It is a pleasure to see you in the Chair, Sir Charles. I congratulate Alex Cunningham on securing this important debate. He has used it to raise important questions that are vital to NHS governance—localism, transparency and accountability. He is right that patients in his Constituency and the wider region should be at the forefront of decision making about their healthcare. NHS England has found that shared leadership and group working arrangements between trusts can stabilise governance and align approaches to help improvement.