The much-anticipated Hewitt Review into the oversight, governance and accountability of integrated care systems (ICSs) landed last week, to surprisingly little fanfare and a somewhat muted reception. To anyone that has followed the path of the review since its launch in November 2022, it will come as no surprise that it is both comprehensive in its breadth and that it draws on extensive engagement with the sector and key partners, for which the review team and its leadership should be given due credit. Reflecting this, the final document weighs in at a hefty 89 pages. So, standing back from the detail, what are the key take-aways?