The way the NHS is organised in the Midlands is changing.

We are seeking to make clinical services as productive as possible and to reduce duplication, particularly in support services.

At national and regional level, NHS England, which oversees the health service, will be amalgamated with the Department of Health and Social Care.

At a local level, the 11 integrated care boards (ICBs) in the Midlands, which commission the majority of health services, are also changing.

A first step, with the aim of making the most of capacity and resources, will see the 11 ICBs cluster together in five groupings:

• NHS Birmingham, Black Country and Solihull
• Coventry and Warwickshire and Herefordshire and Worcestershire ICBs
• Shropshire, Telford and Wrekin, Staffordshire and Stoke-on-Trent ICBs
• Derby and Derbyshire, Lincolnshire, Nottingham and Nottinghamshire ICBs
• NHS Leicestershire, Northamptonshire and Rutland ICBs

The clusters were agreed by the 11 ICBs, and endorsed by ministers, based on a series of criteria including ability to:

• meet statutory functions
• improve outcomes for local people
• address inequalities
• work effectively at neighbourhood level
• operate sustainably with their financial limits

Clustering may lead in time to formal mergers; however, this would not take place until April 2027, not least as configuration also has to take into account potential changes to local authorities which may not be clear before summer 2026.  For now, clustering ICBs will work together through shared leadership and combined teams and will remain separate legal entities.

Chairs for the clusters have now been confirmed as:

From 1 October 2025

• Birmingham and Solihull ICB and Black Country ICB – Danielle Oum
• Coventry and Warwickshire ICB and Herefordshire and Worcestershire ICB – Crishni Waring
• Derby and Derbyshire ICB, Lincolnshire ICB, and Nottingham, Nottinghamshire ICB  – Dr Kathy McLean
• Leicester, Leicestershire and Rutland ICB and Northamptonshire ICB – Anu Singh

From 1 November 2025

• Staffordshire and Stoke-on-Trent ICB and Shropshire, Telford and Wrekin ICB – Ian Green OBE

Chief Executive Officers (CEOs) for the clusters have now been confirmed as:

• Birmingham and Solihull ICB and Black Country ICB – David Melbourne
• Coventry and Warwickshire ICB and Herefordshire and Worcestershire ICB – Simon Trickett
• Staffordshire and Stoke-on-Trent ICB, and Shropshire, Telford and Wrekin ICB – Simon Whitehouse
• Derby and Derbyshire ICB, Lincolnshire ICB, and Nottingham, Nottinghamshire ICB – Amanda Sullivan
• Leicester, Leicestershire and Rutland ICB and Northamptonshire ICB – Toby Sanders

With Chairs and Chief Executive Officers (CEOs) in place, other senior personnel will be appointed for each cluster following due process.