In March 2025, the government announced significant changes to the NHS landscape, aimed at strengthening roles and responsibilities across the wider NHS and reducing duplication, so more funding can be directed to frontline care.
These changes signal a leaner way of working, where every part of the NHS is clear on their purpose, what they are accountable for, and to whom, and will help support delivery of new 10-year Health Plan to improve outcomes for patients and communities.
As part of this NHS reform, Integrated Care Boards (ICBs) were asked to significantly reduce their operating costs (by approximately 50%) and focus on their critical role as strategic commissioners – working to improve population health, reduce inequalities and improve access to more consistent high-quality care.
This represents a step-change in ICBs’ leadership and responsibilities and an opportunity to create a fundamentally different kind of organisation focused on improving the health of our local population.
After careful consideration, the Boards of NHS Surrey Heartlands and NHS Sussex agreed to pursue plans to collaborate and create a new organisation spanning the two counties; these plans were subsequently approved by ministers and NHS England, leading to the creation of the new NHS Surrey & Sussex ICB from 1 April 2026.
From October 2025, the two organisations began to work in a cluster arrangement under joint leadership arrangements, with a robust transition programme overseeing the bringing of the two organisations together.
Following the appointment of Ian Smith as Chair, and Karen McDowell as Chief Executive in late 2025, a joint board and executive team were appointed to lead the two organisations during the clustering arrangement and into the new merged organisation. Board meetings in common were set up (from November 2025) bringing internal governance arrangements closer together whilst still operating as two sovereign organisations (until 31 March 2026).
Why Surrey and Sussex?
Our previous organisations, NHS Surrey Heartlands and NHS Sussex, alongside NHS Frimley, share a proud history of collaboration – grounded in mutual trust, aligned values, and joint delivery across commissioning, workforce, and clinical innovation. From integrated planning to shared leadership development, we have demonstrated what purposeful collaboration can achieve.
There are long-established health partnerships across Surrey and Sussex with the Surrey & Sussex Cancer Alliance, Surrey and Sussex Local Medical Committee and Community Pharmacy Surrey & Sussex, as well as NHS providers who provide NHS services to patients in both Surrey and Sussex, such as:
- Surrey & Sussex Healthcare NHS Trust,
- South East Coast Ambulance Service NHS Foundation Trust,
- Queen Victoria Hospital NHS Foundation Trust,
- Royal Surrey NHS Foundation Trust and
- University Hospitals Sussex NHS Foundation Trust.
This change has given us the opportunity to create a brand-new organisation, and to build on the strong foundations we have individually built, bringing those strengths together to deliver for our collective population.
Changes to our workforce and functions
As part of the changes, ICBs were asked to make significant savings to their operating costs – around 50% on average – to work within the agreed target of £19.76 per head of population. This led to a large-scale staff consultation on a new operating model and structural change, which will result in a much leaner organisation. These changes are expected to take effect in full from the end of June 2026.
In addition, NHS England was clear – through publication of the Model ICB Blueprint in May 2025 – that ICBs would need to focus on their role as strategic commissioners and that there would be functions that would be expected to transfer to other NHS organisations over time, including NHS continuing healthcare (CHC), medicines optimisation, elements of safeguarding and special educational needs and disabilities (SEND). Some other functions are expected to be delivered across a wider ICB footprint including data, digital and business intelligence and specialist commissioning including ambulance commissioning.
At April 2026, these changes are yet to take place, and all functions have transferred to the new ICB; any future transfers will be considered with all due process and engagement.