First off i want to say i that i don't and will never claim rights to these suggestions. I'm just throwing them out there because i would be interested in playing an awesome game.
I really like the option of having followers in the game. I also really like the option of having a house that you can build and design such as the ones in the Hearthfire add on. I understand how the next generation gaming platform will have more ability to run more complex scenes. With that said here is my suggestion on the topic.
After you build your house you also can build a wall with wood or stone around it. This wall can include different upgrades such as towers or gates. The settlement could include a certain resource that could be harvested like a metal with the addition of a mine. Inside the wall you have the option to build different buildings and workshops. These workshops would be things like a forge or enchanting tables. The buildings would be mostly houses (i would say twelve). When you gain a follower, you must have them level up say 4 times before they feel enough loyalty to live in your settlement. To have a follower move into a settlement, you must create a house that matches the varied follower's standards. When you have all 12 followers, a quest can arise where you can raid a few other settlements, bandits, military camps, orcish camps, possibly cities, etc. Yet when you anger another group they will counter you and return the force in varying degrees. Thats where the wall's development comes in to aid you. After a fight a wall can be damaged to different degrees, and can be repaired. An addition to the skills menu (i adore the menu in skyrim) could be labeled "Settlement Sustainability". Under the Settlement Sustainability section you progressively unlock new strategic abilities like settlement upgrades and possibly character movement tactics. I think of orcish settlements in Skyrim and strongholds in Morrowind when I envision this suggestion. I would like to add I hate the idea of having AI settlements all consisting of one race. Its up to the player how their settlement dwellers are chosen. I have seen how people's interests are affected by by the video games they play and I don't think it would set a good example for people in real life who play the game.
My next suggestion is about smithing. I don't like that you can only craft generic styles of weapons and armor. I think that when you are crafting a sword for instance, that you should have a few options about what the pommel, cross guard, chappe, fuller and blade look like. The different style options could increase or decrease the speed, damage, weight, and block of a sword. This suggestion continues to other weapons, armor, arrows and jewelry. The ability to find a pair of antlers and create a helmet with them fastened on would be awesome. In Morrowind you can put clothes on under you armor. I think that this is superior because you can have clothes that give benefits such as price reduction and speechcraft improvement.
Now about taking damage. I think that taking damage should be more area specific, weather it be from blade, burn or disease. Having a few variations on the "health potion" and "healing spell" would make the game a lot more interesting. I have an image of the stimpack body part selector in the pip boy of the fallout series in my mind as i describe this.
Now about combat. There are so many different styles of fighting from japanese to zulu to spanish to yaqui. It would be so much more interesting when you choose what weapon to use, if each kind of sword required its own technique that could be developed. I would compare what I'm thinking of to a simplified Soul Calibur's variety of fighting styles.
Thank you for reading. I hope this gets to someone who can do something.

Actually, there's already an on going thread series for suggestions for the next game here --------> http://www.gamesas.com/topic/1460321-official-beyond-skyrim-tes-vi-23/

Yeah, please keep all the speculation in one thread.