The anchor agenda puts into practice the notion that, as the UK's biggest employer, rooted in local communities, with a stake in people's wellbeing, the NHS can do more to improve population health than just provide high quality healthcare. As anchor institutions, trusts can improve the social, economic and environmental conditions for their local communities, in turn improving population health and reducing health inequalities. System working provides an even greater opportunity for trusts to deliver on these ambitions. If ICSs are to deliver on their fourth purpose and help the NHS support broader social and economic development, then renewing the focus on the wider determinants of health, and coming together to act on them, will be essential to their long-term success.