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Welcome to the South East Clinical Senate Annual Report for 2023-24, the second annual report since the merger of the former Kent Surrey Sussex and Hampshire Thames Valley Clinical Senates. The report describes the activities and independent clinical advice we have provided across health and care systems during this period. This past year should have marked how our learning and transformation driven by the accelerated technology development and innovative and collaborative ways of working following on from the pandemic has been translated into imaginative service redesign and reconfiguration. Whilst that remains a desired aspiration the year has seen a reduction in terms of assurance work. Systems have been constrained by challenges related to Covid-19 pandemic recovery, industrial action, service pressures affecting all areas of our healthcare system and workforce, and the need for our new Integrated Care Systems to bed in and become established. However, that has afforded us some space in which to undertake a number of proactive projects and we have published on a variety of subjects related to clinical senate work. These are detailed within this report.