Tectonic plates are moving, with major structural reorganisation in both the NHS and local government. Funding and demand pressures, alongside national attempts to reform other public services, are straining relationships and integration further.

Amid these tensions, Rob Webster, West Yorkshire Integrated Care Board CEO, argues local leaders can choose to protect relationships and joint working at the level of place, despite organisational mergers.

In a comment piece for HSJ published alongside the podcast, he argues the “belief that the NHS can sort itself out, become a shiny cog in a machine whose only goal is itself” is “reductive and a fallacy”.

And Robin Tuddenham, CEO of Calderdale Council in west Yorkshire and president of the Society of Local Authority Chief Executives, says: “What we’re seeing is the need to adjust to a reshaping of the local state.

“But a reshaping of the local state that hasn’t necessarily [been done] coherently.”

The Calderdale CEO says national government is missing a plan for “the overarching governance of public services” at local level.

The lack of coherence risks an excessive “focus on just trying to get the structures to work”, which is “incredibly consuming of bandwidth and leadership capacity”.

With HSJ deputy editor Dave West and correspondent Mimi Launder.

Send podcast thoughts and ideas to annabelle.collins@hsj.co.uk

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