Q: How has this fund been created? Is it from growth in the ICBs' allocations?
A: The transformation fund comes from the growth allocations received by the ICBs. Specifically, the DLN received £190m of growth funding, which was used for a range of statutory and operational pressures, and £33m was deliberately set aside for transformation as part of that growth settlement.

Q: Will the £33m Transformation Funding be split equally across Derbyshire, Lincolnshire and Nottingham based population?
A: It is anticipated that there will a proportionate of Transformation funding across DLN which may be profiled differently over the next three years based on business case proposals received.

Q: Is there £33m available every year for the next 3 years (Total £99m) or does it increase by £33m each year for the next 3 years? (Total £198m).
A: The Transformation Fund has been identified through ICB core growth funding.
The Transformation fund will be allocated to providers non-recurrently to a maximum of £33m per year.  (Total £99m over 3 years). All proposals must demonstrate a positive return on investment within 2 years and a minimum 4:1 return over three to 5 years with at least 2:1 expected to be cash releasing.
A separate conversation will be had through contracting about how these will be transacted through contracts between acute and community providers. The goal here is to deliver allocative efficiency and make sure resources are being used in the most effective way across the system.

Q: Has the source of Transformation Funding been taken from Acute growth funding?
A: Payment mechanisms for Acute planned and emergency care are being incorporated into Acute contracts as per NHSE operating guidance.
As we look ahead to 2026-27, our system is facing a significant efficiency requirement – between 6% and 8% - so its more important than ever to make every pound count and direct funding to areas that will deliver the best outcomes for our population.
With that in mind, we recognise that simply maintaining the status quo won’t be enough. That’s why we are actively commissioning alternative pathways designed to enhance outcomes and deliver better value for our communities.
Specifically, 0.5% of ICB allocation growth funding has been earmarked to support Transformation of current services and pathways. This targeted investment is not being diverted from Acute growth funding, but rather represents a strategic use of growth allocation to drive service improvement and innovation.

Q: Can the funding be used for revenue and capital spend?
A: The ICB and partner organisations receive separate revenue and capital allocations from NHSE. For capital proposals we would look to maximise capital allocations in the first instance.
The Transformation Fund is ringfenced for revenue expenditure only.

Q: Is it return on investment (ROI) directly for the ICB or can a broader lens be taken?
A: A broader lens can be taken. ROI is not restricted solely to the ICB—benefits in acute trusts and across partners are also recognised, though health‑system savings are particularly important.

Q: Where costs are in one part of the system and savings another and, the service transformation has been a success then how (process) will the ICB manage funding flows to make this sustainable? E.g. A change (increasing cost) in community services enables Acute savings
A: Savings will be embedded and the £33m would continue to flow to sustain successful schemes. The expectation is that partners will maturely agree how benefits and costs are distributed.

Q: How will bids be prioritised if the total bids exceed the £33m allocation and will all stakeholders be part of the approval process?
A: Prioritisation is based on a weighted scoring framework:
25% Strategic & statutory fit
10% Options & rationale
40% Benefits & value for money (including ROI)
25% Deliverability
Assessment is conducted by an internal commissioning review panel, not all external stakeholders. Final decisions go to the Joint Commissioning Executive Group (JCEG). This process ensures that only the strongest 2–3 proposals aligned to priorities and demonstrating deliverability, impact, and ROI are put forward.

Q: You mentioned enlisting sponsorship from a senior commissioner to support bids. Is there a particular role within each system who that should be, and are they suitably briefed to be able to advise? We want to ensure that the significant effort that goes into a bid stands a realistic chance of being successful.
A: Applicants do not need to identify a specific named role themselves.
Instead:
Applicants should provide an indication of their area of interest,
The ICB will then assign a suitable senior commissioning lead,
That individual will be fully briefed to advise on alignment and strengthen the proposal.
This sponsorship is intended as support, not bid-writing.

Q: When will the bid templates be shared?
A: The templates are already available on the website: New DLN Transformation Fund now open  - Lincolnshire ICB.

Q: Given the 'compressed' timeline, it would be helpful to hear whether initial submissions should focus on setting out a clear strategic case, indicative benefits etc, with the expectation that fuller pathway design, clinical engagement and financial modelling will be developed during the mobilisation phase if the proposal is supported. We all acknowledge the need for pace but we also need to be proportionate / pragmatic given we have a matter of days to turnaround how we best spend £33m. Is that how ICB colleagues see this too?
A: Partially. All bids are judged equally against full criteria. Less mature bids will score lower, risking funding. However, ICB will work with applicants over the coming weeks to strengthen bids, and there is a possible second‑round opportunity if funds remain.

Q: The proforma requires the EQIA to be signed off by panel and details included in the bid. Is it going to be feasible for all bids to be reviewed at panel before 01/04 or will there be some flexibility around this requirement?
A: Preference is for EQIAs to be fully approved before submission. However, if an internal governance date is provided, this will be accepted “in good faith” as long as sign‑off is scheduled. Some flexibility exists, though the preference is completion beforehand.

Q: Is there a standard cost of A&E attendance and non-elective admission we should be using for the benefits template?

2024-25 National cost information on A&E attendances and non-elective admissions  is available on the National Cost Collection dashboard NHS England ? National Cost Collection for the NHS

This resource provides a breakdown of national average costs of each point of delivery as well as provider level costs. A more up to date patient level costing may be obtained through discussions with Acute provider finance teams.

Q: Can a non-NHS provider / partner submit an application as the lead organisation?
A:The Transformation Fund is intended to support system transformation at pace and scale. There is an explicit expectation of collaboration across health, care and the voluntary sector, recognising that delivering a positive return on NHS investment and associated financial benefits (including cash‑releasing benefits within two years) will require significant engagement from providers of NHS‑commissioned services.

For the purposes of this fund, NHS providers include NHS trusts, foundation trusts, and other organisations that hold substantial NHS contracts or commissioning arrangements within the DLN footprint. While non‑NHS organisations are not precluded from acting as the lead applicant, given the expectation of NHS financial benefit it would be prudent to clearly articulate why an NHS provider has not been identified as the lead.

Q: Please clarify the rules around this in relation to MHIS. Would anything categorised as MHIS be a straight refusal, or would there be an opportunity for a more nuanced discussion? Similarly, would non-MHIS items such as autism, LD or dementia services be eligible or are these also part of the MHIS rule?
A: The aim of the transformation fund is to accelerate bold, collaborative whole pathway redesign across our health and care landscape, rather than support ‘business as usual’.
Transformation of mental health services will be considered, however proposals should align to the ICB priorities for 2026/27 to reduce use of hospital-based services and deliver constitutional and NHS performance standards by focusing on urgent and emergency care recovery and planned care reform.
These priorities are likely to be underpinned by initiatives including integrated neighbourhood health services, improved care for people living with frailty, multiple long-term conditions and those on end-of-life pathways and ‘left shift’ of planned care. All of these should address health inequalities and inequity for our CORE20PLUS populations.
All transformation funding proposals will need to demonstrate benefits expected from the additional funding (e.g. over and above those delivered by MHIS) and there needs to be a positive return on investment.
To make the most of the financial resources available across the cluster, our approach for MHIS-related proposals will be to utilise MHIS funds as the primary source of support. If a proposal's costs exceed what MHIS funding can cover, we may supplement those additional costs with the transformation fund. This will ensure that we allocate funding efficiently and leverage both streams to maximise impact.

Q: As a VCFSE organisation, we would be interested in partnering with any lead applicants. Is there any support available to link us with relevant applicant leads?
A: Yes. VCFSE organisations are encouraged to email nnicb-nn.systempmo@nhs.net The ICB can act as a conduit, linking VCFSE organisations with potential bidding leads.

Q: Will collaboration with other partners, including the VCFSE sector be included and weighted in the assessment framework?
A: Yes. Collaboration is explicitly weighted within the assessment framework and is considered a core expectation of bids.

Q: To ensure that we develop proposals that actually meet the needs of people, will co-production and working with people be recognised as an integral part of the development of the proposal.
A: Yes. Use of existing insights from communities, VCFSE, comms and engagement teams is expected. Bespoke engagement can be included in future delivery phases where needed.

Q: Will the evaluation be completed in-house using System Analytics Intelligence Unit (SAIU) support and include ROI analysis/projections?
A: Evaluation will involve internal operational reporting from applicants, and ICB-level evaluation supported by SAIU and PMO, focusing on impact and benefits realisation.

Q: What methodology does the Cluster require to be used to evidence ROI and Social Return On Investment (SROI) please?
A: The cluster uses a HM Treasury Green Book‑style economic evaluation approach for ROI. SROI was not specifically defined, but members were invited to discuss details offline.

Q: Many of our patients utilise cross border acute trusts, would you accept evidence of impact in those other acute trusts outside Derbyshire
A: Yes, some cross‑boundary impact is expected for large‑scale transformation.
However, the majority of benefits must fall within the DLN system, given the purpose of the funds.

Q: Will all bids be shared at some points (regardless of process outcome) to enable learning and to share potential areas for future collaboration/opportunities?
A: This hadn’t been previously considered, but the panel said they see no reason it couldn’t happen, subject to applicants being comfortable.