The following questions were raised by members of the public ahead of the ICB Board meeting on 22 January 2026. Individuals who raised a question received a written response.
Board question:
In light of the development of neighbourhood health services and national expectations around co-production, co-design and co-decision making, how are public PPIE contributors currently enabled to exercise meaningful governance level influence, challenge and scrutiny, rather than solely contributing insight through engagement activity?
Response:
The ICB has embedded public involvement within its governance framework through structured assurance and reporting at all levels of the organisation. The Board receives regular insight reports on engagement and involvement, ensuring public perspectives inform commissioning intentions, service change and strategic decisions at Board level.
Public and community voices are embedded through place-based partnerships. These partnerships bring together NHS bodies, councils, voluntary, community, faith and social enterprise (VCFSE) organisations and community representatives, creating opportunities for residents to influence priorities closer to neighbourhood delivery where decisions about service models are increasingly made.
Much work has been underway from a population health perspective to develop community-driven approaches to reducing health inequalities and improving outcomes for our most disadvantaged communities. Some of those examples are detailed here: LSC Integrated Care Board :: Population Health case studies. These approaches – which have been agreed by the Board – allow people to influence, challenge and support decision making at a local level.
Meanwhile, Blackburn with Darwen and Morecambe Bay were both selected as wave one participants in the National Neighbourhood Health Implementation Programme. They are being supported by regional and national colleagues to further develop neighbourhood health services in line with the government’s direction of travel. As wave one participants, they will learn from other sites across the country and share their learning with other places and neighbourhoods within the Lancashire and South Cumbria footprint. This will involve further development of local co-production and involvement approaches to inform strategic commissioning at a local level.
Away from neighbourhood working, patient advisors are working directly with programme teams within the ICB to contribute their lived-experience and offer meaningful governance level influence, not simply provide feedback. Examples of this include members of the Citizens Health Reference Group, a group of patient and public volunteers, sitting on the Vascular Network and the Anticipatory Clinical Management Planning (ACMP) Oversight Group, as well as members supporting the evaluation of primary and community care procurement exercises, including the procurement of community services and integrated urgent care services in West Lancashire. Additionally, the ICB has an established Maternity and Neonatal Voice Partnership with individuals who participate in Maternity and Neonatal Board meetings to contribute their perspectives and lived experience of maternity and neonatal care.
We recognise that patient and public engagement and involvement is an area where there will always be improvement. These examples demonstrate that the ICB has put in place influence, challenge and active contributions and embedding of lived experience in meaningful ways at a range of levels within the governance of the ICB to support decision making and ensure services meet the needs of communities.
Board question:
Given the standing down of the Public Involvement and Engagement Advisory Committee and the current reliance on executive-led reporting and Board assurance, does the Board consider that existing PPIE governance arrangements continue to represent best practice in line with NHS policy on working in partnership with people and communities?
Response:
In March 2025, the Board agreed to disestablish the Public Involvement and Engagement Advisory Committee (PIEAC). You can find out more about the rationale for that decision and how the Board is now assured of the arrangements to discharge its statutory duty to involve here: LSC Integrated Care Board :: Public Involvement and Engagement Advisory Committee.
Through regular insight reports on engagement and involvement, the Board is assured the ICB has strong mechanisms in place to involve local people in shaping the work of the local NHS, and allowing people with lived experience to influence, challenge and support decision making. Our Board reports include a cover sheet which requires public and stakeholder engagement to be detailed for Board consideration.
It is recognised there are always opportunities to strengthen patient and public involvement and engagement arrangements. This includes the development of the Citizens Health Reference Group – a group of patient advisors from across the region. By joining this group, members of the public can work with NHS commissioners to support the development of services, policies and pathways, putting the public voice firmly at the heart of decision-making.
The ICB has established a Virtual Citizens Panel – a database of more than 2,000 residents who live in Lancashire and South Cumbria who have volunteered to take part in regular research, questionnaires and take part in opportunities to share their views and experiences.
These mechanisms provide opportunities for members of the public and people with lived experience to have system wide influence, in addition to the population health work which is done at a local level as detailed above. We look to involve members of the Citizens Health Reference Group in decision making Boards and groups wherever possible. This has included being part of the CEO recruitment process on stakeholder panels, being part in decision making groups for programmes of work and taking part in procurement panels.
In line with national guidance, the ICB continues to work closely with our VCFSE partners, as well as Healthwatch, who can connect to people and communities who voices are often marginalised. This furthers the work which aims to reduce health inequalities and improving outcomes for those people living in our most disadvantaged communities.
Board question:
If not, will the Board consider whether PPIE governance arrangements should be strengthened or reconsidered, so that involvement is embedded in co-design, co-production and decision-making at system and place level, particularly as neighbourhood health services develop?
Response:
The Board is assured that patient and public involvement and engagement remain embedded within the ICB’s governance framework through a combination of executive accountability, Board-level oversight, and system-wide engagement mechanisms. This includes clear executive leadership for patient and public involvement and engagement, routine reporting to the Board, and the use of established engagement routes with communities, voluntary, community, faith and social enterprise (VCFSE) partners, and place-based arrangements.
The Board will keep patient and public involvement and engagement structures under regular review to ensure they remain proportionate, effective, and aligned with NHS England guidance on working in partnership with people and communities.