50 Suffolk and North East Essex ICS | ‘Our Journey Together’ Unitary Authorities Local government reorganisation will see district, city and borough councils abolished as new unitary councils are created in 2028. These much larger authorities—likely to cover populations of around 500,000 —will inherit responsibilities previously held by county councils. Unitary authorities will hold many of the levers influencing the wider determinants of health. They will also take on adult social care, children and family services, and public health—functions currently held by upper-tier councils. Planning for the smooth transfer of these services, and maximising the opportunities they create for integrated care, must be a priority over the next two years. Planning is already underway in some areas. A strong focus on prevention and early intervention will be essential for service sustainability. For many new unitary authorities, this will be the first time they have the opportunity to integrate these services so closely. Careful design will be needed to avoid siloed structures that fail to recognise how decisions in one area can impact population health. Given their expanded responsibilities, it is essential for healthcare commissioners and providers to establish strong, strategic relationships with the future unitary authorities. Much of the ambition set out in the NHS 10-Year Planiii relies on close partnership working at place level. Building these relationships early will help ensure that partners can collectively meet these ambitions. NHS Plan In summer 2025, the Labour Government published the 10-Year Health Plan for Englandiii. This plan outlines how the Government’s three key system “shifts” will be delivered. A central theme throughout the plan is reducing health inequalities, with an ambition to “halve the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone, and to raise the healthiest generation of children ever”. The three system shifts are: The plan emphasises that meeting these ambitions requires organisations to work differently. It highlights the crucial role that mayors, local government and other public partners will play. It notes that “this entails a shift in mindset to think of healthcare less as a single institution and more as a wide network…”. Given the scale of change underway, strong relationships and collaborative working must be seen as essential — not optional. Any organisation seeking to improve population outcomes must embed partnership working at the core of its strategy. The plan also reinforces the evolving role of Integrated Care Boards as strategic commissioners. Providers will take on more responsibility for population health and reducing inequalities, which will require cultural and relational shifts across the system. Neighbourhood Health and New Models of Care The 10-Year NHS Planiii places strong emphasis on accelerating neighbourhood health. At its core, neighbourhood health aims to improve access and empower communities by providing health and care closer to home and at times that better suit people’s lives. This is not a new concept—Suffolk and North East Essex have been developing neighbourhood models for several years. However, the plan signals a need for deeper integration than has previously existed.
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