Welcome to my first blog of 2026. I wanted to take a moment to reflect on a winter period that has already been exceptionally busy across our system. We continue to operate under sustained pressure, with demand remaining high, particularly due to seasonal respiratory illness and norovirus. This is having an ongoing impact across urgent, emergency and community services.

I would like to formally acknowledge the professionalism, clinical judgement and commitment being demonstrated across our areas. The way colleagues continue to respond under pressure is outstanding and really appreciated by the whole leadership team. Please also keep the constructive challenge and practical ideas for improvement coming, as we work through this period together.

Alongside these operational pressures, we are progressing significant organisational change. As with all ICBs nationally, we are evolving our role to operate more fully as a strategic commissioner and a new ICB from April. This is a necessary transition and one that will require strong clinical leadership, clarity of roles and consistent engagement across the system.

Clinical leadership model

A strengthened and more coherent clinical leadership model will be an important part of our future operating arrangements.

As part of this, we are planning to confirm Deputy Medical Director roles for both Norfolk and Waveney and for Suffolk. These posts will act as my deputies and will provide senior clinical leadership, with a particular focus on primary care and neighbourhood-based models of care. This reflects the central role of primary care and neighbourhood health in supporting system transformation and improving care closer to home.

Alongside this, we are considering how best to bring together senior clinical expertise across key priority areas, to provide consistent advice, challenge and leadership at system level. Our intention is to ensure that clinical leadership is well connected across geographies and services, supports effective matrix working, and feels joined up rather than fragmented.

In other systems, this has been achieved through closer alignment of senior clinical roles within the Medical Directorate. On balance, this is a model I believe offers greater coherence, strengthens collective clinical leadership and supports clearer accountability. We are expecting to share the final decisions on structure, roles and alignment shortly and will then work through a process of filling posts.

Digital transformation is increasingly fundamental to safe, effective and sustainable care. We need to continue strengthening digital capability across our senior clinical leadership to support this.

As part of this, I would encourage all senior clinical leaders — including myself — to undertake Chief Clinical Information Officer (CCIO) training. Some of this is available free online here, or for more details please contact John Lynch for Suffolk and North East Essex ICB and Ed Turnham for Norfolk and Waveney ICB.

Shifting care closer to home

Last month, I focused on prevention and proactive care. This update concentrates on our work to shift care away from our acute hospitals and closer to home. This remains central to improving outcomes, reducing avoidable demand and strengthening system resilience, and as an ICB, we are determined to prioritise this in line with our soon to be published 5 year population health improvement plan.

In 2025/26 we have identified significant funds to support this:

• £10.8 million from our growth allocation for urgent and emergency care which we will use on schemes to support admission avoidance.
• £16 million from an exercise to disaggregate our acute hospital contracts, in order to fund the same work but outside of the hospital, shifting care closer to home.

We received approximately 50 bids against these allocations and completed an initial prioritisation exercise. The quality and breadth of proposals has been fantastic and reflects a shared understanding that doing more of the same will not deliver the change our population needs.

While no final decisions have been made, emerging priority areas have been determined which focus on:

Urgent and Emergency Care

• Integrated Urgent care –to improve access to the Urgent Community Response, Urgent Care Coordination and Urgent Treatment centres all of which provide safe high-quality alternatives to Emergency Department attendance and admission to hospital.
• Proactive neighbourhood care management service for people with high needs and at very high risk of unplanned admissions.

Left shift and neighbourhood health

• End of life care – to improve identification and communication and reduce emergency admissions for people approaching end of life.
• Improving the identification and management of people with long term conditions, especially cardiovascular disease and diabetes.
• Improving care and reducing variation for people affected by stroke.
• Supporting prevention – in particular around smoking cessation and weight management.
• Elective care and demand management – to reduce waiting times, and provide more services previously only available in hospitals, closer to home.

We are operating in a challenging environment, but there is clear alignment across the system on the direction of travel, and this is absolutely in line with the NHS Long term plan. We will strengthen our clinical leadership, and continue with our three shifts: neighbourhood-based care, analogue to digital, and sickness to prevention wherever we can, adapting long-standing models where they no longer best serve our population.

Warm regards,

Frankie