Introduction
In December 2023, NHS England revealed which segments Integrated Care Boards (ICBs) and NHS Trusts have been categorised into, under the NHS Oversight Framework. These segments, ranked 1-4, indicate the extent of management challenges within organisations and correspond to the degree of direct intervention by NHS England.
For suppliers, aligning with these segments is crucial to develop an effective NHS targeting strategy:
- Organisations placed in segments 1 and 2 are operationally and financially robust, enjoying a high level of autonomy in procurement decisions. This autonomy opens doors for suppliers to propose innovative solutions and build new business cases.
- Organisations placed in segments 3 and 4 are struggling with financial, operational, or strategic targets, leading to increased management by NHS England. Here, suppliers should focus on renewing existing contracts, as these organisations are under tighter control and less likely to embark on new procurements.
This report explains NHS England's segmentation criteria and exclusively presents the latest segment data for each ICB and Trust. Featuring insights from NHS advisor and Together Digital Co-Founder Liam Cahill, we aim to equip suppliers with the knowledge to leverage this data effectively in their 2024 strategies.
Understanding NHS England's segmentation criteria
NHS organisations are segmented based on their performance against six national themes outlined in the NHS Long Term Plan:
1) Quality of Care
2) Access and Outcomes
3) Preventing Ill-Health and Reducing Inequalities
4) Finance and Use of Resources
5) Leadership
6) Local Strategic Priorities
Based on their performance, ICBs and Trusts are placed into 1 of 4 segments, as outlined in table below. Organisations have an assumed starting point of Segment 2, but persistent underperformance in any one metric can lead to a downgrade into Segments 3 or 4. This triggers specific support and oversight from NHS England's regional teams. Currently, financial challenges are the most common factor pushing organisations into these turnaround measure groups.
NHS Segmentation Criteria, source NHS England.
| Segment | ICB Performance | Trust Performance | Scale of Support Required |
|---|---|---|---|
| 1 | Consistently high performing across the six oversight themes. | Consistently high performing across the six national oversight themes. | No specific support needs identified. |
| 2 | In a "development journey", but demonstrate many of the characteristics of an effective ICB. | Trusts that have the support of system partners in place to address areas of challenge. | Flexible support delivered through peer support, clinical networks, and regional improvement hubs. |
| 3 | Significant support needs against one or more of the six oversight themes. | Significant support needs against one or more of the six national oversight themes. | Bespoke mandated support, drawing on national expertise when required. |
| 4 | Very serious, complex issues manifesting as critical quality and/or finance concerns that require intensive support. | In actual or suspected breach of the NHS provider licence (or equivalent for NHS trusts) with very serious, complex issues. | Mandated intensive support delivered through Recovery Support Programme. |
An explanation from Liam Cahill, Founder & NHS Advisor
We spoke to health-tech expert Liam Cahill to understand what these segmentation scores mean in practice, and how suppliers should integrate this data into their sales strategies.
Watch the video to learn how to tailor your strategy when approaching buyers in each segment.
Now you understand how NHS England have segmented organisations and how you should interpret this information, the section below outlines segment data for ICB's and Trusts, before concluding with next steps for suppliers.
ICB segmentation data
In the table below, we have ranked ICB's by their segment. This information was accessed on NHS England on 31.01.2024.
Table summary
Under this NHS Oversight Framework, NHS England have placed:
- 1 ICB in Segmentation Group 1 (2%).
- 14 ICBs in Segmentation Group 2 (33%).
- 23 ICB’s in Segmentation Group 3 (55%).
- 4 ICB’s in Segmentation Group 4 (10%).
Guidance for suppliers
Suppliers should expect ICBs in segmentation group 1 and 2 to respond most favourably to proactive engagement over new solutions. These organisations are generally under less scrutiny and have a greater degree of trust from NHS England to manage their own strategy and procurement.
For the majority of ICBs in segments 3, or 4, we recommend suppliers reach out to key decision makers to understand the reasons behind their segmentation score (i.e financial or performance based), the timeline of their recovery, and the level of oversight of NHS England.
In general, these organisations are prioritising their "turnaround", so expect these segments to be less receptive to new solutions, and focus your approach on identifying potential renewal opportunities, based on existing contracts.
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