The claim that "local integrated care boards make decisions based on evidence and engagement with patients" is a factual description of the statutory framework governing ICBs in the English NHS. Multiple authoritative sources confirm both elements of the claim: **Evidence-based decisions**: ICBs are required by law (the Health and Care Act 2022, which inserted provisions into the NHS Act 2006) to exercise their functions effectively, efficiently, and economically, with duties regarding quality improvement, reducing inequalities, and having regard to the wider effects of decisions. Individual ICBs (e.g., Nottinghamshire) have published strategic decision-making frameworks that require evidence-based prioritization, Equality and Quality Impact Assessments (EQIAs), and documented assessment of proposals before service changes are approved. **Engagement with patients**: ICBs have a specific statutory duty under section 14Z45 of the NHS Act 2006 (as amended) to involve patients, carers, and the public in decisions about service planning and changes. NHS England's guidance on ICB governance explicitly states that ICBs have "the duty to consult patients and the public about decisions that affect them." The guidance further details how ICBs must engage through Healthwatch, patient and carer engagement forums, VCSE bodies, and other mechanisms, and must report annually on how they have discharged these duties. The claim accurately describes the designed governance framework for ICBs. It describes how the system is legally structured to operate — ICBs do have statutory duties to base decisions on evidence and to engage with patients. Whether every ICB always perfectly fulfils these duties in practice is a separate question, but the claim is about the decision-making framework, which is accurately stated. **Sources:** - NHS England, Guidance on integrated care board constitutions and governance — https://www.england.nhs.uk/long-read/guidance-on-integrated-care-board-constitutions-and-governance/ - NHS England, ICB annual reports and working with people and communities: Guidance — https://www.england.nhs.uk/long-read/icb-annual-reports-and-working-with-people-and-communities-guidance/ - Health and Care Act 2022 (legislation.gov.uk) — https://www.legislation.gov.uk/ukpga/2022/31/part/1/crossheading/integrated-care-boards-functions/enacted - Nottinghamshire ICB, Strategic Decision-Making Framework — https://notts.icb.nhs.uk/wp-content/uploads/sites/2/2022/04/COM-002a-Strategic-Decision-Making-Framework-v1.0-1.pdf - GOV.UK, Health Bill: ICBs as strategic commissioners — fact sheet — https://www.gov.uk/government/publications/health-bill-icbs-as-strategic-commissioners-fact-sheet/health-bill-icbs-as-strategic-commissioners-fact-sheet