Strengths of Transforming Worcestershire
Criteria 1
Criteria 1: Establishment of a single tier of local government
- Criteria 1a: Proposals should be for sensible economic areas, with an appropriate tax base which does not create an undue advantage or disadvantage for one part of the area.
- Criteria 1b: Proposals should be for a sensible geography which will help to increase housing supply and meet local needs.
- Criteria 1c: Proposals should be supported by robust evidence and analysis and include an explanation of the outcomes it is expected to achieve, including evidence of estimated costs/ benef its and local engagement.
- Criteria 1d: Proposals should describe clearly the single tier local government structures it is putting forward for the whole of the area, and explain how, if implemented, these are expected to achieve the outcomes described.
Below is a summary of how our proposal meets Criteria 1. For more information, please read pages 36 to 63 of the Transforming Worcestershire plan.
Sensible economic areas and a fair tax base (1a)
While part of the same county geographically, North and South Worcestershire are very different places, with different strengths, needs and opportunities. This is something residents made clear during the Shape Worcestershire public engagement.
The two areas have distinct local economies, different types of communities with more urban centres in the north and more rural communities in the south, resulting in different priorities for investment, skills, and services. Recognising these differences matters if we want local government to work well for everyone in Worcestershire.
A north and south model also offers a more sustainable solution when it comes to setting new rates of Council Tax. Increases in Council Tax levels are likely to be smaller under the two-council option than a one council solution, particularly for residents living in lower-council tax parts of the county.
A sensible geography to support housing and local needs (1b)
The north and south model reflects the clear urban and rural differences that exist in the county, allowing for tailored service provision, transport planning, and delivery of new housing, building on existing partnerships such as the South Worcestershire Development Plan.
It also avoids creating one large, complicated council covering areas that don’t fit well together and whose needs may be ignored in favour of the demands of other areas. Creating two councils allows decisions to be made more locally, at a scale that is easier to manage and better reflects real communities.
Clear single-tier structures and how they deliver outcomes (1d)
The proposed structure is strong and adaptable, so it can respond to future challenges both locally and across Worcestershire as a whole. It supports leadership at neighbourhood level, gives residents a stronger voice in decisions, and allows services to be shaped around local needs.
Public engagement shows strong support for this approach, with nearly half of residents who expressed a preference in the Shape Worcestershire engagement (62.5%) opting for the two-council option, as well as 70% of town and parish councils. There was strong support in rural areas, where concerns about losing local voice under a single large authority are most acute.
The two-council model is also adaptable enough to fit any future arrangements for devolution in the area.
Note on criteria 1c
All parts of the Transforming Worcestershire proposal meet this criteria.
Criteria 2
Criteria 2: Right size to achieve efficiencies, improve capacity and withstand financial shocks
- Criteria 2a. As a guiding principle, new councils should aim for a population of 500,000 or more
- Criteria 2b. There may be certain scenarios in which this 500,000 figure does not make sense for an area, including on devolution, and this rationale should be set out in a proposal.
- Criteria 2c. Efficiencies should be identified to help improve councils’ finances and make sure that council taxpayers are getting the best possible value for their money.
- Criteria 2d. Proposals should set out how an area will seek to manage transition costs, including planning for future service transformation opportunities from existing budgets, including from the flexible use of capital receipts that can support authorities in taking forward transformation and invest-to-save projects.
- Criteria 2e. For areas covering councils that are in Best Value intervention and/ or in receipt of Exceptional Financial Support, proposals must additionally demonstrate how reorganisation may contribute to putting local government in the area as a whole on a firmer footing and what area-specific arrangements may be necessary to make new structures viable.
Below is a summary of how our proposal meets Criteria 2. For more information, please read pages 64 to 87 of the Transforming Worcestershire plan.
Population size of new councils (2a and 2b)
Our proposal would create two balanced councils with a population of 293,451 in North Worcestershire, rising to 300,113 by 2032, and 327,915 in South Worcestershire, rising to 345,035 by the same date.
Both of the proposed areas would have a population above the average size of existing unitary councils (around 273,000) and provide a solid base for efficient service delivery, financial resilience and strategic capacity.
Our proposal would create two balanced councils with a population of 293,451 in North Worcestershire rising to 300,113 by 2032 and 327,915 in South Worcestershire rising to 345,035 by the same date.
Both of the proposed areas would have a population above the average size of existing unitary councils (around 273,000) and provide a solid base for efficient service delivery, financial resilience and strategic capacity.
While our proposal does not meet the 500,000 population figure originally set out by government, ministers have since confirmed this is more of a guide than a hard rule and alternatives will be acceptable with a clear rationale. The distinct geographies, identities and service needs of North and South Worcestershire provide that rationale, enabling a structure that balances efficiency with local responsiveness.
Analysis by the District Councils Network (DCN) shows there is no evidence to support the view 500,000 population levels drives better outcomes for people.
Alternatively, while a single unitary council would meet the Government’s population guidelines with a starting population of 614, 185, it would create one of the largest unitary councils in the UK. It would need to manage a wide range of population needs, across diverse communities which would make it difficult to respond effectively and tailor services to local need.
Having two councils with balanced populations also makes future devolution discussions easier, as it would avoid a one Worcestershire council outweighing the voice of other partners in any future Strategic Authority.
Improving efficiency and value for money (2c)
Creating two councils could deliver an estimated £9 million of year-on-year savings through consolidating and reducing duplication, streamlining service delivery and unlocking economies of scale in staffing, procurement and infrastructure.
However, reorganisation alone cannot meet the financial challenge local councils are facing. That’s why at the heart of Transforming Worcestershire is seizing the opportunity to work in dramatically different ways, to deliver real and lasting change.
Our approach will be community focused, prevention-led and one that works with residents and partners to reduce demand in the system and deliver genuine public sector reform. This is critical to improving outcomes in high-cost services like adult social care and children’s services over time.
Managing transition costs and transformation (2d)
The Transforming Worcestershire plan is expected to deliver approximately £16.23 million of gross savings and approximately £9 million a year of net revenue (day-to-day spending) savings. The payback period is about 3.9 years. Savings will come from cutting duplication of services, using economies of scale in staffing, procurement (buying goods and services) and infrastructure.
While this is less than the alternative single unitary proposal, we are clear lasting savings cannot be made simply from cuts alone. Our transformation approach – delivering more prevention, better outcomes and reduced demand especially in high-cost services – could deliver additional savings that would be locked in.
We have tested our financial modelling against other reorganisation programmes and are confident it is realistic and credible.
Strengthening financial sustainability across Worcestershire (2e)
There is growing concern about the precarious financial position across Worcestershire, driven largely by the scale and fragility of Worcestershire County Council’s budget and need for Exceptional Financial Support from the Government.
Worcestershire County Council ended the 2024/25 financial year with a £6.2 million overspend across its £433.4 million budget. It had set a savings target of £37.2 million but under-delivered by £4.7 million. The cost of providing services in 2025/26 is forecast at £495.6 million, an increase of £62.2 million from the previous year.
In contrast, the six district councils are in a stronger financial position without the need for Government support, but it is acknowledged that the current structure of local government in Worcestershire is a barrier to dealing with the financial challenge facing councils.
The cost pressure the county council is facing is driven by inflation and escalating demand in adult social care, children’s services, SEND provision, and home-to-school transport. These pressures are significantly above inflation and not matched by increases in Council Tax or government funding.
The county’s budget is dominated by high-cost services and without a change in delivery model, these pressures will continue to grow. The county’s precarious financial position highlights the need for reform.
The north and south model is built to focus on prevention. It is well known that for every £1 spent on prevention £3.17 is saved on adult social care.
Criteria 3
Criteria 3: Delivery of high quality and sustainable public services to citizens
- Criteria 3a. Proposals should show how new structures will improve local government and service delivery and should avoid unnecessary fragmentation of services.
- Criteria 3b. Opportunities to deliver public service reform should be identified including where they will lead to better value for money
- Criteria 3c. Consideration should be given to the impacts for crucial services such as social care, children’s services, SEND and homelessness, and for wider public services including for public safety.
Below is a summary of how our proposal meets Criteria 3. For more information please read pages 88 to 115 of the Transforming Worcestershire plan.
Delivering high-quality, sustainable public services (3a)
Local Government Reorganisation (LGR) is a once-in-a-generation chance to improve services for people across Worcestershire. It should not just be about reorganising councils, but genuinely doing things better.
Our proposal for two new unitary councils – one in North Worcestershire and one in South Worcestershire – is designed around people and places, so services are easier to access, more joined-up and better able to support residents throughout their lives.
Too many services in Worcestershire are currently under pressure and responding to crisis rather than preventing problems early. A north and south model allows services to be closer to communities, building on the strong local knowledge, relationships and neighbourhood focus that already exists in district councils.
By default, services will be place-based. This means local teams working together around neighbourhoods, not remote, one-size-fits-all systems. Adult social care, children’s services, housing, health partners and the voluntary sector will work side by side in integrated neighbourhood teams, reducing duplication and breaking down siloes.
While services will be locally led, we will avoid unnecessary fragmentation. Where it makes sense to work at a wider Worcestershire level, such as safeguarding, specialist services or strategic planning, councils will collaborate through shared arrangements, joint committees and clear governance.
Reform that delivers value for money (Criteria 3b)
The two-council model creates the right balance between local responsiveness and strategic efficiency.
Services will be designed around people rather than organisational boundaries, helping to:
- shift from crisis response to prevention
- reduce long-term demand on services
- improve outcomes for residents
- deliver better value for public money
High-cost and specialist services, such as complex adult care or SEND commissioning, will be managed collaboratively to ensure consistency and financial sustainability. Shared commissioning, market management and county-wide partnerships will protect value for money while avoiding duplication.
In contrast, a single county-wide council risks repeating existing problems on a larger scale, with decision-making further away from communities and fewer opportunities to reshape services around local need.
Protecting and strengthening vital services (Criteria 3c)
Safeguarding vulnerable people is central to this proposal.
Adult social care will be run separately in North and South Worcestershire, each with clear leadership and accountability, while sharing safeguarding arrangements and specialist services where this benefits residents. This allows care to be more personalised, preventative and closely connected to local health, housing and community support.
Children’s services will also be locally led in the north and south, improving oversight, strengthening relationships with schools, health and police, and enabling earlier help for families. A single Worcestershire safeguarding partnership will ensure children remain protected consistently across the county.
Public health will continue as a shared Worcestershire-wide service, recognising that issues such as pandemics, substance misuse and health inequalities do not stop at council boundaries. This avoids fragmentation and protects established NHS partnerships.
Homelessness prevention will remain neighbourhood-focused, building on existing local approaches and ensuring support is joined up with housing, health and social care, helping people earlier and reducing the risk of crisis.
Highway services will be split, with strategic planning managed jointly by the two councils in a shared service. In time, we expect all, or most, of this function will transfer to the Strategic Authority once created. Highways maintenance and improvements will be locally led so they remain responsive and tailored to local needs.
Transport planning and local transport schemes, like bus services and active travel, will be operated separately by each council, but with a high level of collaboration. This will ensure local factors, such as improving connectivity to the West Midlands in the north and rural accessibility in the south, are given appropriate attention.
Waste services will continue to operate the successful model of local collection and countywide disposal which has delivered high rates of resident satisfaction. Waste collection will be managed by each council separately, and disposal shared across Worcestershire and Herefordshire until the end of the current contract in 2029. After that, the opportunity to deliver waste disposal on a regional basis will be explored which may deliver economies of scale and new opportunities for reuse and recycling for residents. This approach ensures efficiency, resilience and local responsiveness is maintained, while allowing for innovation.
Managing change safely and responsibly (3a)
We recognise the risks that come with change. That is why the transition will be carefully planned over two years, learning from successful reorganisations elsewhere.
A dedicated “safe transfer protocol” will ensure:
- no gaps in services
- continuity of care for vulnerable residents
- clear accountability from day one
- risks identified and managed early
The two new councils will be built on a strong culture of collaboration, ensuring Worcestershire’s public services remain safe, stable and sustainable throughout the transition and beyond.
Criteria 4
Criteria 4: Working together in coming to a view that meets local needs and is informed by local views
- Criteria 4a. It is for councils to decide how best to engage locally in a meaningful and constructive way and this engagement activity should be evidenced in your proposal.
- Criteria 4b. Proposals should consider issues of local identity and cultural and historic importance.
- Criteria 4c. Proposals should include evidence of local engagement, an explanation of the views that have been put forward and how concerns will be addressed.
Below is a summary of how our proposal meets Criteria 4. For more information, please read pages 116 to 133 of the Transforming Worcestershire plan.
A model shaped by significant engagement (4a and 4c)
Before bringing forward a proposal for local government reorganisation in Worcestershire, we wanted to be confident it was based on what local people and organisations actually need and support.
That’s why we carried out our extensive Shape Worcestershire engagement to listen to the voices of residents, town and parish councils, partners and staff to understand what matters most to them, and to test whether different options would meet those needs.
The engagement was extensive and reached an estimated 200,000 people through various formats, with over 50,000 visits to the dedicated Shape Worcestershire website. Our approach has since been recognised by the Local Government Association as an example of good practice.
Overall, 4,249 responses were received to the Shape Worcestershire survey with 11 focus groups held on top of that to explore residents’ views in depth.
The message people gave us was clear. Where a preference was expressed:
- 62.5% supported two unitary councils – one in the north and one in the south
- 37.5% supported a single council covering the whole county
Residents told us they believe a north and south model would:
- Improve local services
- Better reflect local identity
- Strengthen links between councils and communities
Support was also strong from local councils, with around 70% of parish and town councils backing the north and south approach.
There were also 32 engagement sessions with partners and stakeholders, and over 700 district council staff shared their views through surveys.
In summary, Transforming Worcestershire is the only proposal based on meaningful and inclusive engagement. We can confidently demonstrate that the north and south model is preferred by residents, staff of the five district councils and town and parish councils. Concerns raised by some partners, police and voluntary sector organisations have been addressed in the proposal. We’re confident Transforming Worcestershire aligns with the preferences of residents and creates a strong foundation to make a success of Local Government Reorganisation.
Two councils grounded in local identity, culture, and history (4b)
Worcestershire is not one single, uniform place. It is a county shaped by history, landscape and the everyday lives of the people who live and work here. From busy towns in the north to rural villages and historic centres in the south, different parts of the county have developed their own identities over time.
Public engagement has shown strong support for a north and south model because people feel it better reflects these differences and they want that sense of place respected and protected in any future local government structure.
During the Shape Worcestershire engagement, nearly 46% of respondents said the north and south model was the best option for supporting local identity, community character and decision-making by leaders who understand their area.
People consistently said they want decisions to be made by councils that:
- Understand local history and culture
- Reflect how communities actually live and work
- Can tailor services to local needs
While every district in Worcestershire has its own individual features, engagement clearly showed a natural divide between the north and the south of the county.
The north of the county has a more urban and industrial character, with strong economic and social links to Birmingham and the wider West Midlands. Areas such as Bromsgrove, Redditch and Wyre Forest share a heritage rooted in manufacturing, engineering and industry.
This area has a diverse population, strong commuting links outside the county and a focus on regeneration, innovation and connectivity. Residents told us their priorities often centre on transport, jobs, skills and access to services in more densely populated towns.
The south of Worcestershire has a more rural and heritage-focused character, with a strong visitor economy and closer ties to south-west England and neighbouring counties.
Areas such as Malvern Hills, Worcester and Wychavon are known for agriculture, market towns, festivals, arts and historic landmarks. Residents here often emphasise the importance of protecting landscapes, supporting tourism, and sustaining rural services and communities.
Travel patterns across Worcestershire further highlight these differences. The north is closely connected to the West Midlands, with many residents commuting daily to Birmingham and surrounding areas. In contrast, the south has a more balanced pattern, with Worcester acting as a central employment hub and surrounding rural areas linked to nearby towns and cities.
Residents and transport providers have told us that these different patterns require different solutions. A north and south model would make it easier to tailor transport and infrastructure planning to local realities whether that is urban mobility in larger towns or access to services in rural areas.
A single council covering all of Worcestershire would need to manage very different identities, economies and travel patterns across a large and diverse area. Many residents feel this risks diluting local voices and reducing the ability to respond to specific local needs.
Our proposal is not about removing Worcestershire from the map – far from it. The county will continue to exist as a recognised place with a shared history, culture and identity.
The north and south model is a way to keep decision-making closer to communities, protect local identity, and ensure Worcestershire’s diversity is reflected – not lost – in how the county is governed.
Criteria 5
Criteria 5: Structures to support devolution
- Criteria 5b. Where no Combined Authority or County Combined Authority is already established or agreed then the proposal should set out how it will help unlock devolution.
- Criteria 5c. Proposals should ensure there are sensible population size ratios between local authorities and any strategic authority, with timelines that work for both priorities.
Below is a summary of how our proposal meets Criteria 5. For more information, please read pages 134 to 143 of the Transforming Worcestershire plan.
Unlocking devolution for Worcestershire (5b)
The Government wants to see devolution in every part of England. This involves creating a Strategic Authority that is made up of several councils across a large area. They are legally called a Combined Authority (CA) or a County Combined Authority (CCA) but we use the term Strategic Authority to keep things simple and because it better describes what the organisation does.
A Strategic Authority:
- Sits above local councils but does not replace them.
- Is led by a directly elected mayor (like in the West Midlands or Manchester).
- Focuses on big, long-term issues such as transport, housing, skills, infrastructure and economic growth.
- Brings together councils, the NHS, emergency services and other partners.
Local councils would continue to run day-to-day services, make local decisions and represent their communities. The Strategic Authority would only deal with matters that are best handled at a wider, county or regional level.
Worcestershire does not currently have a Strategic Authority in place. The Transforming Worcestershire proposal helps unlock devolution by creating the right local government foundations for it to happen quickly and effectively.
All Worcestershire councils agree there should be an early devolution deal for the county. Alongside local government reorganisation, councils are actively working together to explore the creation of a Strategic Authority with a directly elected mayor.
The Strategic Authority would focus on issues that cross council boundaries and require long-term coordination, such as transport, infrastructure, housing growth, skills, net zero and economic development. It would also support closer working between the councils making up the Strategic Authority, the NHS and other public services.
The north and south unitary model, creates clear, stable councils that can work effectively within a wider devolved structure. By simplifying local government and reducing fragmentation, the proposal puts Worcestershire in a stronger position to secure devolved powers and funding.
Devolution matters because Worcestershire faces shared challenges that cannot be solved by individual councils alone. These include productivity gaps, uneven skills attainment and infrastructure constraints. At the same time, the county has strong opportunities in advanced manufacturing, cyber security and professional services.
Without devolution, Worcestershire risks falling further behind areas that already benefit from devolved powers and investment. Worcestershire County Council did not pursue offers from previous governments for a county devolution deal, meaning there is currently no devolution framework in place for Worcestershire. This proposal provides a clear route forward so residents and businesses can start to benefit as soon as possible.
Sensible scale, strong partnerships and realistic timelines (5c)
The proposal also meets the requirement for sensible population size ratios between local councils and any future Strategic Authority, with timelines that support both local government reform and devolution.
The proposed north and south unitary councils would be large enough to deliver services efficiently, while still remaining close to communities. At the same time, they would be well-suited to operating within a larger Strategic Authority that meets Government expectations on scale and capacity.
Worcestershire councils have identified three viable options for a future Mayoral Strategic Authority.
- Herefordshire, Worcestershire and Warwickshire
- Herefordshire, Worcestershire and Gloucestershire
- Herefordshire, Worcestershire, Gloucestershire and Warwickshire
Each option has a population close to, or exceeding, the recommended threshold of around 1.5 million when future housing growth is taken into account. All options offer strong economic geography, shared industrial strengths and clear transport corridors.
These options also allow for sensible alignment of public services, including health, policing and fire and rescue services. While some boundary changes would be required, Government policy and legislation already allow for this, and there is sufficient time before current arrangements end in 2028 to make the necessary changes without delaying devolution.
Importantly, this proposal recognises that local government reorganisation and devolution are separate statutory processes, but that they must move forward together. Establishing stable unitary councils first allows Worcestershire to engage confidently with neighbouring areas and Government on the best long-term devolution footprint, rather than rushing into a sub-optimal solution.
The shared ambition is to hold mayoral elections as early as possible, potentially by May 2027 and no later than May 2028, with full powers and funding from the outset. This ensures Worcestershire is not left waiting years longer than necessary while other areas move ahead.
Taken together, the proposal creates councils of the right size, enables realistic and timely devolution, and provides a clear pathway for Worcestershire to secure stronger leadership, greater investment and better outcomes for residents and businesses.
Criteria 6
Criteria 6: Stronger community engagement and genuine opportunity for neighbourhood empowerment
- Criteria 6a. Proposals will need to explain plans to make sure that communities are engaged.
- Criteria 6b. Where there are already arrangements in place it should be explained how these will enable strong community engagement.
Below is a summary of how our proposal meets Criteria 6. For more information please read pages 144 to 163 of the Transforming Worcestershire plan.
Community engagement and neighbourhood empowerment across Worcestershire (6a)
The proposed north and south model not only keeps decision-making closer to communities but builds genuine community engagement into the work of both councils, rather than treating it as a separate or optional activity.
We have co-designed a model that puts community power at the centre, informed by engagement undertaken with over 4,200 residents, 69 town and parish councils and focus groups, including representatives from the VCSE, health, police, business representatives and staff.
This model is shaped by what people told us matters most - decisions should stay close to communities, services should reflect local needs, and people should be able to see how their voice leads to action.
Our approach to community engagement is guided by a clear “golden thread”:
- People – residents’ voices shape priorities and decisions
- Place – services are tailored to the needs of each neighbourhood
- Prevention – problems are addressed early to reduce long-term demand on services
This supports stronger communities, better outcomes and more efficient use of public resources.
At the centre of our proposal are Neighbourhood Area Committees (NACs) and Integrated Neighbourhood Teams (INTs). Together, they provide clear, practical ways for residents and communities to influence priorities and service delivery.
The relationships between NACs and INTs and the two councils would work as follows, providing three pillars for community power:
- The North Worcestershire and South Worcestershire councils will provide the strategic backbone, resources and coherence while keeping decision-making local.
- Neighbourhood Area Committees will be local democratic forums where councillors, residents, town and parish councils and partners come together to agree priorities, influence budgets and hold services to account.
- Integrated Neighbourhood Teams will bring together staff from councils, health, police, housing and voluntary organisations to deliver joined-up, preventative services based on those local priorities.
This structure ensures a clear link between what communities say they need and how services are delivered.
Town and parish councils would remain a vital part of local democracy in this new relationship. Under this model, they will be key partners within Neighbourhood Area Committees, ensuring local knowledge and grassroots leadership directly inform neighbourhood decisions.
In areas without parish councils, existing civic arrangements will continue, ensuring local representation is maintained. Over time, any changes to community governance would only happen with local support.
Evidence from the Shape Worcestershire engagement and surveys of town and parish councils shows strong support for a north and south model over a single county-wide council. People consistently said they value decision-making that is local, visible and responsive.
Many residents expressed concern that a single large council would be too remote, making it harder for towns, villages and neighbourhoods to be heard. The two-council model directly responds to this by creating councils that are large enough to plan strategically, but small enough to stay connected to communities.
In contrast, a single unitary council covering all of Worcestershire would be too large to maintain meaningful neighbourhood influence. With far more residents per councillor, local representation would be stretched, and decision-making would become more distant.
Criteria 6b: Building on what already works in Worcestershire
For more than 50 years, district councils have shown that being close to communities makes a real difference. Their local knowledge, partnerships and day-to-day presence enable them to listen, respond and adapt quickly.
Strong, well-established arrangements trusted by residents are in place to engage communities and deliver services that reflect local needs.
These include services like:
- Wellbeing hubs that bring services together around local needs
- Preventative support that helps address issues early
- Targeted grants that support community groups and local priorities
- Strong partnerships with the voluntary, community and social enterprise sector
These arrangements are shaped by deep understanding of local places and long-standing relationships with residents, town and parish councils, community organisations and service partners. This allows councils to respond quickly to emerging issues and tailor solutions to different towns, villages and neighbourhoods.
Most importantly, residents are actively involved in shaping priorities and influencing decisions. This creates trust, strengthens local democracy and leads to better outcomes.
Our proposal is designed to protect and strengthen this approach, not replace it.
By creating two councils rather than one large authority, our proposal ensures:
- Local knowledge and trusted relationships are retained
- Community engagement remains meaningful and accessible
- Services continue to reflect the distinct needs of different areas
This model preserves the agility and responsiveness that already exists, while providing the scale needed for strategic planning and investment.
A single unitary council covering the whole of Worcestershire would find it difficult to maintain this level of local connection. Decision-making would be more centralised, councillors would represent far larger populations, and the close relationships built up over decades would be harder to sustain.
Evidence from existing district-led initiatives shows that strong community engagement relies on proximity, trust and local insight. A single authority would struggle to replicate this granularity at scale, increasing the risk of remote decision-making and reduced responsiveness.