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: Key appointments (Chair and CEO) and structural decisions are expected over summer 2025. Understandably these appointments must meet the demands of national processes. Dr Kathy McLean’s appointment as Chair (Designate) of the Integrated Board Cluster was confirmed on 1^st September. Confirmation of the CEO will follow.

This will be followed by the appointment of a single board and Executive Directors for the cluster, which will take place from August onwards, who will work with the Chief Executive Designate to shape the future design of the clustered organisation.

The appointment of the cluster’s Senior Leadership Team will be from November 2025.

The vast majority of staff will be involved in a restructure process after this from early 2026 onwards. We do know that formal consultation will occur once initial structures are developed, and every member of staff potentially affected will be informed and able to provide feedback.  This feedback will inform the development of the final operating model.

 As we go through some changes in the organisation, there might be times when staff are asked to temporarily take on different tasks or roles. This could include people affected by earlier rounds of consultation. Anyone stepping into a temporary role won’t be at a disadvantage when it comes to the overall change.

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: This planning assumption is not pre-deterministic of any future strategic commissioning arrangements. Further advice will be sought from NHSE regional colleagues and engagement with wider stakeholders to confirm a future organisational form, which may include a merger of current ICBs. 

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.

A: Transition Committee has been established to oversee the clustering arrangements, with representation from all three ICBs. The Committee is formed of:

NHS Derby and Derbyshire ICB:

• Chris Clayton, Chief Executive
• Helen Dillistone, Chief of Staff
• Jill Dentith, Non-Executive Member
• Margaret Gildea, Non-Executive Member

NHS Lincolnshire ICB:

• Clair Raybould, Chief Executive
• Sandra Williamson, Director for Health Inequalities and Regional Collaboration
• Sharon Robson, Non-Executive Member
• Julie Pomeroy, Non-Executive Member

NHS Nottingham and Nottinghamshire ICB:

• Amanda Sullivan, Chief Executive
• Victoria McGregor-Riley, Acting Director of Strategy and System Development
• Jon Towler, Non-Executive Member
• Stephen Jackson, Non-Executive Member

In addition, an ICB Transition Programme Board has been established which supports oversight and delivery of the programme:

• Victoria McGregor-Riley, Acting Director of Strategy and System Development, NHS Nottingham and Nottinghamshire ICB
• Helen Dillistone, Chief of Staff, NHS Derby and Derbyshire ICB
• Sandra Williamson, Director for Health Inequalities and Regional Collaboration, NHS Lincolnshire ICB

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): Anne Lloyd, Director of Workforce Transformation, NHS Lincolnshire 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: 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 at this stage are being considered. This includes saving money by reducing the costs of estates, IT systems, travel, and organisational development and maintaining vacancy control measures. Suggestions on how we can continue to be more efficient are welcomed and can be submitted via the form on the staff intranet.

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

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: It is likely, but the aim is to minimise them. It is the intention to explore voluntary redundancy first where this is possible. At this stage we are still unable to announce a Voluntary Redundancy (VR) scheme, as it has not been agreed at a national level.

A: The workforce across the entirety of the three clustered ICBs will be reviewed as part of restructuring and subsequent redundancy processes.

A: Agenda for Change (AfC) terms are as follows: One month's salary for every completed year of service up to a maximum of 24 years' service (24 months payment). Only one full year of service will count towards a redundancy calculation.

A month’s pay, subject to a total annual earnings floor of £23,000 and cap of £80,000 (pro rota for part time workers), will be either an amount equal to 1/12th of the annual salary at the date of termination or 4.35 times a week’s pay whichever is more beneficial to the employee (the average month has 4.35 weeks). The calculation of 4.35 times a week’s pay should be made in accordance with the.

A: Yes. Continuous NHS service (with breaks of less than one week) is used to calculate redundancy entitlement. You can check your Continuous Service Date (CSD) in ESR.

A: Speak to your line manager in the first instance to let them know you believe this is an issue. You will need to evidence your CSD (through payslips, HR documents etc) so start gathering these, and then with the support of your line manager, any correction request can be made. You are always able to contact HR colleagues directly for more information about this process.

A: Yes, TUPE or Cabinet Office Statement of Practice (COSOP) regulations will apply, preserving continuous service. TUPE entitlements remain as detailed in the NHS terms and conditions handbook.

A: The first £30,000 is tax-free. Anything above is subject to income tax. Find out more about how to calculate redundancy: https://www.nhsemployers.org/articles/nhs-redundancy-arrangements.

A: A salary sacrifice amends your gross salary by the amount of your salary sacrifice. Any redundancy calculation will therefore be based on the gross salary once your salary sacrifice has been deducted.

Example: John A Smith has a gross salary of £78,814. They have a salary sacrifice lease car, the annual gross deduction for the lease car is £9,326.

John’s gross salary for the purposes of redundancy will be £78,814 - £9,326 = £69,488.

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: These contracts will be reviewed and discussed on a case-by-case basis with the colleague and their ICB as no decisions have been made on a wider level on fixed-term contracts at this stage. HR colleagues are aware of the need for an equitable process with regard to these contracts and the people subject to them and those affected will be contacted.

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: 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.

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: 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: 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: 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.