The way the NHS is organised in the South West is changing.

Against a backdrop of challenging public finances, 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. This will see a sizeable reduction in staff numbers.

At local level, the seven integrated care boards (ICBs) in the South West, which commission the great majority of health services, are also changing. All will reduce running costs and shift their primary focus to strategic commissioning and neighbourhood health.

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

• NHS Gloucestershire ICB and NHS Bristol, North Somerset and South Gloucestershire ICB
• NHS Dorset ICB, NHS Somerset ICB, and NHS Bath and North East Somerset, Swindon and Wiltshire ICB
• NHS Devon ICB and NHS Cornwall & Isles of Scilly ICB

The clusters were agreed by the seven 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 is designed to lead on 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. These may not be clear before summer 2026.

Chairs for the clusters were approved by the Secretary of State:

• Gloucestershire ICB and Bristol, North Somerset and South Gloucestershire ICB

Jeff Farrar, previously Chair of Bristol, North Somerset and South Gloucestershire ICB

• Dorset ICB, Somerset ICB, and Bath and North East Somerset, Swindon and Wiltshire ICB

Rob Whiteman, previously Chair of Dorset ICB

• Devon ICB and Cornwall & Isles of Scilly ICB

John Govett, previously Chair of Cornwall & Isles of Scilly ICB

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