NHS integrated care boards are responsible for planning and funding healthcare services across their geographic areas. They collectively hold NHS contracts with hundreds of clinical providers, commission digital and technology services, and manage procurement activity running into billions of pounds annually. Understanding how NHS ICB procurement actually works is foundational for any supplier trying to sell into this part of the NHS.

NHS integrated care boards are responsible for planning and funding healthcare services across their geographic areas. They collectively hold NHS contracts with hundreds of clinical providers, commission digital and technology services, and manage procurement activity running into billions of pounds annually. Understanding how NHS ICB procurement actually works is foundational for any supplier trying to sell into this part of the NHS.

Since 42 ICBs became 26 through the first wave of mergers on 1 April 2026, the procurement landscape has changed significantly. New commissioning strategies, restructured procurement teams, and revised contract portfolios mean that supplier intelligence from twelve months ago may already be out of date.

Since 42 ICBs became 26 through the first wave of mergers on 1 April 2026, the procurement landscape has changed significantly. New commissioning strategies, restructured procurement teams, and revised contract portfolios mean that supplier intelligence from twelve months ago may already be out of date.

What legal framework governs NHS ICB procurement?

ICB procurement operates under two distinct legal frameworks depending on what is being purchased. Understanding which applies to your offer is the first step in understanding how an ICB can buy from you.

ICB procurement operates under two distinct legal frameworks depending on what is being purchased. Understanding which applies to your offer is the first step in understanding how an ICB can buy from you.

1. Healthcare services, meaning clinical services delivered to patients, are governed by the Provider Selection Regime (PSR), which came into force on 1 January 2024. The PSR replaced mandatory competitive tendering for healthcare services and gives ICBs significant flexibility in how they select providers, including several routes that do not require a competitive process.
2. Goods, technology, digital services, and non-clinical services are governed by the Procurement Act 2023. An ICB procuring a clinical communications platform, a data analytics tool, or a workforce management system is using the same legal framework as a central government department procuring technology.

Many suppliers sell products that touch both categories. A digital health tool used to support a clinical pathway may be a good or service regulated under the Procurement Act, even if the clinical service it supports is commissioned under the PSR. Understanding where your offer sits determines which procurement rules apply, which notice types appear on Find a Tender, and which framework routes are available.

Many suppliers sell products that touch both categories. A digital health tool used to support a clinical pathway may be a good or service regulated under the Procurement Act, even if the clinical service it supports is commissioned under the PSR. Understanding where your offer sits determines which procurement rules apply, which notice types appear on Find a Tender, and which framework routes are available.

How do ICBs procure healthcare services under the PSR?

The PSR provides five routes for provider selection. Published annual summaries from ICBs show how these routes are used in practice.

The PSR provides five routes for provider selection. Published annual summaries from ICBs show how these routes are used in practice.

NHS Sussex ICB's 2024/25 annual summary illustrates a typical pattern:

NHS Sussex ICB's 2024/25 annual summary illustrates a typical pattern:

• 55 contracts awarded under Direct Award Process C

  55 contracts awarded under Direct Award Process C

• 9 under Direct Award Process B

  9 under Direct Award Process B

• 3 under Direct Award Process A

  3 under Direct Award Process A

• 2 under the Most Suitable Provider Process

  2 under the Most Suitable Provider Process

• 2 through competitive process

  2 through competitive process

The pattern is consistent across ICBs: the majority of healthcare service contracts are awarded without competitive process. For suppliers in clinical services categories, understanding the PSR routes and which criteria an ICB uses to justify a direct award, or to decide when a competitive process is appropriate, is commercially essential.

The pattern is consistent across ICBs: the majority of healthcare service contracts are awarded without competitive process. For suppliers in clinical services categories, understanding the PSR routes and which criteria an ICB uses to justify a direct award, or to decide when a competitive process is appropriate, is commercially essential.

Where competitive processes do run under the PSR, they are typically published on Find a Tender as T01 or T02 notices, or on the ICB's own procurement portal. Staffordshire and Stoke-on-Trent ICB, for example, uses Atamis as its eProcurement portal for all procurement processes, including framework mini-competitions and direct award quotations.

Where competitive processes do run under the PSR, they are typically published on Find a Tender as T01 or T02 notices, or on the ICB's own procurement portal. Staffordshire and Stoke-on-Trent ICB, for example, uses Atamis as its eProcurement portal for all procurement processes, including framework mini-competitions and direct award quotations.

How do ICBs procure technology and non-clinical services?

For technology, digital, and non-clinical services, ICBs use the same framework routes available to other NHS organisations. The most common routes are:

For technology, digital, and non-clinical services, ICBs use the same framework routes available to other NHS organisations. The most common routes are:

NHS SBS frameworks for digital, IT, and professional services. NHS SBS frameworks are designed specifically for NHS procurement and are widely used by ICBs for technology purchases. See our guide to how NHS procurement frameworks work for a full breakdown of the major framework families.

NHS SBS frameworks for digital, IT, and professional services. NHS SBS frameworks are designed specifically for NHS procurement and are widely used by ICBs for technology purchases. See our guide to how NHS procurement frameworks work for a full breakdown of the major framework families.

GCA frameworks including G-Cloud for cloud software and services, and the Technology Products and Services agreement. ICBs can access GCA frameworks alongside other public sector buyers. NHS England spent £23.8 million through G-Cloud 14 alone.

GCA frameworks including G-Cloud for cloud software and services, and the Technology Products and Services agreement. ICBs can access GCA frameworks alongside other public sector buyers. NHS England spent £23.8 million through G-Cloud 14 alone.

Standalone procurement for above-threshold contracts that fall outside existing framework coverage. These generate UK4 tender notices on Find a Tender and are the opportunities most visible to suppliers relying on tender alert services.

Standalone procurement for above-threshold contracts that fall outside existing framework coverage. These generate UK4 tender notices on Find a Tender and are the opportunities most visible to suppliers relying on tender alert services.

Below-threshold procurement for contracts under £214,000. ICBs typically publish these on Contracts Finder and on their own portals. Suffolk and North East Essex ICB, for example, advertises opportunities above £30,000 on Contracts Finder as well as through its In-tend portal.

Below-threshold procurement for contracts under £214,000. ICBs typically publish these on Contracts Finder and on their own portals. Suffolk and North East Essex ICB, for example, advertises opportunities above £30,000 on Contracts Finder as well as through its In-tend portal.

What does the ICB merger mean for supplier intelligence?

On 1 April 2026, twelve ICBs were abolished and six new ones established. A further round of mergers is expected to take effect in April 2027. Procurement teams that existed in predecessor ICBs have been restructured, contacts have moved, and commissioning strategies are being redeveloped.

On 1 April 2026, twelve ICBs were abolished and six new ones established. A further round of mergers is expected to take effect in April 2027. Procurement teams that existed in predecessor ICBs have been restructured, contacts have moved, and commissioning strategies are being redeveloped.

For suppliers, this creates two specific risks. First, relationships and intelligence built with predecessor ICB procurement teams may not carry forward to the successor body. Second, category strategies and framework preferences in merged ICBs are being reset, which means patterns from historical award data may no longer accurately predict future procurement behaviour.

For suppliers, this creates two specific risks. First, relationships and intelligence built with predecessor ICB procurement teams may not carry forward to the successor body. Second, category strategies and framework preferences in merged ICBs are being reset, which means patterns from historical award data may no longer accurately predict future procurement behaviour.

The most effective response is to treat merger timelines as a standing commercial discipline: tracking which ICBs are merging, on what schedule, and who the successor commissioning contacts will be. NHS spend transparency data, published monthly by ICBs and their predecessors, shows which organisations are actively spending in your category regardless of the structural changes underway.

The most effective response is to treat merger timelines as a standing commercial discipline: tracking which ICBs are merging, on what schedule, and who the successor commissioning contacts will be. NHS spend transparency data, published monthly by ICBs and their predecessors, shows which organisations are actively spending in your category regardless of the structural changes underway.

For a guide to engaging with ICBs before a formal procurement begins, see our article on how to approach an NHS ICB before they run a procurement.

For a guide to engaging with ICBs before a formal procurement begins, see our article on how to approach an NHS ICB before they run a procurement.

Arcamus tracks ICB spend data, contract award records, and procurement signals across all NHS integrated care boards, structured to show which ICBs are active in your category and how their procurement activity is evolving through the merger programme. If you want to understand which ICBs are spending in your area, start here.

Arcamus tracks ICB spend data, contract award records, and procurement signals across all NHS integrated care boards, structured to show which ICBs are active in your category and how their procurement activity is evolving through the merger programme. If you want to understand which ICBs are spending in your area, start here.