The proactive care section of your 15 May submission: what credible actually looks like

Every Integrated Care Board (ICB) in England must submit a strategic commissioning narrative by 15 May 2026. The neighbourhood health section will look broadly similar across submissions. Most will describe intent. The ones that drive real change and unlock payment reform will describe evidence.

The difference comes down to the proactive care section.

Most strategy leads assume they have this covered. The ones who've looked closely often find the bar is higher than they expected.

What a credible proactive care section actually requires

The Neighbourhood Health Framework and the Mackey letter set the direction clearly: a step-change in reducing hospital bed-days for highest-risk cohorts, with neighbourhoods at the centre. But a strategic ambition section alone won't be enough. The systems that drive real change will back their narrative with something harder to write: a financially credible case built on local population data, expressed in admission reductions, bed days, and pounds.

That requires three things that most ICB strategy teams do not have sitting on their desks right now.

A sized cohort: not a broad at-risk category, but a defined group of patients whose clinical trajectory, without intervention, is heading toward avoidable admission.

A financial model built on local population data: one that your finance team and your board can stand behind. National averages and published statistics are not enough.

Outcome evidence from comparable programmes: real-world, independently evaluated results from NHS systems that have delivered at scale. Not pilots. Not controlled trial outputs.

Most systems have a gap somewhere

That is not a criticism. Building a financially credible proactive care case is genuinely hard, and the policy direction has moved quickly. ICB strategy teams are often working with population health data that is not yet structured for this kind of modelling, finance teams stretched across competing priorities, and limited visibility of what comparable programmes have actually delivered.

Four weeks is enough time to close most of those gaps, but only if you know which ones you have.

Find out where you stand

We have put together a short readiness assessment, six questions that map directly to what the proactive care section of the 15 May submission requires. It takes two minutes. Your results will tell you exactly where your submission stands and what closing any gaps actually requires.

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