A blueprint document, which was developed by a very small group drawn from ICBs and NHS England, has advised the boards to streamline and reduce headcount as part of a broader 10-Year Plan to modernise the health service, which has sparked concerns across local government.

ICBs have been encouraged to consider mergers, aiming for a guideline population of two million within existing NHS regions by the autumn.

Concerned LGA chief executive Joanna Killian said her organisation would ‘work to ensure local government is part of the NHS England engagement plan' for the changes.

A report to a meeting of the LGA's community wellbeing board this week read: ‘Our members continue to share examples of how the financial strain on the NHS is severely hindering councils' ability to deliver essential services and jeopardising the vital relationship between the NHS and local government. 

‘As local government also enters a period of substantial change through local government reorganisation and devolution, it is important that we continue to partner well and enter this period with a culture of collaboration and mutual respect in delivering our shared objectives.' 

Whitehall insiders insisted the Government would work with the LGA to improve engagement.

Talks over forming regional clusters are being held by ICBs around the country.

In the South West, for example, mergers are being considered between Bristol, North Somerset and South Gloucestershire and Gloucestershire, NHS Cornwall and Isles of Scilly and Devon, and Bath and North East Somerset, Swindon and Wiltshire and Somerset and Dorset.

None of the ICBs were able to confirm when contacted by HM that their clusters were being developed in consultation with local government, however.

Meanwhile, NHSE has set a deadline for ICBs to merge by April 2026 or April 2027.

One Whitehall source said: ‘We have established the Council of Nations and Regions, the Mayoral Council and the Leaders Council to bring local voices into national policy making, and we will continue to ensure that local government are equal partners.'

A Government spokesperson said: ‘Engagement and co-design of health services by ICBs and local government is critical to delivering our 10-Year Health Plan. 

‘ICBs should foster strong relationships with local government to understand their population, and work to improve health outcomes, tackle inequalities and help deliver a neighbourhood health service.'