Christmas 2016 - Looking ahead

Looking ahead

As we head into the Christmas period I want to take the opportunity thank everyone who has supported NHS Halton CCG in 2016.  I also want to acknowledge the contribution of everyone who has provided health and social care support to people in Halton - whether paid or unpaid - for their effort and commitment every day of the year.

There are many challenges that face health and care in the year ahead.  We have to deliver better health, better care and better value within increasingly scarce resources and against a background of rising demand and expectation.  There will be a need to take some difficult decisions and make some difficult choices about how we prioritise our spending as a commissioner.  There is also an opportunity to engage with local people about this and continue to work on ways in which we can encourage more self-care and promote wellbeing.

In April 2017 NHS Halton CCG will have been a statutory organisation for four years, and in November 2017 will have been active for six years.  Inevitably this means that changes will happen.  Next year we will say goodbye to our Chair, Chief Nurse and Chief Finance Officer who have decades of NHS experience between them and will be missed.  We have already appointed a new Chief Nurse and Chief Finance Officer, more on that in 2017.  Our member practices have also elected a new Chair, Dr David Lyon, who will take up post in April 2017.  Congratulations to David on his election, I look forward to continuing to work with him, albeit in a new role, in 2017.

NHS England consultation: Action to reduce sales of sugar-sweetened drinks on NHS premises

NHS England consultation: Action to reduce sales of sugar-sweetened drinks on NHS premises

On the 9 November Simon Stevens NHS England’s Chief Executive announced details of proposed new action to cut obesity and reduce the sales and consumption of sugary drinks sold in hospitals.

England would become the first country in the world to take action across its health service in this way. A formal consultation launched earlier in the month gives details of a proposed new fee to be paid by vendors, or alternatively seeks views on an outright ban.

As Europe’s largest employer, with over 1.3 million staff, the NHS committed in its overall strategy, the Five Year Forward View, to improve the health of its workforce.

A recent survey found obesity to be the most significant self-reported health problem amongst NHS staff, with nearly 700,000 NHS staff estimated to be overweight or obese.

Rising rates of obesity amongst NHS staff are not only bad for their personal health, but also affect sickness absence and the NHS’s ability to give patients credible and effective advice about their health.

NHS premises also receive heavy footfall from the communities of which they are a part, with over 1 million patients every 24 hours, 22 million A&E attendances and 85 million outpatient appointments each year. The food sold in these locations can send a powerful message to the public about healthy food and drink consumption.

Simon Stevens has said that it’s time for the NHS to practice what it preaches. Nurses, visitors and patients all tell us they increasingly want healthy, tasty and affordable food and drink options. So like a number of other countries we’re now calling time on hospitals as marketing outlets for junk food and fizzy drinks. By ploughing the proceeds of any vendor fees back into staff health and patient charities these proposals are a genuine win/win opportunity to both improve health and cut future illness cost burdens for the NHS.

The consultation proposes levying a fee for any vendor of sugar-sweetened beverages (SSB) on NHS premises. It is complementary to the government’s proposed sugar tax, but would begin sooner – in 2017 – and based on best evidence would cover the full range of sugar sweetened drinks. Subject to consultation the drinks affected would be any drink with added sugar including fruit juices, sweetened milk-based drinks and sweetened coffees.

Proceeds from the fee would be used directly to fund expanded local staff health and wellbeing programmes and/or the trust’s patient charities. It also seeks views on an outright ban on certain products being sold on NHS premises, an approach now beginning to be taken by hospitals in several other countries.

The consultation will ask for the views of patients, carers, NHS staff, the public and suppliers and will close on January 18 when feedback will be considered and a decision taken about how this should be taken forward into the NHS standard contract

LOOK AFTER YOURSELF!

As winter approaches it is more important than ever that you look after your own health and wellbeing.  Winter is traditionally the time of coughs, colds and fevers, it is also the time when the NHS is under the most pressure.  This is why NHS Halton CCG is supporting three key initiatives over the coming weeks that reinforce the importance of looking after yourself, of self-care and of getting the right treatment.

We are promoting the flu jab at the moment.  Flu occurs every year, usually in the winter, which is why it’s sometimes called seasonal flu. It’s a highly infectious disease with symptoms that come on very quickly.  Certain people can have, should have, a flu jab that will provide the best protection available against an unpredictable virus that can cause severe illness.  More information for flu clinics in Halton and further advice can be found at http://www.haltonccg.nhs.uk/your-health/seasonal-advice.

The second initiative that we are supporting is Self Care Week, which runs from 14^th November 2016 to 18^th November 2016 and is promoted by the Self Care Forum (http://www.selfcareforum.org/).  Self-care works when people are empowered with the confidence and information to look after themselves when they can, and visit the GP when they need to, gives people greater control of their own health and encourages healthy behaviours that help prevent ill health in the long-term.  In many cases people can take care of their minor ailments, reducing the number of GP consultations and enabling GPs to focus on caring for higher risk patients, such as those with comorbidities, the very young and elderly, managing long-term conditions and providing new services.  More cost-effective use of stretched NHS resources allows money to be spent where it’s most needed and improve health outcomes. Furthermore, increased personal responsibility around healthcare helps improve people’s health and wellbeing and better manage long-term conditions when they do develop. This will ultimately ensure the long-term sustainability of the NHS.  Have a look at the Self Care Forum website, which has lots of practical tips and support.

The third initiative that we are supporting is World Antibiotic Awareness Week, which is also from 14^th November 2016 to 18^th November 2016.  Antibiotic resistance represents one of the greatest threats to human health today.  Inappropriate and over use of antibiotics is a major driver of antibiotic resistance. As antibiotic resistance is increasing, the development of new antibiotics is declining.  Few new antibiotics have been developed in recent years; meaning many of the medical advances that rely on antibiotics to control infection (such as organ transplantation, surgery and neonatal care) may be under threat.  Antibiotics are only effective in bacterial infections.  Our GPs and other healthcare professionals have a range of tools through which they can determine whether the prescribing of an antibiotic is appropriate or not.  So, don’t expect that you will get antibiotics and don’t be surprised if you are not given them.

Simon Banks

Building Boxes, Building Futures

Building Boxes, Building Futures

For just over a year I have been the Senior Responsible Officer (SRO) for the Cheshire and Merseyside Women’s & Children’s Services Partnership, in addition to my duties as Chief Officer of NHS Halton CCG.  The Partnership has brought together 28 organisations with the shared aim making women’s and children’s services financially and clinically sustainable and also improving the quality of those services and the experience of the people who use them.  The Partnership operates under the brand of Improving Me (http://www.improvingme.org.uk/).  On 7^th October 2016 we launched the first Baby Box programme in the North of the United Kingdom and the first to roll out to new mums at scale across multiple boroughs and NHS Clinical Commissioning Groups.

The Partnership will be issuing 30,000 Baby Boxes to women in pregnancy over the course of the initial pilot starting in Halton.  The Baby Boxes will encourage early engagement with maternity services and access to care for all pregnant women. It will form part of their antenatal pathway and be supported by Halton’s midwifery service, which is part of Bridgewater Community Healthcare NHS Foundation Trust.

The Baby Box tradition, which originates from Finland, has been credited with reducing the infant mortality rate in the country from 65 infant deaths per 1,000 births in 1938 to 2.26 per 1,000 births in 2015.  The UK has some of highest rates of infant mortality in Europe, ranking 22nd out of the 50 European countries with 4.19 deaths per 1,000 births.

The boxes, which are made from a very thick cardboard and come with a firm foam mattress, waterproof mattress cover and a cotton sheet, are traditionally used in Finland as a baby’s bed for up to the first eight months of their life.  They replace need for the traditional Moses basket or cot, it is thought the small size of the Baby Box prevents babies from rolling onto their tummies, which experts think can contribute to sudden infant death syndrome.

Most importantly, families receiving a Baby Box will have access to the Baby Box University, a comprehensive maternal and childcare education platform, available from pregnancy onwards. Developed with leading medical experts around the world, Baby Box University enables each of its healthcare partners to customise the educational content to suit local need. Available in a variety of languages, the content transcends the language barriers that can be a problem in diverse populations.
 

I am really proud that we have been able to launch this initiative in Halton.  It is a fantastic opportunity to show local mums that their NHS commissioners and providers of maternity services care about them and their babies at all stages of pregnancy.  This is an important investment in our future population that encourages healthier outcomes for families.  Well done to all involved, particularly Cath McClennan, Programme Director with Improving Me, who was instrumental in bringing this initiative to Cheshire and Merseyside.

Simon Banks

You’ve Got To Be In It To (Try And) Win It

For the second year running NHS Halton CCG has been shortlisted in three categories for a prestigious Health Service Journal (HSJ) award.  The categories we have been shortlisted in are:

·         Improving Environmental and Social Sustainability category for ‘Lead the Change’ (with Wellbeing Enterprises CIC and UnLtd).

·         Specialist Service Redesign category for ‘transforming St Luke’s care home’ (with Community Integrated Care and Halton Borough Council)

·         CCG of the Year

The winners will be announced at the finals, which will be held on 23 November 2016 at the Intercontinental O2, London.

We are extremely proud to be shortlisted for 3 HSJ Awards for the second year running.  The awards are judged by industry leaders, making them one of the most prestigious awards on the health calendar; so it is a huge honour for our work to be recognised in this way.  For 35 years the HSJ Awards, have recognised, celebrated, and promoted the finest achievements in NHS, and showcased them to the service’s most influential leaders.  Over that time the HSJ Awards have grown to become the most sought after accolade in British healthcare – and very probably the largest awards programme of its type in the world.  NHS Halton CCG, with  Wellbeing Enterprises CIC, won a HSJ Award in 2015 for Innovation in Primary Care.

Simon Banks

A Walk In The Park

My last message talked about the benefits to health and wellbeing of being outdoors and enjoying the green spaces of our borough.  Our Annual General Meeting this year will be using one of the many green spaces in our borough, Victoria Park in Widnes.

Our AGM begins at 1pm on 26^th September 2016 at Victoria Park, Birchfield Road, Widnes, WA8 7SU.  Our AGM is an opportunity for local people to hear more about the local NHS and join in a healthy discussion about the future of health and wellbeing in Halton.  We will also be offering a range of taster activities aimed at improving you wellbeing including a Green Gym, Tai Chi, walking rugby, bowling, pram fitness and mock-tails.

Please come and see us on 26^th September 2016.  The activities start at 1pm and the AGM at 3pm.  If you have any special requirements, including transportation, call our office on 01928 593 455, text 0700 108 565 or email talk2us@haltonccg.nhs.uk.

Simon Banks

For more information please see: www.haltonccg.nhs.uk

Getting out and about

Sometimes I get the chance to write a message that is not necessarily directly connected with NHS business. Whilst the next few lines are not necessarily about NHS business they are about health and wellbeing.

Our borough, Halton, our two towns, have a proud industrial history. Many local people and their forebears worked in local industries, particularly in the chemical industry, some people still do. Whilst the borough does have this heritage when you look around and take notice there is also significant amount of green space, some natural and some man made. You cannot go far in the borough without finding a park, a stretch of water or some woodland.

Our offices, in Runcorn Town Hall, are surrounded by green space. When I go home of an evening I look across the River Mersey, a mighty tidal river with wonderful bird life. Sometimes I have a run along the Bridgewater Canal, avoiding being accosted by a family of swans, and it is peaceful and still. Our parks are magnets for people from all over the area, Victoria Park has often been a "go to" place with my kids. The open spaces in the borough attract people walking, running, skateboarding, cycling, or just being. One of our local Widnes Vikings stars, Hep Cahill, is using some of these spaces for communal exercise programmes, as do our local Health Improvement Team.

So, as I write this, the sun is shining and I am watching the River Mersey and the Ship Canal flow by I am feeling good.  My health and wellbeing has been improved by stopping for a bit, taking notice and taking in the environment. You don't have to go far in Halton to do this, it will improve your health and wellbeing, and this actually helps us in the NHS because if you feel well you can stay well for longer.

Simon Banks
www.activehalton.co.uk
https://www.facebook.com/pages/Walking-for-Health-Halton/482818178431169
@HaltonCCG

Game Changer

It was the hottest day of the year so far on 19th July 2016 and I spent the morning back at primary school, with the Widnes Vikings squad, outside in the sun. The purpose of the morning was to launch Game Changer, an innovative  project that has come from our CCG's work with the Cheshire and Merseyside Women's and Children's Services Partnership and with Widnes Vikings. The programme works with children of a primary school age and was launched at Weston Primary School. Game Changer has a specific focus on using the power of sport to engage with the most deprived and disadvantaged groups with a core focus on providing physical activity and social engagement opportunities to those most at need. We are starting with rugby league but the concept is replicable into any sporting arena.

The Game Changer programme aims to make children fitter and healthier, promote inclusiveness and reduce isolation and increase mental resilience. The specifics of delivery are developed with each school and tailored to their needs but the main thrust of the programme is to encourage children to be physically active for 8o minutes each day and take up healthy options for food drink. By using the brand of the local sports club and their players and coaching staff, in this case Widnes Vikings, this increases engagement and the club is able to give something to the local community.

Thanks very much to Weston Primary School for hosting the launch of Game Changer, there were some very excited and engaged children throughout the day. Thanks also to James Rule, Chief Executive, Widnes Vikings and to Denis Betts, Head Coach, Widnes Vikings and their coaching staff and players for their support for this project.  

Simon Banks

Halton People’s Health Forum

Every three months or so we host the Halton People’s Health Forum.  These meetings are planned by a steering group of local residents and are one of the ways in which we engage with our local communities.  The steering group sets the agenda, asks key speakers to attend and, with our support as a CCG, run the events.

The Halton People’s Health Forum has been running for around four years now.  The next meetings are on Tuesday 12^th July 2016, starting at 5pm, in The Brindley, Runcorn and Thursday 14^th July 2016 in Halton Stadium, staring at 1pm.  These meetings are open to the public.

The forthcoming meetings will focus on our work as a CCG with arts and culture in the borough, we will also hear from our local Director of Public Health on the refresh of the borough’s health and wellbeing strategy.  Finally, there will also be a session on our One Halton programme and the work we are undertaking with our partners to improve the health and wellbeing of the people of Halton.

For more information on the Health Forums please contact Alex.schofield@haltonccg.nhs.uk

Contributions recognised

Congratulations to our Chair, Dr Cliff Richards, was named in the list of Members of the Order of the British Empire in the Her Majesty The Queen’s Birthday Honours List on 11^th June 2016.  Dr Richards received the award for service to healthcare.

Congratulations also to Owen Ashworth, Administrative Assistant (Communication & Engagement), NHS Halton CCG. Owen was ‘crowned’ as Innovation Champion in the Widening Engagement category of the Adult Learner’s Week North West Awards in Health and Care 2016.  These awards are supported by the Innovation Agency (Academic Health Science Network for the West Coast) and NHS Health Education England. Owen is an integral and much respected team member who firmly believes disability rights should be at the top of the NHS’s agenda and is helping make this happen by example.

We are really proud to work with both Cliff and Owen. Well done.

Owen receiving his award, photo justjaqphotography@gmail.com

Dr Cliff Richards MBE

Maternity Choice and Personalisation Pioneers

NHS Halton CCG is leading work with 26 other organisations in Cheshire and Merseyside to ensure that women’s and children’s services (e.g. gynaecology, maternity, neonatal and paediatric services) are clinically and financially sustainable for the future.  Since September 2015 this work has been sponsored by NHS England as part of the New Care Models Acute Care Collaboration programme and has been taken forward as the Cheshire and Merseyside Women’s and Children’s Services Partnership .

This collaborative work has enabled us to put in an expression of interest to become a pioneer site to develop models for choice and personalisation in maternity services.  Last month we found out that our expression of interest, submitted on behalf of the Cheshire and Merseyside Women’s and Children’s Services Partnership, had been successful.  Becoming one of seven pioneer sites will support our ambition to improve maternity services and provide more informed choice to women within our population, and to share this learning with others across England..

We hope to work at pace to take forward the choice and personalisation project.  We also intend to do the same with the wider reform agenda around women’s and children’s services, with some clear cases for change appearing by the end of this year.

www.haltonccg.nhs.uk

Mental Health Awareness Week

We are supporting our colleagues in Halton Borough Council’s Health Improvement Team for Mental Health Awareness Week (16^th-21^st May 2016).  We want to end the stigma around mental health.  The Health Improvement Team, working under the Active Halton banner, are using Mental Health Awareness Week to encourage people to talk about their mental health and wellbeing.

The 5 Ways to Wellbeing can help you to maintain and improve your own mental health and wellbeing. Something as simple as going for a walk, a chat with a friend or relative or doing something nice for someone can have real benefits to your mental health.
The Health Improvement Team will also be launching the Maketime campaign here in Halton – which has been developed to raise awareness of the 5 Ways and the vast amount of services and places to go in Runcorn and Widnes.  There are already lots of things going on around Halton you could get involved with – during Mental Health Awareness Week they will be showcasing some of these opportunities to give some ideas and a head start on how to incorporate the 5 Ways to Wellbeing into your daily life.

More information about the Health Improvement Team’s work around Mental Health Awareness Week can be found at http://www.haltonhealthimprovement.co.uk/mhw2016/

Impact of our Urgent Care Centres

One of the common messages that the NHS conveys to the public is that Accident and Emergency (A&E) departments should only be used in the event of an accident or an emergency.  Whilst A&E departments are open seven days a week, 24 hours a day, they are sometimes seeing people who do not need to be there, which puts pressure on their ability to see and treat people who do need to be there.  This is why, in addition to promoting self-care, NHS 111 and Care At The Chemist, NHS Halton CCG has invested in developing two Urgent Care Centres – to relieve the pressure on A&E during peak periods of demand.

The Urgent Care Centre (UCC) on the Halton Hospital site in Runcorn has been operational for around a year, the UCC on Moor Lane, Widnes has been functioning for around six months. They are both open seven days a week from 7am to 10.30pm (last patient at 10pm), which is when people need them most and when A&E is most under pressure.  The UCCs are now starting to demonstrate their worth in reducing pressure from Halton residents on A&E with fewer attendances at and admissions into local A&Es by Halton residents.  On average, Halton UCC patients wait less than one hour from attendance to treatment, with almost every patient being seen and treated with 4 hours.  Patient satisfaction is also high, around 95%, and we have prevented around £657,000 of non-elective admissions.  More detail on the impact of the UCCs can be found on the website for The Academy of Fabulous NHS Stuff - http://www.fabnhsstuff.net/2016/04/25/halton-urgent-care-centres/

In the coming months we want to develop the Urgent Care Centres further.  We can develop them to support general practice and they can begin to deliver the goal of 7 day access to general practice services, they can also offer more elective, outpatient activity locally.  We have more to do, but we want to build on the success of the UCCs.

http://www.haltonccg.nhs.uk/your-health

15th April 2016 - Junior Doctors Strike

Junior Doctors Strike

On 26^th and 27^th April 2016 it is expected that Junior Doctors will be taking strike action.  This will put pressure on our local hospitals as they take steps to maintain emergency cover.  We will be working with our 17 general practices to see if they can offer additional support, perhaps through additional “on the day” appointments over these two days.  We also have two Urgent Care Centres, one in Widnes on Moor Lane and one in Runcorn on the Halton Hospital site, that offer access to minor injury, minor illness, GP consultation and expert children’s medicine from 7.30am to 10pm seven days a week.  For minor complaints you can also try your community pharmacists.

Simon Banks

Our third birthday

Our third birthday
 
This week we mark our third year as a statutory organisation. After forming in November 2011 we then had to "earn our stripes" to become a NHS organisation and use the blue lozenge with those three letters in it.

Over the last three years we have worked closely with our partners in health and care and in the wider community to do our best to involve everybody in the health and wellbeing of Halton. We have had some notable successes, such as the opening of the Urgent Care Centres, the creation of the Community Wellbeing Practices and increased integration with Halton Borough Council.

We have also some continuing challenges, ensuring that we continue to commission high quality services whilst addressing increased demand and public expectations with increasingly scarce resources. Most people think we are doing a good job, we have certainly attracted a few awards, accolades and compliments. That said, we don't always get it right, but when this happens we seek to learn to do better next time. The last three years have flown by, the next three pose even bigger challenges and will also pass very quickly. We hope that you will join us for the ride.

Simon Banks

Sustainability

Sustainability
I am taking a bit of risk in writing this message. The year-end returns have yet to be processed and agreed but, possibly against the odds, NHS Halton CCG seems to be in a good place in terms of meeting our statutory financial duties for 2015/16. However, there is no doubt that next year, 2016/17, will be even more of a challenge and it is likely that we will be setting out a significant cost improvement programme for the coming year.

We will be using our Governing Body meeting on  7^th April 2016 to set out the nature and scale of the challenge we face. Our Governing Body is a meeting that is held in public and starts in the Civic Suite, Runcorn Town Hall at 10am. We will also be using every opportunity, every contact with the people we meet and work with to set why it is imperative to act now to return the system to financial balance and why, if we don’t, the sustainability of the health and care system is under threat.

This is not entirely about a burning platform, it is about intervening and acting to restore financial balance before it is too late to do so. It is about having a burning ambition to deliver redesign and transformation programmes that will close the health and wellbeing gap and the care and quality gap, which cannot be done without also addressing the finance and efficiency gap. Transformation needs sustainability, sustainability creates transformation opportunities. We can all play a part in delivering both.

Simon Banks

Healthy New Towns

This week it was announced that Halton had been chosen as one of ten national “healthy new town” sites. The area around Halton Lea, some 800 residential units, will be used to develop and test creative solutions for the health and care challenges of the 21^st century – obesity, dementia and community cohesion. The Healthy New Towns work is about reimagining how healthcare can be delivered by joining up the design of the built environment with modern health care services, and harnessing new models of technology-enabled primary care. The Healthy New Towns work fits like a glove on to our Well North initiative and our other actions with partners in the borough under the One Halton banner to promote health and wellbeing, social cohesion and community resilience. The expression of interest that we summited as a collective last summer was one of 114 applications from local authorities, NHS organisations and housing developers – so the competition was fierce.  So, well done to all involved in this application, together we will make this a success and the start of a wider movement for renewal and improved care.

Simon Banks

The Bromley by Bow Centre

On 9th February 2016 a few of us from NHS Halton CCG and other local partners are visiting the Bromley by Bow Centre. The Bromley by Bow Centre is an innovative community organisation in east London, working in one of the most deprived boroughs in the UK. Each week they support families, young people and adults to learn new skills, improve their health and wellbeing, find employment and develop the confidence to achieve their goals and transform their lives. 

At the core of the Centre’s thinking is their belief in people and their capacity to achieve amazing things. NHS Halton CCG shares much in common with the mission and ethos of Bromley by Bow Centre and, as part of our "Well North" work, which is incorporated into our One Halton approach, we want to see what we can learn and share. We think that there will be things that we can replicate in our borough, so watch this space.

Simon Banks

There when you need us most

There when you need us most
This week I had a health scare. I had been experiencing some shortness of breath and chest pain. I was about to start a meeting when I felt dizzy and clammy. My mind started racing, I am a fit and active with few risk indicators for cardiac problems, although I confess that I like a beer and a glass of wine at the weekend. Dr Gary O’Hare took me to the A&E at Whiston, although I was reluctant to go he and Dr Cliff Richards insisted that I should get checked out and that it was an A&E issue. In the next few hours I received absolutely fabulous treatment. Three ECGs, two blood tests and a chest x-ray later and I was discharged, with some follow up to come but assured that I was fit and healthy and it was unlikely that I had a heart problem.

So, for me, the NHS was there when I needed it most. It was also there for the people I spoke to throughout the day – the woman with a UTI, the elderly man who had fallen, the woman who wanted to end her life as she felt she could not go on – I enjoyed the quality of the conversations. I saw care, compassion and professionalism everywhere – staff who are deeply and passionately committed to caring for people.  In a strange way I enjoyed the experience, it was interesting to see it from a different perspective.

Congratulations to St Helens and Knowsley Teaching Hospitals NHS Trust
Well done to all those who work at St Helens and Knowsley Teaching Hospitals NHS Trust. The Care Quality Commission has just rated St Helens Hospital has been rated as an outstanding hospital and Whiston Hospital rated as good with outstanding features. This places them amongst the best hospitals in the NHS.  

Simon Banks
Chief Officer

Delivering the Forward View

 The Spending Review in November 2015 provided the NHS in England with a credible basis on which to accomplish three interdependent and essential tasks: first, to implement the Five Year Forward View; second, to restore and maintain financial balance; and third, to deliver core access and quality standards for patients. It included an £8.4 billion real terms increase by 2020/21, front-loaded in 2016/17. With these resources, we now need to close the health and wellbeing gap, the care and quality gap, and the finance and efficiency gap. 

Delivering the Forward View: NHS planning guidance 2016/17-2020/21 was published by the six national NHS bodies on 22^nd December 2015. It can be found here. The document sets out a clear list of national priorities for 2016/17 and longer-term challenges for local systems, together with financial assumptions and business rules. It reflects the settlement reached with the Government through its new Mandate to NHS England. For the first time, the Mandate is not solely for the commissioning system, but sets objectives for the NHS as a whole. The guidance requires the NHS to produce two separate but connected plans:

• a five year Sustainability and Transformation Plan (STP), place-based and driving the Five Year Forward View; and
• a one year Operational Plan for 2016/17, organisation-based but consistent with the emerging STP.

NHS Halton CCG is already working with partners to start work on a STP that is consistent with the One Halton approach and covers three levels – (i) the Halton health and care economy, (ii) Halton and neighbouring health and care economies and (iii) Liverpool City Region. This is our chance to build on our achievements of recent years and move at pace to transform health and care services so that they improve health outcomes, provide excellent levels of quality and are financially and clinically sustainable. In short, we must deliver the Five Year Forward View – there is no other option.

Simon Banks