ICBs can scrap chief nurse and medic, says NHSE

Integrated care boards can now scrap the roles of chief nurse and chief medical officer – despite previous guidance saying they are required – NHS England has indicated.

NHSE told HSJ it was “for each ICB to determine which specific roles they require at board level to deliver their core functions”, after saying systems should reduce executive headcounts as part of its “model ICB blueprint”.

It comes as North East London ICB announced to staff it was scrapping its chief nurse and chief medical officer roles from its executive management team. It is restructuring in order to cut its costs in half and focus on “strategic commissioning” (see below), as instructed by government and NHSE.

The Royal College of Nursing has criticised NEL ICB’s removal of the chief nurse role – and said other systems may follow suit.

Patricia Marquis, executive director of RCN England, said: “The decision to remove the chief nurse post by the North East London ICB shows poor insight into the importance of nursing in ensuring safe patient care. Worryingly, we are now hearing that other ICBs across England are planning to follow suit. The RCN is monitoring the situation and will be supporting members to challenge decisions locally.

“As the biggest and most trusted profession in the NHS workforce, it is vital that nursing continues to have leaders in place to influence decision-making. Failure to do so risks devaluing the nursing profession and undermining the delivery of the NHS 10-Year Health Plan, which is so heavily dependent on the expertise and leadership of senior nursing staff.”

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Source: HSJ, 1 August 2025