1/ 📍 Who speaks up for your neighbourhood?. In most of England, the answer is. no one. 64% of people live in places with no hyperlocal government at all. Meanwhile, parish and town councils — where they do exist — vary wildly in scale, capacity, and effectiveness.

RT @restate_thinks: NEW REPORT: . Today we have published The Alternative People Survey - a survey of civil servants on questions which are….

RT @stkaye: 1/ *The NHS 10 Year Plan: what local government should know* - a quick thread 🧵👇.

RT @SKinnock: Earlier the week I spoke at the @restate_thinks conference, setting out our vision for the health service. The NHS is in a….

18/ Overall view? . Well, as many have now said, there is not really enough *plan* in this plan. The specifics will be important. But as a strategic overview and a statement of intent, I think local government audiences will be struck by some of the ambition here.

17/ Two more notable shifts: the Better Care Fund is set for reform from 2026–27, narrowing its scope to essential integrated functions; and all upper-tier councils will undergo mandatory five-year public health peer reviews to drive local improvement.

16/ The success of these will hinge on how effectively they are integrated with local government.

15/ Health Innovation Zones are an interesting idea: place-based deregulation areas to promote new models of care and use of advanced technologies, to be set up in specific spots like investment zones or enterprise zones.

14/ What else? Well, Integrated Care Partnerships – toothless stakeholder-herding bodies now set for abolition – will not be widely mourned, I think. Key question is whether the other changes will make a better fist of the same job.

13/ ICBs will then stitch these plans together into Population Health Improvement strategies, which could be important for how public health is organised in places.

12/ You might have spotted that “neighbourhood” health plans will actually be drawn up at upper-tier local authority level, which means true, hyperlocal neighbourhood strategy may remain out of reach unless areas take specific steps to work it in.

11/ It also gives us a crucial test of the seriousness of Government’s commitment to this kind of approach: will the heightened autonomy and ‘total place’-style working promised in the Plan ever roll out to other mature Strategic Authorities?.

10/ If it works, it will be a proof-of-concept for the kind of high level collaboration between NHS and strategic authorities that the local government is increasingly hungry for.

9/ Elsewhere in the Plan - the commitment to work closely with Greater Manchester as a “prevention demonstrator” (trailed by Mayor Andy Burnham in his piece for our Re:Think collection looks to be exciting.

8/ Who knows: could local government (or, at least, subregional government) end up in the driving seat?.

7/ Taken together with direct commissioning powers for ICBs and the coterminosity ambition, these changes sketch out a model that echoes what we proposed in our paper Close Enough to Care: a more integrated, accountable and place-led system.

6/ Even so, it's excellent to have this ambition set out in black and white. More intriguingly, the Plan hints at new forms of democratic accountability, including a potential future role for mayors.

5/ That final caveat could prove significant, especially as Integrated Care Settlements are already 'clustering' in ways that do not align with combined authority borders (Hello, East Midlands!).

4/ The Plan promises to make ICBs “coterminous with strategic authorities… wherever feasibly possible.”.

3/ For those of us thinking about the future of place, public services and local power, a few things stand out:. Strikingly, there is a clear commitment to better alignment with local government through most of the Plan.

2/ First of all. there’s a lot to digest in the Government’s newly published NHS Plan. Luckily, our brilliant Re:Imagining Health team have put together a snap analysis! . Find it here: