According to the Swedish Health and Medical Services Act, county councils are obliged to cooperate in regional and highly specialized care. Patients whose problems and treatment require the collaboration of a number of specialists and more expensive equipment are referred to the university hospital in the region. For example thoracic surgery, radiotherapy and neuro surgery require a larger patient base than is provided by a single county

The highly specialized hospital in the Northern region is Norrland University Hospital in Umeå. The university hospital is affiliated to the medical school within the University of Umeå and is also functioning as a research and teaching hospital. Norrland University Hospital is administered by the County Council of Västerbotten.

The cooperation between the four Northern County Councils is regulated by agreements concerning
  • demands for highly specialized care
  • economy and financing
  • plans and development of regional care

Education of new physicians, dentists and other health and medical staff is also included in the cooperation, as well as research and other regional issues.

The Regional Federation consists of twelve county politicians on the board; three from each one of the four Northern County Councils. The federation office is situated in Umeň. The Administrative Board, consisting of directors and officers from the county councils and the federation office, prepare matters and commissions for the political board. A number of regional groups work with special issues as research funding, public health and patient transportation.