Luton Council - which had been a partner in the Bedfordshire, Luton and Milton Keynes Integrated Care System (ICS) has pulled out, according to Health Service Journal, claiming that the ICS disempowered local decisions. Nottingham City Council also suspended its direct ICS involvement in November 2018. In Berkshire West, neither the South Central Ambulance Trust nor local authorities are partners in the Integrated Care System at present.