The Norfolk Initiative for Coastal and rural Health Equality (NICHE) Anchor Institute, at the University of East Anglia, brings together integrated care system partners to address health inequalities across rural and coastal communities. NICHE aims to ‘ignite’ creative, person-centred mindset; ‘innovate’ place-based initiatives, and ‘embed’ critical and creative approaches that catalyse transformations within compassionate communities located across rural and coastal communities. Now in its evaluation phase, NICHE offers insights into sustaining person-centred principles within evolving integrated care systems. Our evaluation explores the tension between system-level integration driven by organisational reform and person-centred practice grounded communities where people live and work. Integration prioritises productivity, organisational alignment, and outcomes; while person-centred care emphasises relationships and sensitive responsiveness to what matters locally. We use a critical realist and practice development framework (McCormack & McCance, 2021), with participatory evaluation methods prioritising co-created meaning, local context, and ripple effects beyond service delivery. Emerging themes show person-centred redesign can both enable and constrain integration. Grassroots employment pathways, interprofessional reflective rounds, and cultural transformation initiatives illustrate how relational practices foster shared purpose and enhanced wellbeing, yet also clash with integration’s standardised pathways and performance metrics. Governance arrangements linking NHS organisations, the university, and community partners provides legitimacy and intellectual resources, yet also surfaces trade-offs between corporate accountability and responsiveness to lived experience. NICHE’s experience offers an embedded, context sensitive approach to innovation. It helps bridging practice, organisations, and governance, offering lesson suitable for an international audience. This presentation shares the evaluation framework, practical learning, and lessons on sustainability, offering a grounded account of how anchor institutes can navigate, rather than resolve, the tensions between integration and person-centred care in coastal and rural communities. McCormack, B. and McCance, T. (2021) The Person-centred Practice Framework. In: McCormack B et al. (eds.) Fundamentals of Person-centred Healthcare Practice. Chichester, UK: Wiley-Blackwell.