The stories of financial tensions between councils and Integrated Care Boards (ICBs), as chronicled by The MJ and its sister title Healthcare Management, will be wearingly familiar to many. Of course, there needs to be some aiming off for different interpretations of specific statutory responsibilities. Also, the timelines chosen for quantifying the scale of the differences will have a bearing on the overall narrative. Despite those important elements of context, however, financial tensions are undeniably a facet of a number of relationships.
The sources of this are often relatively enduring and, in some cases, stretch back well beyond the establishment of ICBs in 2022. Honestly held differences over where the burden should fall for aspects of continuing healthcare, arguments about how the Better Care Fund is allocated, or who invests in – and who gets the financial benefit from – preventative activity are not, on the whole, new areas of dispute. Despite the best of intentions, the wider public service resourcing climate of recent years can also create conditions that exacerbate the challenges of cross sector working.
