Jonathan Higman
Chief Executive
The latest on our cluster developments
I wanted to update you on the changes happening within our Integrated Care Boards (ICBs) across Bath and North East Somerset, Swindon and Wiltshire (BSW), Dorset and Somerset and the next steps in our transformation.
Last year, in March 2025, the Government announced significant changes for the Department of Health and Social Care, NHS England as well as for many other NHS organisations.
As part of these changes, Integrated Care Boards (ICBs) were asked to reduce their running costs by 50% and to reshape their focus, role and functions.
Clustering and merging
It was acknowledged that to achieve this, local systems would need to operate across larger footprints to benefit from the efficiencies of working at scale. In June 2025, NHS England and ministers formally approved the bringing together of our three ICBs – BSW (Bath and North East Somerset, Swindon and Wiltshire), Dorset and Somerset – into a new cluster.
Over the next 12 months we will be joining up our three ICBs into one merged organisation due to happen in April 2027. For now, we will work together as a ‘cluster’.
Senior leadership changes
As part of our approach to bringing our three organisations together, and to support the changes of function, we have:
- Appointed a single Cluster Chair in September 2025 – Rob Whiteman
- Appointed a single Cluster Chief Executive in September 2025 – Jonathan Higman
- Appointed a single Cluster Executive team in December 2025*
- Our Cluster Executive team will formally take on their new responsibilities from Wednesday 18 March 2026.
We have been working closely together since January to support the development of our new target operating model and organisational structures.
Next steps in our change process
Our focus is on building a strong future as a strategic commissioning organisation; through high quality and effective commissioning we have a unique opportunity to make a difference to our people and communities by helping them to live happy and healthy lives.
We must also significantly reduce our running costs, and I want to take a moment to recognise that this next step in our change process is going to be incredibly difficult for our staff. We expect nearly 200 colleagues to leave our organisations over the coming weeks as part of our voluntary redundancy process.
In parallel to this, on Wednesday 18 March, we will launch a staff consultation on our new organisational structure. This new structure is radically different. It signals a change in our role and purpose as an organisation and will have a further significant impact on teams and staffing as we come together as one team working across our new cluster.
Over the coming weeks we are keen to engage with you as a valued partner as the change in the operating model of the ICB will mean that we will not be able to continue to do everything that we are doing today. We will need to manage this in a planned way, and I am keen to work together to ensure we manage this transition successfully.
This is an incredibly unsettling time for colleagues working in the three ICBs and I thank you for your ongoing support to our people and organisations as we go through this process.
Strategic commissioning – our role and purpose
The NHS is in the midst of a significant change programme. The 10 Year Health Plan provides a vision for a sustainable health service for the future focussed around three shifts:
- Analogue to digital
- Hospital to Community
- Treatment to Prevention
As a strategic commissioning organisation, we have a key role in working with our partners to enable this transformation through effective commissioning which ensures we deliver the maximum value for our populations.
Our new role as a strategic commissioner will be to radically re-imagine how we use our resources to improve our population health outcomes.
The national Strategic Commissioning Framework sets out our new role as a ‘strategic commissioner’.
Our role is to transform our local NHS through exceptional commissioning and build an innovative health system fit for the 21st Century that truly meets our communities’ needs.
We want to increase our focus on prevention and ensure that when people need care this is easier to access, and more joined up, this means:
- Enabling people to live in better health for longer
- Focusing on developing a neighbourhood health service
- Radically changing how people interact with the NHS through a significant increase in the use of technology.
Our purpose is to make sure we use every pound (and resource) in our system to deliver the greatest possible value for everyone we serve.
Cluster governance arrangements from May 2026
The cluster governance model is now being designed in alignment with our new target operating model and the functions/duties that the ICBs and the cluster are required to discharge as strategic commissioners.
Our three ICB boards across BSW, Dorset and Somerset will be retained while the ICBs remain as legal corporate entities until our planned merger in April 2027; however, the boards will delegate the majority of their powers and authorities to a new Joint Cluster Committee (the Cluster Board) and only meet on very rare occasions to transact the business that they cannot delegate.
The ICB Boards will establish joint committees and delegate powers and authorities to them. It is envisaged that this will be the case for all but the Audit Committees.
This is now subject to approval by the three ICB Boards in our cluster.
We are also working with partners to develop a series of place-based governance arrangements that will enable us, over time, to delegate additional responsibilities to place.
