Sutton Council has voiced concerns over upcoming national NHS changes, particularly regarding the commissioning of health services. These concerns were raised during a Scrutiny Committee meeting on Wednesday 24 September 2025.
The council highlighted a lack of clarity and consultation surrounding the proposed reforms, which include the abolition of NHS England and the refocusing of Integrated Care Boards (ICBs) as 'strategic commissioners'. According to the Update on National NHS Changes - Commissioning of Health Services R Scrutiny Committee 202 report, these changes also involve a significant 50% reduction in staffing, running, and programme costs, to be implemented by quarter three of 2025/26.
The changes aim to provide greater alignment and accountability, place the NHS on a more sustainable financial footing, and deliver the NHS 10 Year Health Plan, focusing on shifting from hospital to community care, analogue to digital systems, and sickness to prevention.
However, the council has identified several key challenges and risks. These include uncertainty about the delivery timeline and the transfer of functions, the local impact of budget reductions, joint funding arrangements, property ownership, and the delivery of neighbourhood health services. The report pack identifies uncertainty regarding how and when things will be delivered and what functions will be transferred, to whom and by when. This uncertainty is generating risks and making it increasingly difficult to sustain strong partnership working at a local level. The report does not detail any specific contingency plans.
Specific functions currently performed by ICBs, such as system control centres, research and development, estates and infrastructure, and oversight of provider performance, are slated for transfer to other bodies or organizations, although the specific entities remain unspecified in the report.
Property ownership and estates are a key challenge and risk for The Council as a local delivery partner. The specific concerns are that the current proposals indicate that ICBs will transfer responsibilities relating to estates and property, which could present a number of challenges to The Council when it comes to local issues such as planning, assets strategy and joint service delivery from local buildings.
The council considers the proposed changes to health functions to be substantial and would welcome more clarity on the planned arrangements for consultation and engagement with local authorities about the proposed changes.
Despite the challenges, the council acknowledged potential opportunities, such as a focus on place-based leadership and multi-agency working at a local neighbourhood level, building on the integrated neighbourhood team (INT) model.
The committee reviewed a report titled National NHS Changes - the new Model ICB A Scrutiny Committee 20252409, which provided an overview of the proposed changes. The report stated that NHS England wrote to ICB and NHS provider leaders outlining the NHS 2025/26 core priorities and laying the foundations for national NHS reform on 1 April 2025. The South West London (SWL) Integrated Care Board (ICB) is therefore facing rapid major change and transformation.
NHS England has worked with ICB leaders across the country to co-produce a draft 'Model ICB Blueprint' that clarifies the future role and purpose of ICBs, recognising the need to build strong strategic commissioning skills to improve population health and reduce inequalities, and focus on the delivery of the three strategic shifts – sickness to prevention, hospital to community, analogue to digital.
Under this new model ICB's will become strategic commissioning bodies focused on core functions such as population health management and strategic planning and purchasing, whilst some of their wider functions will be transferred to other bodies or organisations.
