What Happens When Care Doesn’t Stop at the ICB Border

One of the quietest pressures in the NHS is what happens when care crosses a line - not a clinical one, but a geographical one.

Every day, patients are referred from one ICB or Trust area into another because of where they live, work, or because specialist services aren’t local. But those referrals often fall into the gaps between systems.

Different governance rules.
Different IT platforms.
Different contact points.

For clinicians, it can mean chasing the right person instead of treating the right patient. For patients, it means waiting longer simply because the system isn’t designed for cross-border communication.

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Why cross-border referrals break the model

Most digital tools in the NHS were built for single organisations, not shared ecosystems.
So when an ICB wants to refer across a boundary, they suddenly face:

• separate user bases and access rights
• manual uploads or email chains to transfer information
• inconsistent audit trails for governance and reporting

It’s not that clinicians don’t want to collaborate, it’s that the infrastructure doesn’t let them.
And with elective recovery targets tied to where patients reside rather than where they’re treated, that friction adds pressure to both systems.

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Connected care means connected systems

A truly integrated referral model doesn’t stop at organisational borders.
It allows clinicians to connect securely, regardless of location or platform.

That’s been one of the most powerful outcomes we’ve seen with Cinapsis. When an ophthalmologist in one Trust can review an image uploaded by an optom from a neighbouring ICB - securely, instantly, and with the record linked back to both systems, you see the real meaning of “connected care.”

It’s not just about digital convenience; it’s about system resilience.

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“The NHS was never designed to run as a collection of islands. Yet that’s how most digital infrastructure still behaves.

True integration means that geography becomes irrelevant to clinical collaboration. Whether a patient lives five miles away or in another ICB, the experience should be the same: fast, safe, connected care.”
— Dr Owain Rhys Hughes, CEO & Founder, Cinapsis

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The future of elective recovery depends on how well we handle all patients regardless of where they live, without multiple systems having to be used based on geography because the current systems can only be used in certain circumstances.

Connected care doesn’t just reduce pressure inside one ICB; it strengthens the entire network. Because in reality, patients don’t see borders. And neither should the systems that care for them.

→ Want to see how Cinapsis is helping NHS teams collaborate securely across system boundaries? Get in touch.

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