management accounts to contract payments
• business intelligence and data analysts
• continuing healthcare nurses and assessors
• safeguarding, quality and patient safety leads
• medicines optimisation pharmacists and technicians
• primary care, estates and digital programme managers
• communications, engagement, HR and governance staff

Most work is office based or hybrid, Monday to Friday. Some roles, such as continuing healthcare, involve visiting patients at home or in care homes.

Pay and conditions

ICBs employ staff on Agenda for Change. Many roles sit at band 6 and above, with a large share of posts at band 7 and 8a. From 1 April 2026 in England, band 7 runs from £49,387 to £56,515 and band 8a from £57,528 to £64,750. Directors are on very senior manager pay, outside Agenda for Change.

Your NHS service carries over if you move between a trust and an ICB, so your annual leave entitlement, sick pay and redundancy service are protected under the national handbook. Staff are in the NHS Pension Scheme.

Running cost cuts and mergers

ICBs have been through repeated restructuring. The government told them to make large reductions in running costs and announced that NHS England would be absorbed into the Department of Health and Social Care, with some functions passing to ICBs and others ending. Many ICBs launched organisational change programmes, with voluntary redundancy schemes followed by consultations on compulsory redundancies. Neighbouring ICBs have been grouping into clusters and some are merging, so the number of boards is set to fall below 42.

If you work in an ICB, this means job security is lower than in a front-line NHS post. Organisational change policies in the NHS normally give priority for suitable alternative roles and redeployment, and NHS redundancy pay under Agenda for Change is usually more generous than the statutory minimum. Statutory redundancy pay in 2026/27 caps a week’s pay at £751 and the total at £22,530. How the enhanced scheme applies to you depends on your service and age, so get the figures from HR and take advice from your union. See redundancy rights for the legal minimum and consultation rules.

If you are applying from outside, check the ICB’s latest board papers for its operating model and planned staffing before accepting a post. A fixed-term or secondment role during a restructure can be a reasonable way in, but understand when it ends.

Getting a job in an ICB

ICB posts are advertised on NHS Jobs and assessed through a supporting statement against the person specification, like any NHS job; see how to write an NHS supporting statement. Many roles ask for experience you would not gain on a ward: contract management, financial analysis, data and reporting, or programme management. Clinical roles usually ask for current professional registration and several years’ post-registration experience.

People often move into ICBs from trusts, councils or the Civil Service, and back again. Because the work is about planning and contracts, skills in Excel, Power BI or similar tools, writing board papers and negotiating with providers carry weight. During restructures, vacancies may be ring-fenced for staff at risk of redundancy before being advertised externally, so fewer posts reach open advertisement in those periods.

How ICBs affect staff elsewhere

Even if you never work for an ICB, its decisions reach you. The contract it agrees with your trust sets activity targets and money. Decisions to move a service, such as community diagnostics or a mental health pathway, to a different provider can lead to a TUPE transfer of staff. Waiting list targets, financial recovery plans and vacancy controls in trusts often trace back to agreements made between the trust and the ICB.

To find which ICB covers an area, use the NHS “find your local integrated care board” tool. Vacancies are on NHS Jobs, and the structure of the wider service is in how the NHS in England is organised.