Principles for partnership in workforce change for ICSs

Read the SPF's guidance for social partnership working across Integrated Care Systems (ICSs).

20 September 2022

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The Health and Care Bill created changes in governance and roles of ICSs. Their core purpose is to improve outcomes in population health and health care, tackle inequalities in outcomes, experience and access, enhance productivity and value for money, and help the NHS support broader social and economic development.

In relation to the workforce, ICSs are establishing their role in line with the guidance set out in Building strong integrated care systems everywhere: guidance on the ICS people function.

The SPF recognises there is an important role for Integrated Care Boards (ICBs), which are the statutory NHS bodies in ICSs, to establish effective social partnership arrangements at a system level, to ensure the workforce implications of system change are supported through partnership discussions with trade unions at all levels.

In assistance of this the SPF has created this guidance note and will work to support and develop these arrangements, both from a national and regional perspective. Although these concentrate on the NHS, it is acknowledged that ICSs are focussed on relationships across health and care, and how the concept of one workforce can deliver better services and outcomes for the populations they serve.

Social partnership between employers and trade unions is built on shared principles of trust and mutual respect; openness and honesty in communications, and a positive and constructive approach based on shared goals and aspirations.


  • Any significant changes that affect NHS staff* arising from the exercise of the people functions by an ICB across the system, should be assessed in partnership with trade unions for their potential impact on the workforce, and consultation/engagement routes agreed as appropriate.
  • Where plans for workforce change are developed at a system level, these will be subject to discussion with relevant trade unions and employers through system level partnerships. This could mean some unions taking the lead role in system led processes, and co-ordinating responses from all staff side constituents.
  • Where workforce change occurs, the primary relationship for partnership and consultation, in relation to individual staff members or collective consultation, will remain at the employer level (either provider or ICB). Employers will need to fulfil their legal consultation and collective agreement/arrangements with trade unions. Systems will not override the process of engagement unless it is agreed between employers and trade unions. Boundaries will be established through engagement at system level with relevant employers and affected trade unions.
  • Guidance and procedures, relating to how system changes impact on staff, need to ensure transparency, equitability, fairness, and equal treatment of staff - in line with the People Promise. The overarching aim being to retain staff and demonstrate we value our people.

* Employers working in partnership with staff and their representatives is embedded in the NHS Constitution because it is the best way to effect change. The NHS Constitution requires all providers supplying NHS services and local authorities in the exercise of their public health functions, to commit to 'engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements.’

To note

The National SPF has also developed guidance for ICBs to establish their partnership machinery.

For further information on the SPF and supporting materials for ICBs/ICS, please see the supporting system development and service delivery section of the SPF website.