Since its founding in 1948, the National Health Service (NHS) has been a cornerstone of British society — free at the point of use, publicly funded, and based on need rather than ability to pay. Yet behind the enduring principles lies a system that has undergone near-constant reformation. These reforms have reshaped the organisation, funding, and commissioning of health services across the decades.
As the NHS enters another period of structural reform, the re-imagination of Integrated Care Boards (ICBs) presents both risk and opportunity. One of the most critical decisions ICBs will face is whom they treat as partners in shaping services and policy. In particular, it is time to recognise the central and irreplaceable role of local negotiating committees