Under a blueprint document in May, ICBs were asked to streamline boards and reduce headcounts but North East and North Cumbria ICB chief executive Sam Allen told a board meeting at the end of last month that its plans have had to be put on hold.

Allen said: ‘We are ready now to consult with our staff on our proposals to achieve the operating model on the operating costs we have been set by NHS England but we are unable to proceed at this point in time because it is not year clear how the redundancy costs will be funded.

‘I am concerned about the impact that is having on our staff in terms of their well-being but also morale in what is also a busy time for us as we seek to implement the 10-Year Plan. I hope that we are able to find resolution on this in the very near future.'

Sarah Walter, director of the NHS Confederation's ICS Network, said: ‘Health system leaders are having to make some very tough decisions in order to meet their stretching financial recovery plans. This includes massively downsizing, wholesale restructuring, and mergers ICBs.

‘But it is clear that if they cannot get redundancy schemes underway soon then they will not be able to make the savings planned for this financial year. The knock-on effect of this will be the NHS cannot balance its books and the Government's ambitious reforms will be delayed. It is vital that funding for patient-facing services is not impacted by redundancy programmes.

‘That is why it is vital that ICBs are given the go ahead to start these vital changes, which are necessary to start putting the NHS on a sustainable footing.'

The news comes as The Times reported no central pot for the redundancies which are expected to cost up to £1bn has been put in place.

An NHS England spokesperson said: ‘ICBs have worked flat out to identify savings that can be reinvested back into patient care, and NHS England is now working through how to deliver the associated redundancy costs as quickly as possible.'