HR Framework for Developing Integrated Care Boards: what you need to know

A summary for members of NHS England and NHS Improvement's HR framework for the transition to integrated care boards.
Syeda Munim

19 August 2021

This briefing digests the main points of NHS England and NHS Improvement’s (NHSEI) HR Framework for Developing Integrated Care Boards. It highlights where members’ concerns and questions have been addressed, and signposts to advice and support. It also provides our take on the framework and how we will be supporting members through the transition.

Key points

  • The HR Framework sets out NHS England and NHS Improvement’s national policy ambition for the safe and compassionate transfer of clinical commissioning group (CCG) staff to NHS integrated care boards (ICBs). The framework allows for some local flexibility and intends to complement regional and integrated care system (ICS) approaches, as well as local employer policies on the transfer and transition already in place in systems.
  • Guidance is included on recruiting for senior leadership roles and some specification given on how current board-level staff will be affected. Board-level staff will not be covered by the employment commitment and therefore ICSs must have appropriate support packages in place for displaced staff members. 
  • To ensure minimal disruption, staff below board level will ‘lift and shift’ from CCGs to ICBs. Although this does not guarantee they will continue in their current role, the employment commitment aims to ensure that there is minimal organisational change. 
  • We welcome the HR Framework as an essential piece of guidance to deliver the successful transition from CCG to ICS. The NHS Confederation, including NHS Clinical Commissioners, the ICS Network and NHS Employers, have worked in partnership with NHSEI and trade unions to develop the technical guidance. While we understand that it is difficult to address the needs of every system, we will continue to work with NHSEI to support members wherever possible. 


The ICS Design Framework, published in June 2021, set out NHSEI’s expectations for the next stage of system development. It included a commitment to publish further resources and guidance to support people transition planning and implementation, in line with the principles set out in the integration and innovation white paper for handling change and transition.

The HR Framework, co-developed with a sub-group of the Social Partnership Forum, the ICS Transition Partnership Group, CCG and ICS HR directors, and NHSEI HR and OD leads, provides this guidance. Over 60 pages, it details advice, guidance and best practice on the ‘human resources and employment law considerations required to enable the safe transfer of people to the new NHS ICBs.’

The framework is divided into five main sections:

  1. Staff engagement and partnership working: which outlines how staff engagement and partnership working have been done at national, regional, ICS and employer level. 
  2. Looking after our people: which covers the impact of the transition on people’s health and wellbeing, and provides guidance on supporting the workforce.
  3. Belonging in the NHS: which provides guidance on recruitment and staff transition procedures.
  4. Managing the change for board-level colleagues: as board-level roles are not covered by the employment commitment, this section explains how colleagues can be best supported through the transition.
  5. Safe transfer for all people: which sets out the approach to the transition to ensure the safe and compassionate transfer of people from CCGs into ICBs

Employers are responsible for ensuring that decisions are taken in respect of relevant employment law, equality legislation and the public sector duty to ensure that decisions are fair, transparent, accountable and evidence-based. This also includes referring to:

This briefing highlights the need-to-know information and signposts to further resources and guidance.

Senior leadership role in an ICS

Members raised concerns over the lack of clarity surrounding the senior leader appointment process. The framework includes details to address these concerns and provide a clearer steer:

  • Below board level ‘lift and shift’: The employment commitment aims to ‘lift and shift’ all staff below board level so that their roles and responsibilities continue into the newly established ICS body. Colleagues at board level are not considered/included under the employment commitment.
  • Board level defined: The definition of ‘board level’ given in the framework is: ‘Colleagues who are likely to be affected by change following confirmation of a statutory ICS executive/board level structure.’ (p.13) The definition intentionally permits flexibility on which roles are considered ‘board level.’ There is no intention to provide a firm definition or clarification following this.
  • Roles not covered by the employment commitment: Lay members and non-executive directors are not covered under the employment commitment. However, those who wish to support the NHS in non-executive roles are encouraged to contact Keely Howard (non-executive development manager), to be included in the NHSEI talent and appointments team database.
    • All senior appointments, including chief executives and those reporting to the chief executive, must have appropriate representation from the relevant NHSEI team.
    • Professional or qualified roles must also be represented by a member of the relevant profession from NHSEI. 
    • All panels must have a diverse make up in line with the commitments outlined in the NHS People Plan.
    • If external open recruitment processes take place, appropriate attraction strategies should be considered to get the best candidate. ICSs may wish to consider executive search agencies or commissioning support units to support.
    • Organisations should outline aspirations and intentions of diversity at leadership and board level. NHS WRES guidance can be found on the NHSEI website.

Managing change for board-level colleagues

  • CCGs are encouraged to follow the policies they currently have in place on managing organisational change. The management of business cases should include:
  1. people impact assessment
  2. employee/trade union engagement and communication
  3. support plans for employees going forward
  4. arrangement for redeployed or displaced employees.
  • Board-level colleagues on fixed-term contracts will transfer under TUPE in the same way any other employee on any other employment contract will. Guidance on exit and severance payments can be found on the Gov.UK website.

Looking after our people

  • Organisations are responsible for ensuring that health and wellbeing is a top priority, particularly through the transition.
  • Staff members most affected by the transition, particularly those not covered by the employment commitment, should be supported and, where possible, organisations should aim to retain talent, skills and experience.
  • Senior leaders who are displaced should be provided with appropriate and tailored support packages; these are to be provided by the ICS. For support, access NHS Employers’ health and wellbeing  guide, and NHS England’s information on supporting people.

Belonging to the NHS

  • It is recommended that ICSs and CCGs set out clear approaches to filling subsequent vacancies with minimal disruption and increased attention to inclusive recruitment. For guidance on inclusive recruitment, please see NHS Employers’ report.
  • The framework lists six high-impact actions that members may find useful for positive and rapid progression on inclusive recruitment (Section 3.2). Further detail on intended outcomes, measures and links to race equality standards can be found in appendix 4 of the framework.
  • COVID-19 has shone a spotlight on the lack of equality, diversity and inclusion not only in health but the NHS workforce. The framework puts forward suggestions to combat this:

    • NHS employers, including system leadership, to increase BME representation at their trust and encourage rapid and focused corrective actions.
    • Raise the profile and voices of BME colleagues to support their contribution towards decision-making in organisations.
    • Equality training or refresher sessions to be provided for all. Organisations should consult their staff networks to support and inform decision-making.
    • Intentions to achieve diversity at leadership and board level should be expressed and outlined. See NHSEI’s WRES guidance.

Safe transfer for all people

  • Transfer schemes: The expected legislation will include detail on transfer schemes; colleagues at board level will be part of the transfer scheme whether in a new designate role or in a displaced position. For colleagues engaged in work for the ICS via contract for services or secondment, the transfer scheme will ensure that the agreement/contract will move over to the new ICS NHS body (See, section 5.1.1, appendix 1 and FAQ).
  • Lift and shift: Guidance on the Employment Commitment – all functions and colleagues, below board level, at CCGs will transfer from their organisation to ICS with no requirement for organisational change (Section 5.1.2).
  • People impact assessment: People impact assessments (Section 5.2) are required to identify potential impacts of the proposed changes on people working within CCGs and existing ICS workforce structure. They will also support the identification of risks and mitigating actions that could be taken and built into the management change process.

NHS Confederation viewpoint

We welcome the publication of the HR Framework as a critical piece of guidance required to support the people transition involved in the creation of statutory ICSs, including staff currently employed by CCGs. NHSEI consulted our member networks – including NHS Clinical Commissioners and the ICS Network – and NHS Employers, which is also part of the NHS Confederation, to inform the development of the technical guidance. We welcome the strong partnership working with relevant trade unions and the considerable input from our members. This has helped to shape the content, which provides vital guidance on how the transition process should be managed. NHS Clinical Commissioners and the ICS Network will continue to work with NHSEI to support CCGs to complete the safe and compassionate transfer of staff to ICSs. 

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