We are concerned ICSs may struggle to make progress on their longer-term aims to prevent ill-health, given pressure for progress on immediate national priorities, for example, the need to reduce elective care backlogs and bring down A&E and ambulance waiting times.15 We asked NHS England how ICSs can be expected to balance these two sets of pressures and how it would ensure that ICSs addressed them appropriately. NHS England told us it was critical that ICSs responded to both short- and longer-term challenges: in their five-year strategies ICSs must set out how they would meet their core purposes, including addressing more forward looking aims around preventing ill-health, and reducing health disparities. NHS England also described how its oversight framework for ICSs includes both short and long term metrics.16