A full merger is one of three proposals to be considered by board meetings this week as the ICBs look to achieve 50% cost savings by the end of the year.

The other two proposals are collaborating as two stand-alone ICBs or forming a cluster as two separate organisations.

A fully merged NCL and NWL ICB would be the largest in terms of population size in England – serving around 4.5m people in 13 London Boroughs (eight from NWL and five from NCL).

The recommendation points out that being able to offer scale, as a merged organisation, would enable more resilience and cost-effectiveness and also highlights the appeal of retaining and attracting staff and having greater opportunities to collaborate with partners across the combined area.

A blueprint document in May asked ICBs to streamline boards and reduce headcount.

ICBs were asked to submit plans by 30 May on how they intended to achieve a £18.76 per head of population operating cost envelope.