Health overseers have expressed encouragement at the progress made by NHS services in the Black Country, despite ongoing challenges faced by healthcare providers. NHS England conducted its annual assessment of the Black Country Integrated Care Board’s (ICB) performance for the year 2025/26, highlighting several areas of improvement alongside persistent issues.
The assessment acknowledged difficulties in key areas including finance, primary care, cancer care, and mental health services. Additionally, the ICB has been affected by significant structural changes following the merger between NHS Birmingham and Solihull and NHS Black Country ICBs, aimed at reducing running costs and eliminating duplication.
Presented earlier this week to the NHS Birmingham and Solihull and NHS Black Country Joint ICB Cluster Board, the report detailed a mixed picture of performance. It observed that while the ICB and its providers struggled to meet the 2025/26 Operational Plan targets-particularly in finance, primary care, cancer, and mental health-there were notable improvements in elective care delivery and a varied performance regarding learning disabilities and autism services.
READ MORE: DWP urged to halt PIP payments for low-level mental health cases amid rising costs
Urgent and emergency care (UEC) saw advances, with the system leading regionally on frailty care in partnership with ICBs from other areas and the national team. The Black Country ICB achieved the best Category 2 ambulance response times in the West Midlands, outperforming regional and national averages.
However, challenges remain with prolonged waits in emergency departments (ED). Twelve-hour waits exceeded targets between October and February, although figures improved closing the year at 8.2 per cent against a plan of 8.9 per cent. Ambulance handover delays also fell behind projections from September onwards, with March 2026 performance recorded at 36 minutes and 49 seconds compared to a plan of 27 minutes and 6 seconds.
The ICB continues to implement improvement programmes and regional collaborations to address these issues. Elective care delivery showed system-wide progress; waiting list size changes were above average, though the total number on the waiting list in March 2026 stood at 165,224-6.4 per cent higher than planned. The percentage of patients seen within 18 weeks in March reached 64.4 per cent, 1.6 per cent above target, but those waiting over 52 weeks slightly exceeded projections at 0.9 per cent against a 0.4 per cent plan, including five patients waiting beyond 65 weeks.
Mental health remained a particular area of concern, with none of the operational plan targets met in 2025/26. Recovery initiatives are underway for children and young people’s access services and NHS Talking Therapies, identified as the most challenged metrics.
Innovative approaches to managing frailty and dementia have been adopted through new neighbourhood model pilots. Strong patient and carer co-production efforts have helped shape service pathways, notably in children and young people’s and neurodevelopmental services. The opening of the first 24/7 community hub has also improved patient outcomes and mental health service engagement locally.
Overall, the report reflected cautious optimism, stating: “We are encouraged by progress towards a more mature system of integrated care, with decision-making increasingly informed by, and responsive to, the needs of local people and communities.”