Speaking to delegates at The MJ Future Forum in Hertfordshire the deputy chair of the Buckinghamshire, Oxfordshire and Berkshire West ICB, Sim Scavazza, said the number could be cut from 42 to around 26.

The former Miss Selfridge managing director said the Government's plans to reform the health service and cut bureaucracy would lead to disruption in ICBs and threaten local initiatives. Scavazza revealed the boards were now being required to cut their costs by 50% by the end of the year.

In a frank presentation, the board deputy chair said some ICBs may ‘cling' to the footprint of new strategic authorities ‘for their survival' but added that potential for health and local government to work collectively at place level was ‘where the dream is'.

Admitting that the health service was not as good at speaking and focusing on residents as local government, Scavazza said ‘place is vital' and needed to be shaped by local need and capable of allowing ‘variation'.

However, principal consultant at the Good Governance Institute Aidan Rave told the session that while there was an attraction to strategic authorities being involved in health there would be reluctance from the health service to the regional differences created by devolution.