A: Clusters are arrangements that allow ICBs to work together through shared leadership and combined teams. However, clustering ICBs remain separate legal entities with unchanged boundaries, separate financial allocations and legal duties.

Ref: NHS England.

A: Dr Kathy McLean’s appointment as Chair of the Integrated Care Board Cluster was confirmed on 1 September, with Amanda Sullivan confirmed as Chief Executive on 25 September. The ICBs’ Cluster Executive Directors will take up their posts on Saturday 1 November. 

A phased approach to change has been agreed. This will create strong leadership from which to develop detailed structures, and ensures the change process is practical and sustainable. The sequencing we will follow, with indicative timeframes is set out below: 

The vast majority of colleagues will be involved in a restructure process in due course. We do know that formal consultation will follow the approved Change Management and Pay Protection Policy and will occur once initial structures are developed. Every colleague who will potentially be affected will be informed and able to provide feedback.  

As we go through some changes in the organisation, there might be times when colleagues are asked to temporarily take on different tasks or roles. This could include people affected by earlier rounds of consultation.  

A: Clustering refers to formal collaboration between ICBs (e.g. Derby and Derbyshire, Lincolnshire, Nottingham and Nottinghamshire) under a shared governance and leadership structure. Each ICB remains a statutory body.

A: The latest updates from NHS Employers states that current clustering arrangements will not automatically become the new boundaries for merged ICBs. Any merger is subject to ministerial approval, but clustered ICBs will be exploring mergers to function on their reduced costs. 

A: A single Chair (Designate) and Chief Executive (Designate) will be appointed for the cluster. These will initially be designate roles because each ICB will retain its statutory status under Cluster arrangements.

A: Staff will remain employed by their current ICB – but this will be reviewed as part of any future management of change process. 

A: Initially, a Transition Committee was established to oversee the Clustering arrangements, with representation from all three ICBs.  

Now a Chair, Chief Executive and Executive Team has been established, this senior leadership team will oversee the change management, with support from colleagues across all three ICBs. Within the Executive Team, the Transition Director will be responsible for this transformation portfolio. 

There are also five working groups across the cluster, each with an SRO who will connect with cluster colleagues to deliver aligned, expert advice to the programme: 

1. Management of change (people): Philippa Hunt, Chief People Officer, NHS Nottingham and Nottinghamshire ICB 
   
   
2. Operating model: Victoria McGregor-Riley, Director of Strategy and System Development, NHS Nottingham and Nottinghamshire ICB 
   
   
3. Staff and stakeholder communications: Sean Thornton, Director of Communications and Engagement, NHS Derby and Derbyshire ICB 
   
   
4. Finance: Marcus Pratt, Interim Joint System Director of Finance, NHS Derby and Derbyshire ICB, NHS Nottingham and Nottinghamshire ICB 
   
   
5. Governance: Lucy Branson, Director of Corporate Affairs, NHS Nottingham and Nottinghamshire ICB .

A: Trade unions are being actively engaged in the management of change process. We have held dedicated meetings with trade union representatives and our People leads continue to keep them updated. We are moving to a formal recognition agreement across the cluster. A formal recognition agreement is a written contract between an employer and a trade union that establishes the terms for the union to represent employees and engage in collective bargaining on their behalf across the cluster ICBs.

A: The trade unions we are meeting with across the DLN cluster are:  

• UNISON 

• Unite the Union 

• Royal College of Nursing 

• British Medical Association 

• The Pharmacy Defence Association 

• GMB Union 

• Managers in Partnership 

A: This is unlikely. Colleagues will only be excluded from the scheme if they are already part of another consultation process.

A: The consultation and selection process post-consultation would be completed before the new operating model for the clustered ICBs goes live. 

A: The only information we have is published in the ICB cluster blueprint. When more information becomes available it will be shared with colleagues so that they have more information upon which to make personal decisions.

A: This will be subject to consultation. 

A: This is something we definitely want to do. While we all have different populations, frailty, deprivation and activity pressures is something we are all experiencing, therefore it would make sense that we have a joint view of our intentions and align where possible. 

A: We may not need multiple providers, however the numbers and geographic coverage hasn’t been discussed yet. This will be part of our market development approach.

A: This will be subject to consultation. 

A: We are waiting to understand the funding that will follow any staff groups that transfer into the clustered ICBs.

A: The equality impact assessment will be shared with colleagues and include consideration of both statutory protected characteristics and specific ICB policies. 

A: The clustered ICBs are working to the requirements set by NHSE and as announced by the Government. The clustered ICBs will be developing a future operating model in line with the requirements as specified for operation as a strategic commissioning organisation. 

A: Programme costs are those costs that are typically associated with frontline care delivery, compared to running costs which are generally our organisational overheads. Running costs are made up of a range of expenditures – including staff pay, supplies and services that are needed to keep our organisation running.

A: All areas are being considered. This includes saving money by reducing the costs of estates, IT systems, travel, and organisational development and maintaining vacancy control measures.

A: Yes, this is under review as part of broader strategic planning.

A: All options to avoid redundancy will be considered but it is important to share that reducing hours or job sharing is unlikely to deliver the level of savings that are required.

A: No. All ICBs are required to meet a spend of £19 per head of population. This is a national target.

A: The cost per head of population has been increased from £18.76 to £19.00 to take account of the recent NHS Pay Award, which takes effect in August’s pay. Finance colleagues continue to work through and understand the implications of the change from £18.76 to £19.

A: No further guidance or timescales have been issued and we await the publication of the Model Region and Model Provider Blueprints to give us a clearer indication as to how this transition will take place. As we develop our new arrangements we will continue to ensure dedicated capacity to manage the transition, including any transfer of functions out of the ICB.  We will continue to work in   partnership and collaboration with NHS England and other receiving organisations to ensure timely, safe and effective transfer of functions.

A: The work carried out by CSUs has been factored into the ICBs’ planning from the outset. Services delivered at scale by CSUs have been included in cost reduction modelling, even where they are currently delivered externally. Dr Penny Dash's Review of patient safety across the health and care landscape makes the recommendation to dissolve Healthwatch England and Local Healthwatch, and for their remits to be shared between DHSC, ICBs and local authorities. Further details on these services, like many others, will be provided as the detail becomes available.

A: Finance colleagues will be working to meet the requirements and timescales necessary to achieve the running cost allowance allocations set at £19 for the coming financial year. 

A: All employers have a legal requirement to consult with ALL staff with regards to any changes that maybe proposed to their employment. In accordance with the Employment Rights Act 1996, employers MUST offer individuals who are pregnant, on maternity, adoption or shared parental leave suitable alternative positions if there is one.

A: Yes, there are some special categories of staff including those who are pregnant. Please see the Change Management and Pay Protection Policy for more information. 

A: The ICB must consult with ALL staff with regards to any proposed changes to an individual’s employment.

A: The ICB has a legal requirement to consult with ALL staff in regard to any proposed changes to an individual’s employment. This includes staff that are on career break or external secondment.

A: There are no additional protections for people on sick leave, and each case would need to be discussed individually. People who are pregnant or on maternity leave are protected. We are committed to a reasonable and fair process across the cluster, so please speak with your line manager in the first instance if this affects you.

If you volunteer to take redundancy and take up subsequent employment within a qualifying NHS employer or any of the organisations listed on the GOV.UK website, you will be required to pay back some or all of your redundancy pay according to the stipulations in your settlement agreement. This is detailed in the scheme as: 

• Six months claw back period for redundancy payments less than £100,000 

• 12 months claw back period for redundancy payments more than £100,000 

If you leave via Compulsory Redundancy and subsequently take up employment with an NHS organisation, the claw back period is one month following your exit date for Agenda for Change contracted staff. 

A: There is a difference between continuous service and reckonable service. You need two years of continuous service to be eligible for a redundancy payment and this is where the one-week break comes in. Where there is a break of a week (measured Sunday to Saturday) that will break that service. Where there has been a break in service of 12 months or less, the period of employment prior to the break will count as reckonable service. 

A: Yes – but this will be subject to colleagues meeting the agreed VR scheme criteria, which will be consulted upon.

A: This is for individuals to seek advice and make the appropriate pensions applications. 

A: Contractual redundancy is calculated on your gross salary. If you take partial retirement and reduce your hours by 10% or more any redundancy payment will be calculated on your new adjusted salary.

A: If you chose to retire and return you will be required to have a break in service and return to work after a minimum period of a week. For continuous service purposes this breaks your service and should you be made redundant your previous continuous service will not count towards a contractual redundancy calculation.

Example – In 2022, Lesley was 60 years of age, had 30 years' service and worked full time. Lesley made a decision to retire and return, drawing her pension, and returning to her role on significantly reduced (15) hours per week.

As Lesley chose to retire and return, she is required to take a break from work of at least a week. The break from work breaks her continuous service.

If Lesley is made redundant her continuous service will be calculated from the date that she returned to work, and the hours and income of her role in 2022. The previous service she had accrued does not count towards any redundancy calculation.

A: It will be dependent upon where in the application process you are, the closer to your retirement date the harder it is stop the process with the national team but it is not impossible. Please speak with the HR Team to discuss next steps.

A: Unfortunately not. Section 16.6 of Agenda for Change Terms and Conditions states:

16.6 The following employment will not count as reckonable service:

Where the employee has previously been given NHS pension benefits, any employment that has been taken into account for the purposes of those pension benefits.

You may still be eligible for a statutory redundancy payment, but we will discuss these with individuals as they are identified.

A: If you're aged 55 and over and you have agreement from your employer, you can choose to take part, or all of your pension benefits while you continue working in NHS employment and build your pension benefits in the 2015 Scheme. This is called partial retirement - it may also be known as drawdown.

The pension benefits you take through partial retirement will be paid as a monthly amount.

You can take a minimum of 20% and up to a maximum of 100% of your pension benefits in one or two drawdown payments, without having to leave your current job.

More information on partial retirement is available at Partial retirement | NHSBSA.

Partial retirement maintains continuous service (unless there was a break in service) but does not count towards contractual redundancy payment - more information in Agenda for Change Terms and Conditions Section 16.

A: It is likely that individuals will have several options available to allow them to choose to exit the organisation should they wish to.

Flexible retirement is always available to staff. Individuals will need to consider the available options within the remit of their own personal circumstances to make an informed choice on the best course of action for them. Advice and information on individual pension forecasts can be sought from NHS Pensions NHS Pensions | NHSBSA.

A: People will need to seek individual pensions advice. If an individual is waiting on a pensions statement to make a decision about voluntary redundancy, notice will be running if the individual has been approved but the exit date will be agreed once the individual has the information on which to reasonably make a decision. Self-Invested Personal Pension (SIPP) scheme rules would need to be considered by the individual.

A: All external recruitment is paused. Internal secondments and fixed-term posts are under review.

A: Yes, if they are significantly different from existing roles.

A: No – colleagues will be automatically re-graded as part of any process

A: Yes

A: A position on all HR processes and policies, including secondments, will be developed for the clustered ICBs. 

A: This will be subject to consultation – appointments process, and process following competitive selection processes, will be communicated as part of any future schemes.

A: Once a proposed structure is consulted upon, individuals and their representatives will be able to make observations and recommendations as part of the consultation process.

A: We know it has been a frustrating time waiting for updates on the next steps, but progress is continually being made. You may want to prepare for future changes by:

Familiarising yourself with the model ICB blueprint  and think about how your work fits into that.

Listing your skills, experience, and achievements.

Signing up for NHS elect career training sessions.

Speaking to your line manager about whether you want to be updated on any news if you are on leave.

Continuing to support your colleagues across the cluster. Be kind and compassionate and look out for those colleagues who may be experiencing upset and difficulty. Let your line manager or an executive colleague know if you think extra support is needed.

Your organisation’s dedicated intranet pages will be updated as more information becomes available and will include updates on decisions, as well as career and wellbeing support. We have agreed that all three ICB’s will relay the same information so that access to this information is full and fair.

We have agreed that all three ICBs will relay the same information so that access to this information is full and fair.

A: You can find more information on the staff intranet, including details on the Employee Assistance Programme. These pages include information about the Midlands Regional Support Offer, which is designed to complement local health and wellbeing offers https://midlands.leadershipacademy.nhs.uk/our-offers/regional-support-offer-2025-2026/

A: We are not aware of any national schemes specifically for ICBs, however specific support across the clustered ICBs will be provided.

A: For those who do wish to share concerns or have questions to raise we encourage you to do so. You can raise these by emailing licb.staff-feedback@nhs.net or on Team Talk Live.

Your line manager, executive director and HR colleagues are also available if you wish to raise anything of a personal nature.

A: The cluster is reviewing the current arrangements for networks and will be seeking input from colleagues across the cluster.

A: A Continuous Service Date (CSD) is used to determine how much of your service, if any, with any recognised NHS organisation is taken into account when calculating your entitlement to:

•    Sickness absence pay,
•    redundancy pay,
•    contractual maternity / paternity / adoption leave and pay,
•    annual leave.

There are three dates that are used to calculate your entitlements to the contractual elements above, but the important one for redundancy calculation is your CSD 1 Week date.

This is the date that you have continuous service with the NHS from, with either no break or a break of less than a week. A week is measured Sunday to Saturday: there should be a break of 1 full week from Sunday to Saturday for the break to be considered a break in service.

You can check your continuous service date in the ESR Self Service Portal. When you log into the portal you will find a screen as below:

Scroll down until you see ‘My Employment’:

Click ‘View Details’ and then ‘View more information’ at the bottom:

On the next information screen scroll to the bottom of the page and you will see your CSD Dates there:

A: This should have been addressed at the point you received your contract of employment. However, if this did not happen, you will need to provide evidence of your previous employment. This can be in the form of the following original documents:

•    Contract of employment
•    P45 from end of previous employment
•    NHS Pension statement detailing previous employment dates.

If your surname has changed you will need to provide evidence of your name change.

A: You can request HMRC to provide evidence of your employment history. You can find further information here -https://www.gov.uk/get-proof-employment-history

A: GP practices are independent employers and do not employee staff on Agenda for Change terms and conditions of employment. Service in a GP practice does not count towards continuous service.
If your previous employer has accepted your GP service as continuous service, this should be reflected in your contract of employment and should be visible in ESR when we run an Inter Authority Transfer (IAT). If this is not obvious when we run the IAT you will need to provide the evidence that your previous employer accepted the service as continuous, otherwise we will process the IAT as stated.

A: Aggregate service is calculated at the point of your appointment and is accurate as at your start date with the organisation. Your aggregate service figures will not update during your employment with the ICB.