6G will likely be the first generation of mobile communication that will feature tight integration of localization and sensing with communication functionalities. Among several worldwide initiatives, the Hexa-X flagship project stands out as it brings together 25 key players from adjacent industries and academia, and has among its explicit goals to research fundamentally new radio access technologies and high-resolution localization and sensing. Such features will not only enable novel use cases requiring extreme localization performance, but also provide a means to support and improve communication functionalities. This paper provides an overview of the Hexa-X vision alongside the envisioned use cases. To close the required performance gap of these use cases with respect to 5G, several technical enablers will be discussed, together with the associated research challenges for the coming years.