In line with the approach for all health services, the 2023–24 planning guidance for NHS trusts and ICBs reduced the number of nationally mandated objectives to six for mental health.38 Although the national programme led by NHSE has maintained a consistent focus to date, NHSE and other national arm’s length bodies are going through a period of significant change, with mergers and reductions of 30–40% in central staffing. This reorganisation raises many potential risks to NHSE’s capacity and ability to monitor 31 C&AG’s Report, paras 3, 11 32 Qq 104–105, 121–125, 152–153, 165 33 Q 7; House of Commons Committee of Public Accounts report, Introducing integrated care systems, Thirty-Fifth report of session 2012–23; PMS0015, page 3; PMS0018, page 2 34 Qq 168–171; C&AG’s Report , paras 11, 2.17 35 Qq 152–157 36 Q 7 37 Qq 79, 119, 163–166 38 C&AG’s Report, para 1.12 14 Progress in improving NHS mental health services and hold ICBs to account.39 We have also noted recently that support and accountability arrangements for ICSs are still underdeveloped.40 We asked about inconsistencies in local practice which are of concern, for example, the patchy implementation of clinical guidance for people with eating disorders; but it was not clear to us from the answer how NHSE would ensure that ICBs keep on top of these issues.41 Defining the long-term goal of ‘parity of esteem’