Organisational change
Every English commissioner has been abolished and replaced twice in a decade. The boundaries move again. The record should not have to.
The org chart will change again. The record should not have to.
Moved here from the landing page, because this is a UK argument and it belongs with the other UK material rather than in the general pitch. Health systems reorganise everywhere; England is simply the best-documented case.
| When | What | Instrument |
|---|---|---|
| 2013 | 211 clinical commissioning groups created | Health and Social Care Act 2012 |
| 2021 | 106 after eight years of merger | consolidation, no statutory change |
| 2022 | 42 integrated care boards; CCGs abolished | Health and Care Act 2022 |
| 2025 | NHS England abolished; transition into 2027 | announced March 2025 |
| 2026 | 36 integrated care boards | a single Order, in force 1 April 2026 |
| Announced | Aligned to strategic authorities | Cabinet statement, 31 July 2026 |
What happens on the day a boundary moves
An integrated care board is merged into a larger footprint aligned to a strategic authority. Three organisations change hands; forty thousand people do not notice.
The person’s record
Identity is resolved across organisations, never merged into one owner. Nobody’s record is copied, re-keyed or re-numbered because their commissioner changed.
The citizen’s front door
Same portal, same login, same proxy access for a carer. Declared communication needs and reasonable adjustments travel with the person, so letters keep arriving in the format they asked for.
Who is looking after them
A neighbourhood case names one key worker and a list of participating organisations. Adding or removing an organisation is a change of data, not a new case — so nobody is split in two.
The measure of local need
Deprivation and population need are keyed to geography, not to the organisation. Small-area statistics do not move when a board does — and the Order redrawing the boundaries is itself written in them.
Access, recomputed not re-keyed
Reach is resolved at sign-in from a person’s organisations, delegations and groups. Change the structure and the access follows — no spreadsheet of permissions to rebuild, and every grant and lapse on a tamper-evident log.
The commissioning map
Held as a sourced, effective-dated record. The old boundary stays true for the period it applied to, so last year’s performance still reconciles against the body that actually held the contract.
A system bought in one organisational era should still be the system you are running in the next.