The Integrated Care Board (ICB), Explained in Plain English

By Len Burgess, Senior Care Advisor · Published 26 May 2026

NHS body that holds your local healthcare budget, runs your CHC decisions, and is currently in the middle of the biggest restructure since it was set up

This is part of our Care Jargon Buster series, which covers the NHS body that holds your local healthcare budget, runs your CHC decisions, and is currently in the middle of the biggest restructure since it was set up. What an Integrated Care Board is, what it does, and how to navigate one in 2026.


If you have read any of our other posts on NHS Continuing Healthcare, you will have come across the Integrated Care Board, the ICB, in nearly every one of them. The ICB is the body that runs your CHC assessment, signs off on your decision, hears your appeal, and decides how it interprets the national framework in your local area. If you are dealing with NHS-funded care of any kind, you are dealing with an ICB.


But "ICB" is one of those terms families rarely hear until they need to. And what they then find is an organisation with confusing boundaries, a recent history of restructure, an even more confusing future, and very little plain English explanation of what it actually does. This post fixes that.


A quick orientation note before we go further. The "ICB" we are explaining here is the NHS Integrated Care Board. It is not the Institute of Certified Bookkeepers (which is also called ICB), or any of the other organisations that share the abbreviation. If you are here about NHS healthcare in England, you are in the right place.


What is an Integrated Care Board?

An Integrated Care Board is a statutory NHS organisation in England that plans, funds, and oversees most NHS services for a defined geographical area.


In plainer language, an ICB is the bit of the NHS that holds the money for your local area and decides how to spend it. Hospitals, GP practices, community services, mental health services, ambulance services, and care funded by the NHS (like NHS Continuing Healthcare) all flow through your ICB in one way or another.


The ICB does not directly deliver care itself. It commissions it by contracting with the providers who do.


A few essentials to lock in:



For families, the most important thing to know is that your ICB is the NHS body responsible for CHC in your area. The CHC team that carries out your assessment, the panel that signs off on the decision, and the local resolution team that handles your appeal all sit inside, or are commissioned by, your ICB.


How does the ICB actually work?

The ICB does four main things, and understanding them in this order makes the rest of the NHS landscape much easier to follow.


It plans services. The ICB looks at the health needs of its local population, identifies gaps and priorities, and produces strategies for how NHS services should develop. This includes things like where to invest in mental health support, how to manage waiting lists, how to integrate hospital and community care, and how to respond to local pressures.


It manages the money. The ICB is allocated a budget by the central government (around £3,000 per head of population, on average) and is responsible for deciding how that budget is spent across hospitals, GP services, community services, mental health services, and a long list of other things, including NHS Continuing Healthcare.


It commissions providers. The ICB does not run hospitals or GP surgeries itself. Instead, it contracts with the organisations that do, such as NHS Trusts, Foundation Trusts, GP practices, and private and voluntary sector providers. Those contracts set out what the providers must deliver, to what standard, and for what cost.


It is accountable. The ICB is answerable to NHS England (and, through it, to the Department of Health and Social Care), and is required to publish board papers, decisions, and performance data so the public can see how it is operating.


Each ICB sits within a broader Integrated Care System (ICS), which adds in the Integrated Care Partnership (ICP): a wider group of partners including local councils, social care providers, voluntary sector organisations, and others.


The ICB handles the NHS budget and commissioning. The ICP brings in the wider perspective and develops the long-term health and well-being strategy for the area. Together they form the ICS.


For families, the practical interface is almost always with the ICB. The ICP is a strategic body that rarely deals with individual cases. The ICB is the one that signs your CHC decision, processes your Local Resolution appeal, and replies to your complaints.


Who is generally appointed to an ICB?

This is the question of who actually sits on the board and runs the organisation. By statute, an ICB board must include:



The make-up reflects the ICB's job of bringing together the bits of the local NHS and care system, so the board includes voices from across those bits rather than just one.


You can usually find the names of your ICB's board members on its website, along with published board papers showing what decisions are being made. This level of transparency is one of the few genuinely useful things about the way ICBs are set up.


If you ever need to escalate something within an ICB, knowing who the chief executive or the relevant director is gives you a real point of contact.


A note of realism. ICBs were designed to be highly local and rooted in their communities. The current restructure, which is merging many ICBs into much larger organisations, is reducing that local feel. By April 2027, many people will be served by an ICB covering a much bigger geographical area than the one that originally served them in 2022.


How does this apply to me?

These are the five questions families ask most often.


1. What is the difference between an ICB and a CCG?

This is the single most common confusion, especially for families who first dealt with the NHS funding system more than a few years ago. ICBs replaced CCGs in July 2022. Clinical Commissioning Groups (CCGs) were the previous bodies that commissioned NHS services in local areas.


There were over 200 of them at peak. In July 2022, they were abolished, and their functions were transferred to 42 ICBs (now 26 and falling), which cover larger geographical areas.


In practice, if you see CCG referenced in older NHS letters, on older council websites, or in older guides to care funding, it is almost certainly referring to what is now called the ICB. The name has changed, the boundaries are bigger, and the structure is different, but the function (planning and funding local NHS services, including CHC) sits in the same place. For all practical purposes, where you used to write to your CCG, you now write to your ICB.


2. Are CHC and the ICB the same thing?

No, but they are closely related, and the confusion is understandable.


NHS Continuing Healthcare (CHC) is the funding package for fully NHS-funded care for people whose primary need is a health need. It is the support itself.


The ICB is the organisation that decides who gets CHC in your area, signs off on the decisions, holds the budget that pays for it, and handles the first stage of any appeal. The ICB is the body that does CHC for your area, but CHC is not the only thing the ICB does. CHC sits inside a much larger set of responsibilities.


So when you read in any of our other posts that "your ICB" handles the CHC assessment, signs off on the decision, or rejects your Local Resolution appeal, this is what we mean. It is the local NHS commissioning organisation that owns the process from start to finish (up to the point where, on appeal, it goes to NHS England's regional Independent Review Panel).


3. Who runs an ICB, and who sits on the board?

An ICB is led by a chief executive (a senior NHS manager) and chaired by a separate non-executive chair appointed by NHS England. The board itself usually includes the chief executive, the chair, several non-executive members, a Chief Medical Officer, a Chief Nursing Officer, a Chief Finance Officer, and partner members representing the local NHS Trusts, GP services, and councils.


Many of the senior people on an ICB are clinicians and NHS managers with significant local experience. The partner members give the board direct links to the organisations the ICB is commissioning from, so decisions can be informed by what is actually happening on the ground.


Board meetings are held in public (with some papers in private for confidentiality reasons), and board papers are usually published on the ICB's website a week or two in advance. If you want to understand how decisions are being made in your area, those papers are genuinely worth reading.


4. How do I find my local ICB?

The simplest way is through the NHS website's "Find your local Integrated Care Board" tool, available at nhs.uk. Enter your postcode and the tool will tell you which ICB covers your area, with a link straight to its website, or you can use our local authority search button below.


It is worth doing this before you need it, because some families only discover their ICB when they need to contact it urgently, and finding the right one in a hurry while also dealing with a relative in the hospital is a recipe for stress.


A practical tip for 2026: because of the ongoing mergers, the name of your ICB may have changed recently or may be about to change. If you have an older letter or contact detail, the chances are reasonable that the organisation has either been renamed or now sits inside a larger merged body. Always cross-check against the NHS website rather than relying on older correspondence.


5. How many ICBs are there, and is that changing?

There were originally 42 ICBs when the system launched in July 2022. As of late 2025, that number had already dropped to 26 as some ICBs began clustering or merging in response to a 50% cut to running costs announced by the government in March 2025.


The first formal mergers were approved by ministers and took effect on 1 April 2026, abolishing 12 existing ICBs and creating 6 new ones. A second phase of mergers will take effect on 1 April 2027. By the time this process settles, the total number of ICBs in England will be significantly smaller, with each one covering a larger area.


For families, this has two real implications.


First, the organisation you deal with for CHC and other NHS commissioning may go through a name change or boundary change in the next year or two.


Second, the team handling your case may be reorganised in the middle of your application or appeal. Keep clear records of every conversation, every decision letter, and every named contact, so you can follow up effectively if your case ends up with a different team than the one that started it.


The takeaway

The Integrated Care Board is the local NHS body that holds the budget, commissions the services, and makes the funding decisions in your area, including NHS Continuing Healthcare.


Knowing what your ICB is, where it sits, and how to contact it is a quietly important part of navigating the care funding system, because so many of the other terms in this Jargon Buster series eventually run through it.


Three practical takeaways. Find your ICB before you need it, using the NHS website's locator tool. Read the board papers if you want to understand how decisions are being made locally. And keep good records of every contact, because the system is currently in flux, and the team handling your case today may not be the team handling it next year.


Our funding calculator can show you how NHS funding routes like CHC and FNC fit into the overall cost of care, alongside council funding and other support. And keep an eye on the next post in this series, where we tackle the Multi-Disciplinary Team (MDT).


This article is for general guidance only and reflects the way Integrated Care Boards operate in England as of 2026. The ICB landscape is in the middle of a significant restructuring, with mergers taking effect in April 2026 and April 2027, reducing the total number of ICBs and changing many boundaries. For the most up-to-date information on your local ICB, always check the NHS website's locator tool at nhs.uk. ICBs cover England only; Scotland, Wales, and Northern Ireland have their own NHS structures.

Sources

Frequently asked questions

What is the difference between an ICB and an ICS?

This is a question people get wrong constantly, and the distinction is worth knowing. The Integrated Care Board (ICB) is a single statutory NHS organisation that holds the budget and commissions services. The Integrated Care System (ICS) is the broader partnership it sits inside, made up of the ICB plus the Integrated Care Partnership (ICP): a wider group including local councils, social care providers, voluntary sector organisations, and community groups. In short, the ICB is the NHS commissioning body. The ICS is the whole local system, of which the ICB is one part. For families dealing with CHC and other NHS funded care, the ICB is the part you actually interact with. The ICS is mostly a strategic framework that operates behind the scenes.

Can I contact my ICB directly with a complaint or query?

Yes. Every ICB has a published contact route for complaints and queries, usually a dedicated Patient Advice and Liaison Service (PALS) function or a complaints team, with details on its website. You can use this for issues with NHS-funded care decisions, including challenging a Local Resolution outcome before it goes to the Independent Review Panel, or raising concerns about how a CHC assessment was handled. Keep your complaint specific, in writing, and supported by evidence such as decision letters, care records, and dates. The ICB is required to respond within set time frames, and serious or unresolved complaints can be escalated to the Parliamentary and Health Service Ombudsman.

Does the ICB pay for care home fees directly?

Only in specific circumstances. If your relative has been awarded NHS Continuing Healthcare, the ICB pays the full cost of their care, including care home fees, directly to the provider. If they have been awarded NHS Funded Nursing Care (FNC), the ICB pays the weekly FNC contribution (currently £267.68 in 2026/27) directly to the nursing home, which should reduce the bill by that amount. Outside those two situations, the ICB does not normally pay care home fees. People who are self funding pay their own bills, and people receiving local authority funded care have those fees managed by their council, not by the ICB. Knowing which body is paying which part of the bill is one of the most useful pieces of clarity you can have when navigating the system.

What changes for me if my local ICB merges with another one?

In most cases, the practical impact on individuals is small in the short term, but worth being prepared for. Your CHC, FNC, or other NHS funded care should continue without interruption: the merger is an organisational change, not a change to the support you are receiving. However, you may notice a few things. The name on letters and correspondence may change, sometimes to something quite different. The contact details and named staff handling your case may change. The website and PALS contact you previously used may redirect or be replaced. And decisions in progress, such as appeals or reviews, may be temporarily slowed while teams are reorganised. Keep clear records of your case, including reference numbers and any named contacts, and chase any unexplained delays in writing.

Are ICB board meetings open to the public?

Generally yes. By statute, ICB board meetings are held in public, with the agenda and board papers published on the ICB's website usually a week or two beforehand. You can attend in person or, in most cases, watch online. There are exceptions where particular items are discussed in private (for example, individual patient cases or commercially sensitive contract details), but the main business of the board is public. This is one of the more useful features of how ICBs are designed. If you want to understand how decisions are being made about local NHS funding, including CHC policy and the local interpretation of the National Framework, the published board papers are genuinely worth reading.