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National policymakers are “working it out as they go along”, and integrated care board staff are “on their knees” amid a confused restructure, local leaders have reported.

Health Foundation report based on interviews with integrated care board leaders throughout last year, shared exclusively with HSJ, found they were “scathing” about the “handling and subsequent management” of the announcement of 50% cuts to staffing budgets.

ICB leaders who spoke to researchers labelled the cuts as “disgraceful”, “unprofessional”, and “an absolute shitshow”. They described surprise at “manager bashing” from government and concern that this would deter “the next generation of managers” from joining the NHS.

Leaders also described ICB colleagues as being “on their knees” and having “terrible, terrible morale”, and raised questions about the future of partnership working and ICBs as organisations. 

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Source: HSJ, 11 March 2026

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