ICS leaders call for clarity on digital leadership

A lack of clarity over digital leadership could limit the pace and impact of digital transformation in the NHS 10 year health plan, according to integrated care system (ICS) leaders.

They have created a report, ‘System digital leadership in the new world’, based on a session held at Digital Health Summer Schools 2025.

It says that overlapping responsibilities between NHS England, regions, integrated care boards (ICBs), providers, and neighbourhoods is causing confusion “over who leads what, and where authority begins and ends”.

“This fuels duplication, disengagement, and a lack of clear accountability,” the report adds.

Without national clarity and agreed delegations of responsibility, digital leadership will remain fragmented, potentially “weakening delivery, delaying change, and exhausting the workforce with unclear mandates,” the report says.

It follows NHSE’s publication of the Model ICB Blueprint, in May 2025, which identified digital leadership as one of 18 functions to be transferred to providers to help ICBs cut 50% from their overheads.

However, ICS leaders said that the ambiguity of digital roles and ownership post-ICS reform is a barrier to realising the 10 year health plan’s vision for digital transformation.

They also highlighted the variation in digital maturity across geographies, with no consistent baseline of digital capability.

“Some ICSs have strategic digital leadership embedded into planning, while others lack even foundational infrastructure.

“This inconsistency undermines interoperability, limits equity, and makes national initiatives impossible to scale effectively,” the report says.

Digital is not seen as a business priority at board level, the report says, with few ICBs, providers, or NHS England directorates having digital leaders embedded in core decision-making.

To address these issues, it calls for defined responsibilities and leadership structures for digital across systems, including clarity on strategic direction, delivery accountability, assurance mechanisms, and local enablement.

Without this, it says that transformation will “remain patchy, over-reliant on informal leadership, and vulnerable to churn or policy change”.

The report also recommends that digital leadership is embedded in system decision-making.

“Strategic decisions made without digital input risk reinforcing legacy models, missing opportunities, or introducing tech that fails to embed,” the report says.

Workshop participants emphasised the importance of “hyper-local” leadership — not just in primary care networks and neighbourhood teams, but also among local authority and voluntary sector partners to ensure that local transformation is led by those closest to citizens.

“Digital exclusion is a place-based issue, shaped by trust, access, literacy, and local service models. 

“Only neighbourhood-level leadership can address these in context,” the report says.

To enable this it suggests funding for local partners, such as the voluntary community sector to co-design digital support offers.

John Mitchell, chair of the Digital Health Networks ICS Digital Council, said: “The insights from this report are a timely reminder that if we want digital transformation to succeed for everyone, we must invest in the people and partnerships that make it happen.”

He added that the findings of the report have been fed back into formal NHS England discussions.