Defence · Scrutiny & accountability · 8 November 2026
NAO report questions ICB capacity after major workforce cuts
A National Audit Office report has published findings that Integrated Care Boards have restructured and made redundancies to meet savings targets. The review notes it is unclear if necessary skills and capacity have been retained.
The National Audit Office has published a review of Integrated Care Boards, finding that they have restructured and made redundancies to meet savings targets. The report states it is unclear whether the boards have retained the necessary skills and capacity to function effectively.
Integrated Care Boards are required to cut running costs by 43% to save £908 million annually. Achieving this target involves reducing approximately 8,000 full-time equivalent posts. The number of ICBs decreased from 42 to 25 due to clustering and merging by April 2026. Most ICBs had developed new operating models to reduce costs and focus on strategic commissioning by June 2026.
ICBs spent £582 million on redundancies in 2025-26, with £401.5 million allocated by NHS England. Estimated running costs for 2026-27 are £1.4 billion, which exceeds the £1.2 billion target by £200 million. The restructuring has affected staff morale and created risks to organisational capacity.
The NAO recommends that NHS England and the Department of Health and Social Care clearly define the future roles of ICBs. The review notes that redundancies have taken longer than originally planned. It is not clear yet if they have retained the necessary skills and capacity.
Written by StreetOwl from National Audit Office’s own announcement. It was drafted by StreetOwl’s own model, every figure and quotation was checked by code against the announcement, and it was read and approved by Michael Rossi before it went up. It says what was announced, not what anyone should do about it.
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