Pioneers of reform: realising a new vision of ICB strategic commissioning

Appendices

Appendix A: ICB spending as a percentage of all public sector spending in England

Total public spending in England 2025/26 (revenue and capital)

UK forecasted total government spending 2024/2025: £1,335 billion. (Of this sum, £277 billion is expected to be spent on health). Source: Autumn Budget 2024 print
According to the House of Commons Library, 65 per cent of all public spending in 2022/23 was in England. We assume this percentage holds in 2025/26, given the Barnett formula fixes funding for the devolved administrations in Scotland, Wales and Northern Ireland relative to spending in England.
Therefore, of the £1335 billion public spending for 2025/26 committed at the October 2024 Budget, total public spending – including annual managed expenditure covering areas like welfare - in England is £867.75 billion, while departmental budgets are £648.4 billion. £214.1 billion of this goes to health and social care in England.

Integrated care board allocations 2025/26 (revenue and capital)

NHS England’s Allocation of Resources 2025/26, published 30 January 2025, breaks down spending by sector. We amalgamated spending by sector and across every ICB (Our spreadsheet is available on request). This includes:
- ICB core allocations 2025-26: £123,889,611,000
- Specialised allocations 2025-26 (physical health services + MH resource allocation): £15,872,440,000
- Primary medical care (PMC) allocations 2025-25 (recurrent allocations): £11,927,659,000
- Pharmacy, optometry, dental (POD) applications 2025-26 (Total allocation): £6,150,657,000
- ICB running cost allowance (RCA): £873,992,000
This gives a combined revenue allocation of £158,714,359,000
NHS England published Capital guidance 2025/26 which provides a ‘system-level allocation to fund day-to-day operational investments’ of £4.9 billion for 2025/26
Therefore, the combined total revenue and capital allocation is: £165,614,359,000

ICB spending as a proportion of total public spending in England 2025/26 (revenue and capital)

ICB total spending of £165,614,359,000 as a share of total public spending in England 2025/26 of £867,750,000,000 is 18.86 per cent.
ICB allocations are 18.86 per cent of total departmental spend – rounded up to 19 per cent with no decimal places.

Appendix B: Further resources

Timmins, N. and Ham, C. (2013) The Quest for Integrated Health and Social Care: A Case Study in Canterbury, New Zealand. The King's Fund.
Baker, G.R. et al. (2019) Jönköping County Council: A Learning System. BMJ Quality & Safety.
Habicht, T. et al. (2018) Estonia: Health System Review, Health Systems in Transition.
Vrangbaek, K. (2016) The Danish Health Care System, The Commonwealth Fund International Health Care System Profiles.

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