45 Suffolk and North East Essex ICS | ‘Our Journey Together’ A shifting culture Stakeholders told us that they believed that the Suffolk and North East Essex ICS’ leadership became more clearly accountable to partners and the public and recognised that local people and the local workforce know best what works for their communities. Stakeholders highlighted that leaders had been willing to come together and to have difficult conversations. They were open to learning, reflecting and working together to tackle the most entrenched inequalities in society. Stakeholders gave examples of when leaders had responded not only to the people, communities and partner organisations who they have consulted, but also to those who have raised new emerging issues such as the ‘dental deserts’ in Suffolk. Stakeholders also valued opportunities for the whole system to come together and share and celebrate achievements, through initiatives including the ICS annual EXPO and ‘Can Do’ Health and Care Awards. Picture – Winners at the Suffolk and North East Essex ICS ‘Can Do’ Health and Care Awards in July 2025 Stakeholders talked about how various joint leadership appointments across the system had been very successful in creating mutual understanding and mutual accountability between organisations and between sectors, however they also highlighted that these roles have tended to remain within statutory NHS and local authority bodies. There are several key non-executive roles at system and alliance levels, but there remains a lack of parity of esteem between NHS and VCFSE organisations in this respect. An ongoing challenge in health and care Interestingly the paper by Cairney and Toomey also included some specific reflections on progress on systems leadership in health and care in England: • “…the gulf between the frequent promotion of systems leadership and the lack of conduciveness…” • “Leaders face contradictory dynamics that encourage systems leadership rhetorically but ‘sacks’ CEOs for failure to meet short term targets” • “…many people in leadership positions ‘don’t have a collaborative bone in their body’…” • “Many actors use the language of systems leadership without clarity, energy, or sincerity” These comments about the continuing difficulties of systems leadership in health and care closely mirror the reflections of local stakeholders in Suffolk and North East Essex who talked about the ongoing conflicting pressures for health and care leaders trying to combine systems leadership with their organisational leadership roles.
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