NHS England has designated Northamptonshire Healthcare NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust as the first organisations eligible to hold an Integrated Health Organisation (IHO) contract. The trusts will now work with NHS England and local commissioners to co-develop the IHO model during 2026/27, with the first contractual arrangements expected to go live in 2027.
What designation means
The letters sent to chairs and chief executives of the two trusts and their respective integrated care boards (ICBs) were signed by NHS England’s deputy chief executive (interim) Glen Burley and regional directors. NHS England described the move as recognising “the significant progress that has been made” in preparing the systems’ strategy, orientation and infrastructure to take on new responsibilities.
“This is a significant achievement and recognises the significant progress that has been made, in partnership with your ICB and system partners, to develop the strategy, orientation and infrastructure that will be required to take on responsibility for planning, resource allocation and delivery across the care pathway.”
Next steps and assurances
NHS England said it will work with the designated trusts to develop a roadmap towards mature IHO arrangements ahead of any contract going live. The regulator is taking a developmental approach for this first wave of designations and intends to carry out a risk-based contract assurance process prior to the start of any IHO contract. NHS England warned that some capabilities may be tested in greater detail as part of that assurance work.
What an IHO will be expected to do
The letters emphasised that the defining characteristic of IHO contract holders will be taking responsibility for improving outcomes across a defined population. The IHO model represents a move towards:
- population-focused planning and delivery rather than single-organisation approaches;
- leadership across organisational boundaries to drive population health improvement;
- management of additional financial and clinical risk at system level.
Practical timetable
Both trusts will spend 2026/27 co-developing the model with NHS England and commissioners. The earliest operational start for IHO arrangements is currently projected for 2027, subject to the outcome of the assurance work and further development of national policy and local capability.
| Trust | Designation | Development period | Expected live date |
|---|---|---|---|
| Northamptonshire Healthcare NHS Foundation Trust | Eligible to hold IHO contract | 2026/27 (co-development) | 2027 (expected) |
| Northumbria Healthcare NHS Foundation Trust | Eligible to hold IHO contract | 2026/27 (co-development) | 2027 (expected) |
The designation marks the start of a phased, evaluative approach rather than immediate widespread rollout. NHS England has signalled it will continue to refine national policy and test local capabilities, reflecting the complexity of transferring planning, resource allocation and delivery responsibilities to organisations with a population health remit.
Further announcements are likely as NHS England completes assurance activity and as the two trusts, their ICBs and system partners publish more detailed local plans for taking on the new responsibilities.
