Anyone trying to work out who actually decides what care gets funded in London quickly runs into two similarly-named bodies: the Integrated Care Board and the Integrated Care Partnership. They are not the same organisation, they do not have the same powers, and confusing them means misunderstanding how integrated care board commissioning actually works across the capital. This piece sets out the legal distinction, who sits where, and what it means for how London’s care is planned and paid for.
Two Bodies, One System
Every part of England is covered by an Integrated Care System (ICS) — a partnership arrangement bringing NHS organisations, councils and other local bodies together to plan care for a defined population. Within each ICS sit two statutory components with very different jobs.
The Integrated Care Board (ICB) is the NHS body. It holds and manages the NHS budget for its area, commissions most NHS services from hospitals, community providers and primary care, and is directly accountable for NHS spending and performance. Its board is drawn from local authorities, NHS trusts and foundation trusts, and primary care representatives, and it is required to produce a five-year plan setting out how the NHS will contribute to the area’s wider care strategy.
The Integrated Care Partnership (ICP) is broader and has no budget of its own. It is a statutory committee that brings together the ICB, local councils, and voluntary and community sector organisations to write an integrated care strategy covering not just NHS services but the wider determinants of health — housing, employment, public health and social care. The ICB is legally required to take that strategy into account when it makes commissioning decisions, but the ICP itself cannot commission or spend.
In short: the ICP sets the direction, the ICB writes the cheques.
Where the Split Comes From
Both bodies exist because of the Health and Care Act 2022, which was passed in April 2022 and became operational when ICBs and ICPs were formally established as statutory bodies on 1 July 2022. The Act abolished Clinical Commissioning Groups (CCGs), the GP-led bodies that had held the commissioning budget since 2013, and replaced them with this two-tier structure. The reasoning behind the split was explicit: separate the body that is accountable for NHS money (the ICB) from the forum that is meant to represent the full range of local interests, including those outside the NHS entirely, in shaping strategy (the ICP).
That design has a direct echo in the London Health Commission’s own founding logic. The 2014 "Better Health for London" report argued that the capital’s health outcomes could not be improved by the NHS acting alone — that air quality, housing and employment mattered as much as hospital capacity. The ICB/ICP split is, in effect, a statutory version of that same argument: NHS commissioning decisions are meant to be shaped by a wider partnership, not made in isolation from it.
London’s Four ICBs
London’s commissioning map has consolidated significantly since 2022. The capital is now covered by four ICBs, following the merger of the North Central London and North West London ICBs into a single West and North London ICB, effective 1 April 2026, which now covers 13 boroughs.
| ICB | Approximate coverage | Status |
|---|---|---|
| NHS North East London ICB | East London boroughs | Unchanged |
| NHS South East London ICB | South-east London boroughs | Unchanged |
| NHS South West London ICB | South-west London boroughs | Unchanged |
| NHS West and North London ICB | 13 boroughs across north and west London | Formed April 2026 from the merger of NCL and NWL ICBs |
Each ICB has its own corresponding ICP, meaning London now runs four parallel strategy-and-budget pairings rather than the larger number of smaller CCGs that preceded them. Fewer, larger commissioning footprints is the clear direction of travel — a pattern worth watching for anyone tracking how the capital’s care planning is structured.
Why the Distinction Actually Matters
For anyone engaging with London’s health system — a provider, a local charity, a resident trying to understand why a service changed — knowing which body does what changes where you direct attention. A complaint about NHS waiting times or a funding decision is an ICB matter, because the ICB holds the budget and commissioning authority. A concern about how health, housing and social care fit together, or about whether the wider strategy reflects local need, is properly an ICP matter, because that is the forum designed to represent those interests.
The distinction also explains a recurring source of public confusion: an ICP can publish an ambitious strategy on, say, reducing health inequalities, without that strategy translating immediately into ICB spending decisions. The ICB must have regard to the strategy, not follow it automatically. Understanding that gap is essential to reading any London ICS strategy document realistically, rather than assuming a stated priority is automatically funded.
Conclusion
The ICB and ICP are often used interchangeably in casual conversation about NHS commissioning, but the Health and Care Act 2022 built them as two deliberately different institutions: one holding the money and the statutory NHS commissioning duty, the other holding the broader mandate to set direction across health, care and the wider determinants of health. With London now organised around four ICBs following the 2026 north London merger, understanding which of the two bodies actually controls a given decision is the first step to understanding how the capital plans, commissions and funds its care.