Complaining to your ICB

What is an integrated care board?

An integrated care board, usually shortened to ICB, is an NHS organisation responsible for planning and commissioning healthcare for the population in its area.

ICBs replaced clinical commissioning groups in July 2022 and now have responsibility for most local NHS commissioning in England.

In practical terms, commissioning means arranging and funding NHS services rather than necessarily providing the treatment itself.

Why would I complain to an ICB instead of the provider?

For an NHS-funded service, a person can generally choose between complaining:

• directly to the provider that delivered the service; or
• to the commissioner responsible for that service.

For most ordinary local NHS services, the commissioner is the relevant ICB.

The two routes exist because the provider and commissioner have different roles. The provider has direct responsibility for the care it delivered, while the commissioner is responsible for the NHS service it arranges and funds.

Which NHS services can I complain to an ICB about?

NHS England currently directs commissioner complaints to the local ICB for services including:

• GP services;
• NHS dental services;
• optician services;
• pharmacy services;
• hospital care;
• mental-health services;
• out-of-hours services;
• NHS 111; and
• community services such as district nursing.

Each ICB has its own complaints arrangements and usually publishes contact information on its website.

What changed for GP, dental, pharmacy and optician complaints?

The commissioner route for primary care changed on 1 July 2023.

Before that change, someone who wanted to complain to the commissioner about a GP, dentist, pharmacy or optician could be directed to NHS England.

Commissioner complaint handling for these primary-care services transferred to ICBs, and NHS England’s current complaints policy records that complaints to the commissioner are now made directly to the relevant local ICB.

Can I complain to both the provider and the ICB?

Not for the same complaint.

The NHS complaints framework gives the complainant a choice between the provider and commissioner routes. NHS England’s current guidance states that a person cannot complain to both about the same matter.

That choice matters because it also means the commissioner should not be treated simply as the next stage after somebody has completed a complaint with the provider.

What happens when an ICB handles a complaint about a provider?

A commissioner does not necessarily investigate a provider complaint entirely without involving the provider.

NHS England’s own commissioner complaints policy illustrates how the commissioner role works. Where NHS England receives a complaint about a service it commissions, it discusses how the matter should be handled and may either:

• handle the complaint as commissioner; or
• with the complainant’s consent, pass it to the provider where the provider is better placed to deal with it.

Where the commissioner retains the complaint, it can obtain relevant evidence from the provider so that it can give a properly informed response.

How do I find the right ICB?

NHS England maintains a directory of integrated care boards and their contact details.

Where it is not clear which ICB covers the area, NHS England also points to a postcode-based organisation search that can identify the relevant ICB.

The ICB’s own website will normally contain its complaints procedure and the appropriate contact route.

When is NHS England still the commissioner?

Not every NHS service is commissioned locally by an ICB.

NHS England’s current patient guidance continues to direct complaints to NHS England where it commissions services including:

• healthcare in prisons;
• military health services; and
• specialised services supporting people with rare and complex conditions.

The specialised-services landscape is more complicated than a simple ‘ICB versus NHS England’ rule because some commissioning responsibilities have already been delegated while others remain with NHS England.

Is the ICB/NHS England boundary changing again?

Yes.

NHS England published a further direct-commissioning programme in March 2026.

Subject to parliamentary approval, it expects additional NHS England commissioning functions to transfer to ICBs from April 2027, including health-and-justice services, additional specialised services and other directly commissioned functions.

During 2026/27, ICBs are taking a stronger leadership role in preparation for the transfer, while NHS England remains the legal decision-maker for services that have not yet been formally delegated or transferred.

What if my complaint involves several NHS organisations?

A healthcare problem can cross organisational boundaries.

For example, the same sequence of events might involve a GP, ambulance service, hospital and community service.

The NHS complaints regulations require organisations involved in a cross-boundary complaint to co-operate and work towards a co-ordinated response rather than leaving the complainant to manage several disconnected investigations.

That can include agreeing which organisation should take the lead and sharing relevant information needed to investigate the issues.

Are there complaints that should go somewhere other than an ICB?

Yes. The ICB route does not cover every type of healthcare complaint.

Examples include:

• services directly commissioned by NHS England;
• public-health services for which the local council is responsible; and
• some complaints specifically about the use of powers under the Mental Health Act, which can fall within the Care Quality Commission’s Mental Health Act complaints role.

The CQC says it can consider complaints about how Mental Health Act powers or duties have been used, including matters concerning detention in hospital, guardianship and community treatment orders.

CQC says it will usually ask the person to complain to the service provider first before it starts its own investigation.

What time limit applies to an ICB complaint?

The ordinary NHS complaints rules apply.

A complaint should normally be made within 12 months of:

• the event being complained about; or
• if later, when the matter came to the complainant’s attention.

A late complaint can still be considered where there were good reasons for the delay and it remains possible to investigate the complaint effectively and fairly.

What if I am unhappy with the ICB’s final response?

The ICB should provide a final response explaining its findings and the outcome of the complaint.

If the NHS complaints process has been completed and the concern remains unresolved, the independent final-stage route is the Parliamentary and Health Service Ombudsman (PHSO).

This is particularly important where somebody chose the commissioner route in the first place: the next stage is not ordinarily to restart the same complaint with the healthcare provider.

Does complaining to an ICB affect a clinical negligence claim?

No.

A commissioner complaint may produce explanations, records, findings or other information that is useful for understanding what happened, but it does not decide the separate civil-law questions of breach of duty and causation.

Making or pursuing an ICB complaint does not itself stop the limitation period for a clinical negligence claim.