The document also advises ICBs to streamline Boards and reduce headcount.

ICBs have been asked to submit plans by 30 May on how they intend to achieve a £18.76 operating cost envelope.

While vaccinations and screening are to be delegated by NHS England to ICBs in April 2026, the development of neighbourhood and placed-based partnerships and primary care operations and transformation are to be delegated to neighbourhood health providers over time.

The document follows a meeting last month in which ICB chiefs were reportedly asked to set out their merger plans with a guideline population of 2m within existing NHS regions by the autumn.

Sarah Walter, director of the NHS Confederation's Integrated Care Systems Network said the document, which has been developed with ICBs, set out a ‘helpful overview of the future role of ICBs' and provided ‘much-needed clarity about the proposed future functions in the context of a changing health and care landscape'.

Walter added: ‘It is helpful to see ICBs' role as system leaders confirmed, with a focus on improving population health, reducing inequalities and ensuring the best use resource, both now and in the future. ICBs will perform a crucial role as strategic commissioners in delivering the Government's plans for the future as they drive reform and deliver against the ambitions set out in the forthcoming 10-Year Health Plan.'

Walter said the 10-Year Plan will ‘contain a new operating model, giving clarity on the future role of the centre, regions and future neighbourhood health model'.

She added: ‘It is vital to ensure that the progress made by ICSs in fostering a collaborative approach to supporting the health of the population is preserved amidst these changes.'

Mark Dayan, policy analyst and head of public affairs at Nuffield Trust told HM  the blueprint signaled a 'narrowing down of the role of ICBs' and a move towards future expansion of NHS regions. 

Dayan said the full direction of travel would be revealed with publication of the 10-Year Health Plan.