Consultants sought to help ICBs control £7.5bn care spend

NHS England is developing plans to procure external expertise to help it cut the cost of the £7.5bn all-age continuing care services on a “no saving, no payment” basis.  

All Age Continuing Care (AACC) involves the assessment and then funding of ongoing support for eligible individuals who have long-term, complex health and social care needs. 

The government initially signalled that integrated care boards would lose responsibility for AACC as part of their rationalisation and shift to strategic commissioning. That decision was reversed  when it became clear there was no viable alternative host at present. However, ICBs have been told to consider delegating non-statutory responsibilities.

Market engagement documents on the proposed programme warn of unwanted variation of up to 2.6 times per capita across integrated care systems and a persistent national overspend on AACC of around 5%.

NHSE is considering contracting suppliers to first “diagnose” the reasons behind the variation and overspend and then to undertake “targeted system-level deep dives” to resolve the problems.

The engagement documents state the proposed “commercial model” would link “payment exclusively to validated, cash-releasing savings”. It adds it would result in “no new central consultancy spend” and that there would be “no payment where savings are not delivered”.

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Source: HSJ, 4 June 2026