The Scottish Borders could become the first region in Scotland to see its council and NHS board merge to create a singe authority, the Local Democracy Reporting Service says.
The proposals are being discussed at a council meeting today and would see the combined organisation take charge of nine thousand staff and a four hundred million pound budget.
Michael Cook, the authority's corporate policy advisor, came up with the proposal and has described it as an "unprecedented opportunity".
A decrease in public spending, social inequality and the potential impact that Brexit may have on the region are just some of the challenges addressed.
The report says, addressing those concerns is difficult due to the co-ordination needed between the council and NHS Borders.
It says problems such as obesity and child abuse are "currently beyond the capacity of any one organisation to understand and respond to."
"Too often, agencies focus on acute problems and so unilaterally rather than co-ordinating efforts to address those factors which give rise to the problems in the first place."
If approved in the meeting today, the proposals will be submitted to the Scottish Government and the Convention of Scottish Local Authorities.