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Section 1 Welcome – from Angela Monaghan, Chair and Mike Potts,

Chief Executive

Welcome to our annual report for 2011/12.

This has been a momentous year for the NHS nationally, and no less for us

here in Wakefield District. Just as the year ended the Health and Social Care

Act 2012 passed into statute, marking the culmination of a process which has

already seen huge organisational change.

Business as usual for local people

We have worked hard to ensure that the NHS locally is in good shape to

adapt to the requirements of the new Act and, despite the undoubted

upheaval of the changes, we are delighted to report that it is still business as

usual for local people. If you dip into some of the stories later in this report,

you will see that we are continuing to extend access to GP services, we are

still committed to helping local people lead healthier lives, and we are actively

working to secure the long term future of clinical services both in hospital and

in the community.

Calderdale, Kirklees and Wakefield District – working together

Perhaps the most significant change during the year has been our joining

together with NHS Calderdale and NHS Kirklees, as a cluster of primary care

trusts.

The cluster is led by one Board, with one Chair and one Chief Executive.

Supporting the Board in Wakefield District is a Chief Operating Officer, Gill

Galdins, who is responsible for the day to day running of the PCT. However,

while coming together under one board, the three PCTs have not merged and

we each continue as a statutory body in our own right until abolition of the

PCTs at the end of March 2013.

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We are not alone in making these arrangements: across the country, 152

PCTs have moved into 50 clusters. The benefits have been huge, enabling us

to secure resilience during transition, helping us to make efficiency savings

and, crucially, allowing us to provide robust support for the emerging clinical

commissioning groups as they prepare to take over the commissioning reins

in April 2013.

Quality, improvement, productivity and prevention (QIPP)

NHS Wakefield District, like NHS organisations across the country, faces a huge challenge – the „QIPP‟ challenge - to work more efficiently and to contribute to the £20bn savings which the NHS has to achieve by 2015. As you read on in this report, you will find out more about some of the ways in which we are making our contribution. More importantly, however, you will see how we are working together across the local health and social care system to ensure not only that the local NHS is financially sustainable, but that healthcare itself is transformed. Our aim is to ensure we transform services so that patients can rely on safe, high quality care that delivers outcomes comparable with the best in the country. Our commitment So, change and challenge have been the backdrop to all the achievements of the year and it is a tribute to both the commitment of our staff and the constructive support of our partners in the public, private and voluntary sectors that we have continued to see improvements in services and care. We remain determined that local people should have confidence in local health services, and that people who currently have some of the poorest health outlooks in the country, should have a healthier future. Angela Monaghan Mike Potts Chair Chief Executive

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Section 2

The changing face of the NHS Throughout this report you will read references to different organisations which are coming into being as a result of the reforms embodied in the Health and Social Care Act. These include clinical commissioning groups, the National Commissioning Board, and Health and Wellbeing Boards, as well as arrangements for the transition of public health responsibilities to local authorities. Here you will find a guide to the key elements of these changes:

GP practices have come together into Clinical Commissioning Groups (CCGs) and from April 2013 they will take over the majority of the commissioning responsibilities currently carried out by the PCT. Other health professionals and lay members are included on the Boards of the CCGs.

Within NHS Wakefield PCT there is one CCG known as NHS Wakefield CCG and they are leading and implementing the business plan and operating plan for 2012-13, including leading all QIPP schemes and agreeing their own commissioning intentions.

NHS Wakefield CCG has been formally established as a sub-committee of the Cluster Board called a Clinical Commissioning Executive (CCE) and has been delegated 100% of the appropriate commissioning budget.

Strategic Health Authorities (SHAs) will be abolished in March 2013.

PCTs will be abolished at the end of March 2013.

The majority of the PCT‟s public health responsibilities will be transferred to the local Council. The PCT has been working with Wakefield Council and the CCG to ensure that plans are in place for an effective transition of staff and programmes, and these plans are seen as the regional exemplar.

Commissioning Support Services (CSS). These organisations are being set up to provide specialist commissioning support which is available to CCGs if required. The Cluster approach to developing commissioning support has been to work in partnership with our CCGs to understand what they will need and whether they will want to build their own capacity, buy it in or share with other organisations. A key decision has been to develop a CSS across West Yorkshire that will cover our Cluster, and the neighbouring Cluster of NHS Airedale, Bradford and Leeds. This will offer support services to CCGs covering a population of 2.3 million. The new year (2012-13) has opened with the appointment of Alison Hughes as interim Managing Director to lead this organisation through the process of authorisation.

Local Involvement Networks (LINKs) will be transformed into HealthWatch and will ensure that the views and feedback from patients

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and carers are an integral part of local commissioning across health and social care.

Health and Wellbeing Boards will bring together key decision makers to set a clear direction for the commissioning of health care, social care and public health, and to drive the integration of services across communities. CCG representatives are members of these Boards, and the Wakefield Health and Wellbeing Board is already working in shadow form building on existing mature relationships and developing their joint agenda.

There will also be a number of new national bodies which will set the direction for local services, including the NHS Commissioning Board, Public Health England and HealthWatch England.

Insert as ‘feature’

Introducing NHS Wakefield Clinical Commissioning Group (CCG) The NHS Wakefield Clinical Commissioning Group, formerly known as Wakefield Alliance, has 40 member practices across the Wakefield district and is chaired by Dr Phil Earnshaw, a practising GP based in Ferrybridge. Jo Webster is the Shadow Accountable Officer and the headquarters are in Wakefield. The Shadow Board includes practice, nurse, secondary care and lay representation. The CCG has a clear vision: to commission quality services that will improve their patients‟ experiences of care and their health outcomes, by involving and listening to patients, practices, partners and staff when redesigning services. Their priorities are prevention, urgent care, care closer to home, end of life care, care for older people, dementia, long term conditions, and maternity, children and young people‟s services. During 2011/12 the CCG has continued to develop its way of working, adopting a proactive approach to working with member practices and other partners in the interests of improving care across the district. Currently it is exploring models of network working, where subgroups of practices work together on specific commissioning decisions.

For 2012/13 the CCG is operating in shadow form, increasingly taking on the responsibilities of the PCT by becoming a subcommittee of the Board (the Clinical Commissioning Executive or CCE) with delegated powers to commission services.

There is a national process for ensuring that CCGs are ready to take on their full commissioning responsibilities from April 2013, and it is good news that NHS Wakefield CCG was given the go ahead to apply for authorisation in the first wave of applications. This places them in the vanguard of CCGs across the country, and we are confident that as the PCT lays down its responsibilities, the CCG will be in a strong position to promote the healthcare of local people.

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Section 3:

Our priorities

Our strategic decision-making is driven by both national priorities and by the characteristics and needs of local people. The assessment of local needs is carried out jointly by us and our partners in Wakefield Council. The resulting report – our Joint Strategic Needs Assessment (JSNA) - takes a snapshot look at the health of the population. It uses this information to map trends which show what health problems might look like in the future. On this basis we are able to plan future service provision that can best meet the changing needs of the district. If you would like to see the current JSNA for our district, it can be found at: www.wakefield.gov.uk/HealthAndSocialCare/HealthServices/JPHU/StrategicNeeds Our strategic goals Along with our colleagues we are committed to three overarching strategic goals:

By putting the programmes in place that support these goals, we believe that in the coming year we will deliver measurable differences:

£27.5m of QIPP initiatives across the Cluster in 2012/13 (of which £12.5m relate to NHS Wakefield)

50% of savings over the next three years being transformational, and a sound basis for further transformation across our health economy

authorised Clinical Commissioning Groups (CCGs)

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successful public health transition

safe transfer of functions to the NHS Commissioning Board.

You can read more about how we intend to meet our objectives in the Cluster‟s Operating Plan for 2012-15. Link to website. Delivering quality, improvement, productivity and prevention We have a strong record of managing within our financial resources, and of meeting our targets for savings that also transform services. Although the PCT itself will not be here after the current year, the imperative for transformational change will remain and will require more than a few months to implement and embed. To ensure that improvements continue into the future, we have worked with our clinical commissioners to agree five transformational QIPP programmes for 2012-15:

Preventing unplanned admissions and managing long term conditions

Changing planned care pathways

Strengthening mental health and learning disability provision

Introducing assistive technology and risk stratification

Alternative community services

These choices have been made on the basis of local need, understanding of best practice and in response to local people who have told us clearly that they want to see the best outcomes, even where that might mean doing things differently, they want more joined up care and that they want to see as much care as possible as close to home as possible.

As clinicians, partners and patients work together on the redesign that will bring about these changes, we are confident that the future of local healthcare is in good hands.

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Section 4

Working in partnership

Transforming the system

To make a real difference in the long term, both financially and in improved outcomes, will take new ways of thinking and concerted effort by commissioners, providers and recipients of services alike.

During the year we brought our planning together and established an overarching health and social care transformation programme in the Wakefield District (including Mid Yorkshire Hospitals NHS Trust as well as Wakefield and Kirklees Councils). A process of engagement has been developed so that provider organisations, and in particular their clinical leadership, are equal partners in designing how changes can be developed. Local Authorities have also played a central role in shaping the transformation agenda.

Wakefield District and North Kirklees Health and Social care Transformation

There is a strong history of joint working and delivery of service improvement across our area. Some of these are captured later in this report. Our health and social care partnership programme focuses on the big programmes of work which will put the health and social care economy into a stronger position to be financially sustainable, improve performance and also help our local hospital provider, The Mid Yorkshire Hospitals NHS Trust to achieve Foundation Trust status. The programme covers:

Mid Yorkshire‟s clinical services strategy: NHS Wakefield District, our CCGs and other relevant stakeholders are all engaged in testing and challenging the Trust‟s options for service reconfiguration to ensure that they are clinically effective, financially sound, and will provide the services that patients want

urgent care – ensuring that effective, integrated services sit behind the 111 telephone number which is being introduced nationally in 2013 for patients who need healthcare in a hurry

care outside hospital - promoting joined up care between community services and the local authority‟s services to keep people out of hospital, or to help them to be fit to return home after a stay in hospital

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improving quality and access to primary care, building on what has already been achieved and helping to keep patients with long term conditions out of hospital by identifying their risks and monitoring their condition.

Section 5

Improving services, improving health

Health care is changing with the focus switching from hospitals to the community. Not many years ago, even the simplest diagnostic tests meant a trip to a hospital clinic. Now, many screening services are offered at your local GP surgery or somewhere much closer to your home. There‟s also a greater emphasis on keeping people well and helping them to manage long term conditions such as asthma and diabetes so they don‟t need to be rushed to hospital as an emergency. We also encourage people to „Choose Well‟ and help them to understand the options when someone needs to get medical help quickly out of surgery hours – a trip to A&E should be the last resort, not the first. We‟ve already laid good foundations during 2011-12, and here are just some of the examples of where we‟re improving services and improving health.

Seeing a GP – getting better Measuring the quality of your GP services Local people are finding it easier than ever to get GP care, as the GP led Walk-in Centre on King Street in Wakefield city centre goes from strength to strength. The centre is open 8am to 8pm, 365 days a year with extended opening over some bank holidays. The new local GP contract, which contains key performance targets to make sure patients receive the highest quality care at their GP surgery, is now fully operational, with practices measured on how easy it is for patients to get appointments, care for patients with long term conditions and childhood vaccinations/immunisations. And all our GP practices take part in the Quality Outcomes Framework (QOF) which covers a range of clinical and non-clinical topics to make sure that patients with a wide range of conditions are identified and monitored.

Young people prescribe improvements for GP surgeries Making GP surgeries more welcoming and improvements to a GP practice website are two of the spin-offs from a project asking young people what they thought of local NHS services.

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Pupils from Snapethorpe Primary School were asked what they thought of the Lupset Health Centre website and how they felt when they first visited a doctor's surgery. They suggested that the website's font size could be too small for people with visual impairments and said they felt that visiting a surgery for the first time was 'frightening'. The feedback from the pupils will lead to improvements right across the district as it is shared among GP practices which are keen to communicate with their patients, particularly the younger generation whose voices are seldom heard directly. Primary care transformation scheme Almost 90% of our local GP practices have signed up to a major primary care scheme which will be launched in 2012-13. The aim of the scheme is to reduce A&E attendances and also emergency admissions. This will be achieved by making it easier for people to see their GP, and by improved planning for patients with long term conditions. The scheme has been driven by the NHS Wakefield CCG and the enthusiasm and commitment of practices has been overwhelming, clearly demonstrating how CCG members can work together to achieve positive change for the whole health economy.

Caring for your eyes

Eyecare goes ‘PEAR’ shaped A new Primary Eyecare Assessment Referral System (PEARS) has been set up in Wakefield, meaning that patients with sudden eye problems can be seen in local opticians rather than having to be referred to hospital clinics. As well as offering a more convenient service for patients, this is preventing waits and providing a fast referral to hospital for those who really need it. By the end of the year, almost 800 patients had been treated, saving approximately £100,000 for local health services, and giving patients quicker more convenient care.

Taking your medicine Electronic Prescription Service release 2 (EPSr2) Technology is improving all the time and our pharmacies are about to embrace a new electronic prescription system which can generate, receive and process prescriptions electronically (EPSr2). This will get rid of the bulk of the paper administration associated with prescribing and dispensing. We have been described as one of the few exemplar PCTs in the introduction of EPS which delivers huge cash saving across the NHS which issues around 1.5 million paper prescriptions every working day in England, rising by around five percent each year. Patients can now choose the most convenient pharmacy to collect their prescriptions from and, as an extra benefit, by seeing patients on a regular basis, pharmacists will have a good understanding of which medicines patients are taking.

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New Medicine Service (NMS) Patients newly diagnosed with long term conditions, such as aasthma and Chronic Obstructive Pulmonary Disease(COPD), Type 2 diabetes, and high blood pressure are benefiting from the New Medicine Service (NMS). Through NMS, a pharmacist will help people to get maximum impact from their medicine. The idea came from research which showed that advice from a pharmacist can help to improve the uptake and use of medicines which is a vital part of the patients self care regime. If patients use their medicines wisely they are more likely to manage their condition well and less likely to need emergency hospital support. More Flu Jabs for at risk patients Fourteen community pharmacies helped to make the flu vaccine more widely available to „at risk‟ patients. Uptake of the free flu jabs meant that fewer vulnerable people risked getting flu or being seriously ill from the complications which can set in. This kind of preventative medicine is better for patients and also saves the NHS money in the long term with fewer patients likely to need expensive hospital treatment because of flu complications. GPs in Community Pharmacies We had GPs in five pharmacies during bank holidays when it‟s not always possible for people to see their own GPs. People with minor illnesses could „pop in‟ to see the doctor and get any medicines they needed in a single visit.

Open wide Making it easier to see a dentist We have continued to work with local providers across the district to create access to high quality dental care and have put extra money into buying more capacity so it is easier for people to get an appointment or treatment with an NHS dentist. Patients can now contact their nearest dental surgery to register, or if the practice has reached its full capacity, West Yorkshire Urgent Care Services will help to find another suitable dentist close by.

Living with illness ‘Best Performing’ Diabetes Service 17,500 patients with Type 1 and Type 2 diabetes across the Wakefield District now have one of the best performing services in the UK – thanks to new working practices and enthusiasm for delivering care as close to home as possible.

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Since 2003, the Wakefield District Diabetes Network, which includes health care professionals from across the district, has been taking part in DiabetesE, an online self assessment which measures and benchmarks service quality. When appropriate, patients living with diabetes are seen at their local GP surgery, by practice staff or a hospital team working in the community. This has increased attendance rates and patient satisfaction. The Diabetes Care offered across the Wakefield District has been recognised as „exemplary‟ by the Department of Health. The experience gained in developing this redesign will be fed into other projects to improve the care and management of other long term health conditions. Rightsteps® Improving mental health Just over a year since its official launch, Rightsteps® Wakefield has helped more than 3,000 local people get support or treatment for problems such as depression, anxiety or post traumatic stress disorder. We commission the Rightsteps® Wakefield service from the national social enterprise Turning Point because we believe that a small amount of treatment early on may prevent a person becoming more troubled or unwell and therefore needing more intense treatment at a later date. Rightsteps® Wakefield is now offering a wider range of talking therapy treatments including group work and supporting people with employment. Asthma pilot project benefits patients Asthma sufferers across our district have benefited from a pilot project aimed at those patients admitted to hospital because their asthma had got worse. The Mid Yorkshire Hospitals NHS Trust in partnership with NHS Wakefield District was one of just seven locations chosen to take part in this 12-month project, working with the NHS Improvement - Lung Team. (Each location is looking in detail at a different stage in a patient's journey from their diagnosis to their experiences in hospital.) Through the project, the quality of inpatient asthma care is being improved and better monitoring, prescribing, patient and staff education and self management is improving patient experience and reducing the need for future asthma related admissions. Radical approach to drugs and alcohol recovery NHS Wakefield District was one of eight sites the Government chose to pilot innovative new ways to help addicts get off drugs and achieve a sustained recovery. The scheme means that those providing substance misuse services locally will no longer be paid simply on how many people they treat, but on the outcomes they achieve. The trial aims to focus on giving clients the individual support they need to tackle the problems they face.

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Section 6 Quality counts A strong focus on quality and safety is the driving force that underpins all our commissioning: we constantly seek assurance about the safety of services, and we proactively seek opportunities to improve the quality of the services provided. Quality and safety is the first item considered at every Board meeting, and it is a standing item for our Clinical Commissioning Executive. We monitor a vast array of information that helps us understand exactly what is happening about the things that matter to patients, including waiting times, infection rates, same sex hospital accommodation and many others. Here are some of the highlights from the past year:

Target Achieved

Diabetes 100% of people with diabetes are to be offered diabetic screening

Cancer 93% of possible cancer patients are to wait no longer than 2- weeks from an urgent referral to a first outpatients appointment

Cancer 96% of patients receiving first definitive treatment within one month (31 days) of a cancer diagnosis

Breast feeding Increasing the number of mums breastfeeding 6-8 weeks after birth

Access Access to a named hospital consultant

Access to mental health services Ambulance response times Healthcare Associated Infections Reducing healthcare associated infections such as MRSA and Clostridium Difficile

Stroke Proportion of people who have a stroke who spend at least 90% of their time in hospital on a stroke unit

Source: Cluster Board Routine Performance Report 2011/12 Learning from the experience of our patients

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We aim to make sure that people in the Wakefield area receive the highest possible standards of care. It‟s important that all patients have confidence in local health services and that people know how they can make a comment on the health services they receive. Sometimes things don‟t go as they should, and we ensure that any complaints we receive are thoroughly investigated to achieve the best possible outcome. We encourage a culture that seeks and then uses people‟s experiences to make services more effective, personal and safe. During 2011/12 the Patient Advice and Liaison Service (PALS) at NHS Wakefield District received 993 enquiries and the Information Governance Team received 347 Freedom of Information requests. In the same period we received and responded to 109 complaints. We also supported GPs, pharmacists, dentists and opticians to respond thoroughly to the complaints they received. What we received complaints about:

Primary Care 59

Other NHS Providers 38

PCT Commissioning 12

Total 109

Complaints about Primary Care Contractors: (59)

Medical (GP) 48

Dental 9

Pharmaceutical 1

Optical 1

Managing the risks

The way we manage risk is a key element of how we aim to ensure safety and quality. Our risk management systems enable us to monitor and test how health services are provided, including the performance of our commissioned services against government targets and best practice standards such as treatment times and control of infection in hospitals. Effective incident reporting, complaints and public involvement all contribute to our risk management, and add to our knowledge of what is happening with our services and how the public receive and perceive NHS services.

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Internal systems of control and communication ensure that serious issues are raised in a timely and relevant way within the organisation, from specialist team meetings through to Cluster Board meetings where appropriate. In January 2012 we aligned our risk register and risk reporting procedures, using a live database system and timeline across the three PCTs. Our risk management teams report incidents nationally to the National Patient Safety Agency and to the Counter Fraud and Security Management Service. This helps us compare ourselves with other organisations and learn lessons to prevent similar incidents from happening in our area. Risk Management forms part of our integrated governance arrangements and evidence shows that well managed organisations have better outcomes, including;

safe and clinically effective services for patients

maintenance of core services in times of emergency

better value in our use of resources

better health outcomes for our population. In other words, good governance can save lives.

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Section 7

Involving patients and the public

Listening to what people tell us about the local NHS services, instead of relying on existing knowledge and assumptions helps us to meet people‟s needs better. We can develop high quality, more responsive services when we involve and listen to people already using services and those who might use them in the future. We also make sure people understand and comment about our plans and why some services need to be changed. The Department of Health introduced a new duty to inform the public about our engagement and consultation activities. To show how we met this duty in 2010/11, we published a detailed Patient and Public Involvement Annual Report which is available at http://www.wakefielddistrict.nhs.uk/YourZone/GetInvolved/ The report for 2011/12 will be published by September 2012 which will provide more detailed information about the engagement exercises and consultations that are given here. Your experience of Urgent healthcare services within Calderdale, Kirklees and Wakefield „Urgent care‟ describes the NHS services you use when you need advice or treatment immediately, but which is not an emergency or life-threatening. We set up a new urgent care system in 2008, the West Yorkshire Urgent Care Service. The contract for this service is coming to an end soon and we wanted your views on what a new service should look like and to hear about your experiences of the current service. During a three month engagement project people told us that they valued the service. However, there did seem to be a lack of awareness about urgent care services. Further information about this engagement exercise will be available at www.wakefielddistrict.nhs.uk/YourZone/WYUCS/ More patient choice on community services Residents living in Calderdale, Kirklees and Wakefield District are soon to have more choice in when, where and who provides some community based services. The initiative is part of the Government‟s commitment to allow patients who are referred for a particular service, to be able to choose from a list of qualified providers. That‟s providers who meet NHS standards for quality, care and value for money. During September and October we asked local patients, patient groups,

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members of the public and other stakeholders for their views on which services they would like to see more choice of providers in. Based on the response to the survey and further prioritisation and benefits appraisal carried out by NHS Wakefield District in partnership with our emerging Clinical Commissioning Groups (CCGs) , the following services will now be opened up to any qualified provider in 2012/13:

Adult hearing services in the community (Wakefield District, North Kirklees, Greater Huddersfield, Calderdale CCGs)

Diagnostic tests closer to home (Wakefield District, North Kirklees, Greater Huddersfield, Calderdale CCGs)

Primary care psychological therapies (adults) (Calderdale CCG) Mid Yorkshire Clinical Services Strategy The NHS in Mid Yorkshire wants local people to help shape the future of hospital services. NHS Wakefield District, along with Mid Yorkshire and other partners, are developing plans and proposals for future hospital services. These plans are being developed based on information gained from engagement with service users and staff from October to December 2011 which is likely to lead to further public consultation later this year. However, it‟s important we hear the views of local people before then and this includes you. For details on how to get involved and for further information visit www.wakefielddistrict.nhs.uk/YourZone/

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Section 8 Valuing our staff Ensuring that healthcare continues to meet the needs of local people requires motivated, capable and committed staff. It has undoubtedly been a challenging year for staff as the pace of change has continued to increase. Despite this, and at a time of great uncertainty, staff have continued to work hard to ensure that patients receive the best possible services and that we use resources in the best possible way. Support during organisational change In order to support our staff colleagues through this time we have organised a range of supportive initiatives:

organisational change briefings

pensions advice sessions

financial planning sessions

career management workshops

human Resources drop-in sessions,

Staff survey To help us monitor the views and opinions of our staff, we take part in the national NHS staff survey. This helps us to understand where we need to concentrate our efforts to improve as an employing organisation. 72% of our staff completed the staff survey in 2011, which was a 15% increase on last year‟s figure. Our top three highest scores showed that:

our staff feel that there are still good opportunities to develop their

potential at work

fewer are working extra hours

they believe the PCT has a good commitment to work-life balance

We scored less well for appraisals carried out in the last 12 months but in 20 areas out of 38, NHS Wakefield District was average or above average compared with other PCTs nationally. In 8 of those areas we scored in the top 20% of PCTs in the country. We are also once more in the top 20% of PCTs nationally for honouring the NHS Constitution pledge to „develop and support staff‟, something of which we are very proud. Monitoring We continue to monitor sickness data and provide relevant support to staff according to their needs. During this year our sickness rate was 2.9%, which is slightly above our target rate of 2.5%.

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. We also take our responsibilities for equality and diversity very seriously and comply with our duty to monitor our workforce on key employment indicators by ethnicity, disability status, age and gender. We try to ensure that our workforce represents our local communities and that all employees are treated fairly and equally.

Our staff

Gender

Commisioning PCT

Count %

Male 46 17%

Female 220 83%

Disabled

Commisioning PCT

Count %

No 206 77%

Yes 13 5%

Not Declared 47 18%

Age group

Commisioning PCT

Count %

Under 25 3 1%

25-34 52 20%

35-44 83 31%

45-54 93 35%

55+ 35 13%

Sexual Orientation

Commissioning PCT

Count %

Heterosexual 190 71% I do not wish to disclose my sexual orientation 74 28%

Gay 0 0%

Lesbian 2 1%

Ethnic Origin

Commissioning PCT

Count %

A White - British 244 92%

B White - Irish 2 1%

C White - Any other White background 4 2%

CY White Other European 1 0%

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F Mixed - White & Asian 2 1%

G Mixed - Any other mixed background 1 0%

H Asian or Asian British - Indian 3 1%

J Asian or Asian British - Pakistani 4 2% L Asian or Asian British - Any other Asian background 1 0%

M Black or Black British - Caribbean 2 1%

N Black or Black British - African 2 1%

Religious Belief

Commissioning PCT

Count %

Atheism 26 10%

Buddhism 1 0%

Christianity 130 49%

Hinduism 2 1% I do not wish to disclose my religion/belief 89 33%

Islam 5 2%

Other 13 5%

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Section 9

Lean and green

We encourage staff, patients and visitors to think lean and green when it comes to the environment. Wherever we can we are asking people to take opportunities to reduce waste and use of utilities and minimise any negative impact on the environment. Here are some of our green initiatives: Locally we have been working to make our buildings more environmentally friendly with new energy efficient boilers and low energy lighting. This year we have carried out more than £350,000 of backlog maintenance including:

double glazed windows, replacement roofs with improved insulation

and new modern energy efficient lighting at health centres in

Normanton, Wrenthorpe, Featherstone and Eastmoor

modern condensing boilers at Newstead House and Featherstone

health centre.

During the last twelve months our first Sustainable Travel Plan has been put into action. This is a bid to improve the health of our staff by encouraging them to become more physically active and also to lessen our impact on the environment by reducing the number of car journeys made for work. Our latest staff travel survey shows that since the adoption of the travel plan the percentage of staff travelling to or from work by car, taxi or van has fallen by a third (from 76.6% of staff to 50%). Although this is in part due to organisational changes, the fall can also be contributed in part to a number of innovative staff travel initiatives. For example:

We have been heavily involved in Walking Works, a two year national campaign funded by the National Lottery, which has helped us develop a range of initiatives and tools to encourage our staff to walk more during their working day.

We have obtained support from Metro, the National Lottery and walking

charity Living Streets to help us set up a Sustainable Travel Hub which encourages staff to make greater use of walking, cycling and public transport when travelling to on NHS business.

A staff cycle loan scheme has been established to encourage staff to

pedal rather than drive to meetings.

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We have worked closely with partners including Wakefield Council, other NHS Trusts and Wakefield District Housing to encourage public sector staff throughout the district to make better use of more active forms of travel such as walking and cycling. This has been done through initiatives such as the Wakefield Health Walks and Rides and the Best Foot Forward Pedometer Challenge.

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Section 10: Planning for an emergency Emergency planning is all about being prepared and ready to provide a rapid, effective response to major incidents which may happen in our area, responding to patient need and helping protect the health of local people. Our emergency plans have been tested at local, national and regional level with staff taking part in a number of emergency planning exercises including a major event in November 2011. This was designed to test how the NHS in West Yorkshire would cope if there were an incident with mass casualties. We continually update and change our plans in light of the lessons learnt from these exercises, providing further training for staff to update their skills and knowledge.

Section 11:

Equality and diversity

We take our responsibilities for equality and diversity very seriously. We consider what our local communities need and how their needs can best be met by the services we commission. We are determined to reduce health inequalities through understanding the health needs of local communities and making the services we commission inclusive and accessible. Equality is for everyone and we strive to design services that are equally available, making sure that:

services are open when they are needed

people understand the information they are given

people understand what to do if things don't go well.

This ensures that we do the best for all our population and also ensures that we meet our legal responsibilities, which are carried out through the NHS Equality Delivery System. By implementing this system communities help us determine how well we are doing and what we could do differently or better in the future. Further information about the NHS Equality Delivery System can be found at: http://www.wakefielddistrict.nhs.uk/ourPCT/ProvidingQualityServices/newEqualityandDiversity/

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Section 12

Director of Finance commentary The PCT's financial statements have been prepared in accordance with the Resource Accounting Manual (RAM) issued by HM Treasury. The full details of the accounting policies adopted by the Primary Care Trust can be obtained from our Audited Accounts. The accounts, and summary financial statements shown within the Annual Report, reflect the financial consequences of the PCT's activities and achievement of objectives for the twelve month period ending 31 March 2012. During 2011/12 the PCT invested £670million gross expenditure in commissioning healthcare services for the population of Wakefield District. This included investing £78 million in prescribing costs (12% of total resources available). Commissioned services expenditure with secondary care providers totalled £484 million (72% of total resources available) and expenditure on General and Personal Medical and Dental Services totalled £80 million (12% of total resources available). The balance of the expenditure funded other costs such as Health centre running costs and Headquarter support services. The PCT has worked hard to secure high quality services, making every effort to ensure we use the resources economically and with effectiveness and efficiency. Our Annual accounts demonstrate that we have been successful in achieving each of our key financial duties The PCT has - achieved operational financial balance i.e. its expenditure is not in excess of its income - contained expenditure within its resource limit and has reported a £3,074K surplus at the end of the year as required by the Strategic Health Authority. This surplus will be carried forward for use in 2012/13. - remained within its cash limit, with a yearend cashbook balance of £5K. All NHS organisations have a target of paying 95% of invoices within 30 days to assist local suppliers in managing their financial positions. NHSWD has achieved 97% against both the value of invoices paid and the number of invoices paid. The PCT has achieved its statutory financial duties within a challenging economic environment. This is in response to the increased productivity and cost reductions required to achieve the £20bn savings nationally. The 2011/12 plan included Quality, Innovation, Productivity and Prevention (QIPP) savings

Page 25

programmes totally £10.4M of which all but £106k was achieved enabling the PCT to balance its books. Following a review of the PCT's estate the PCT has held four properties for disposal from the beginning of the year and has been successful in selling three of these properties resulting in a profit on sale of £14K. Capital expenditure funded from the sale of these properties was spent in accordance with the provisions of the NHS capital accounting manual with the majority being spent on general maintenance of the PCT remaining properties in line with health and safety, DDA and infection requirements. The PCT has produced a financial plan for 2012/13 and beyond, which has been approved by the Cluster Board, which includes further QIPP savings programmes to be achieved across the whole health economy of Wakefield District. The plan has been designed to ensure that we continue this trend in investment in our current and future healthcare developments which will benefit our local population whilst also ensuring that our financial management and control remains strong. Annual Governance Statement The Annual Governance Statement states that our risk management and assurance processes were in place for the full financial year, with no significant gaps in controls or assurances. A full copy of the Annual Governance Statement which is a statutory responsibility, is publicly available within the full annual accounts. Charitable funds Charitable funds relate to donations, legacies and gifts. The PCT does not hold any of these funds as they were transferred to other organisations with effect from 31st march 2011 under Transforming Community Services. Risks During 2011/12 there has been uncertainty around the final activity levels with our major providers and specialist services consortia and the associated costs. This has been managed throughout the year through negotiation and close performance management. The major risk areas for the PCT in 2012/13 are around the achievement of the necessary savings to ensure financial balance within the context of maintaining quality services across Wakefield District.

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Statement of Comprehensive Net Expenditure for year ended

31 March 20122011-12 2010-11

£000 £000

(restated)

Administration Costs and Programme Expenditure

Gross employee benefits 12,944 51,924

Other costs 657,106 620,741

Income (19,782) (20,809)

Net operating costs before interest 650,268 651,856

Investment income 0 0

Other (Gains)/Losses (14) 0

Finance costs 89 69

Net operating costs for the financial year 650,343 651,925

Discontinued Operations - Included in above

Gross employee benefits 4,459

Other costs 2,434

Income (279)

Net Operating Costs 6,614

Of which:

Administration Costs

Gross employee benefits 8,200

Other costs 12,038

Income (4,156)

Net administration costs before interest 16,082

Investment income 0

Other (Gains)/Losses (14)

Finance costs 89

Net administration costs for the financial year 16,157

Programme Expenditure

Gross employee benefits 4,744

Other costs 645,068

Income (15,626)

Net programme expenditure before interest 634,186

Investment income 0

Other (Gains)/Losses 0

Finance costs 0

Net programme expenditure for the financial year 634,186

Other Comprehensive Net Expenditure

Impairments and reversals put to the revaluation reserve 52 684

Net (gain)/loss on revaluation of property, plant & equipment (370) (285)

Net (gain)/loss on revaluation of intangibles 0 0

Net (gain)/loss on revaluation of financial assets 0 0

Net (gain)/loss on other reserves 0 0

Net (gain)/loss on available for sale financial assets 0 0

Net actuarial (gain)/loss on pension schemes 0 0

Reclassification adjustment on disposal of available for sale financial assets 0 0

Total comprehensive net expenditure for the year 650,025 652,324

Page 27

Statement of financial position at

31 March 201231 March 2012 31 March 2011 31 March 2010

(restated) (restated)

£000 £000 £000

Non-current assets:

Property, plant and equipment 11,841 11,865 13,399

Intangible assets 0 0 5

investment property 0 0 0

Other financial assets 0 0 0

Trade and other receivables 0 564 636

Total non-current assets 11,841 12,429 14,040

Current assets:

Inventories 0 360 266

Trade and other receivables 3,423 7,230 8,566

Other financial assets 0 0 0

Other current assets 0 0 0

Cash and cash equivalents 5 5 5

Total current assets 3,428 7,595 8,837

Non-current assets held for sale 120 623 405

Total current assets 3,548 8,218 9,242

Total assets 15,389 20,647 23,282

Current liabilities

Trade and other payables (40,848) (51,488) (54,832)

Other liabilities 0 0 0

Provisions (4,192) (3,044) (300)

Borrowings 0 0 0

Other financial liabilities 0 0 0

Total current liabilities (45,040) (54,532) (55,132)

Non-current assets plus/less net current assets/liabilities (29,651) (33,885) (31,850)

Non-current liabilities

Trade and other payables 0 (564) (636)

Other Liabilities 0 0 0

Provisions 0 (100) (257)

Borrowings 0 0 0

Other financial liabilities 0 0 0

Total non-current liabilities 0 (664) (893)

Total Assets Employed: (29,651) (34,549) (32,743)

Financed by taxpayers' equity:

General fund (34,262) (39,161) (37,788)

Revaluation reserve 4,611 4,612 5,045

Other reserves 0 0 0

Total taxpayers' equity: (29,651) (34,549) (32,743)

Page 28

STATEMENT OF CHANGES IN TAXPAYERS' EQUITY

For the year ended 31 March 2012General

fund

Revaluation

reserve

Other

reserves

Total

reserves

£000 £000 £000 £000

Balance at 1 April 2011 (39,161) 4,612 0 (34,549)

Opening balance adjustments 0 0 0 0

Restated balance at 1 April 2011 (39,161) 4,612 0 (34,549)

Changes in taxpayers’ equity for 2011-12

Net operating cost for the year (650,343) (650,343)

Net gain/(loss) on revaluation of property, plant, equipment 370 370

Net gain/(loss) on revaluation of intangible assets 0 0

Net gain/(loss) on revaluation of financial assets 0 0

Net gain/(loss) on revaluation of assets held for sale (5) (5)

Impairments and reversals 0 0

Movements in other reserves 0 0

Transfers between reserves 366 (366) 0

Release of reserves to Statement of Comprehensive Net Expenditure 0 0

Transfers to/(from) other bodies within the group 0 0 0 0

Reclassification adjustment on disposal of available for sale financial

assets

0 0 0 0

Net actuarial gain/(loss) on pensions 0 0 0

Total recognised income and expense for 2011-12 (649,977) (1) 0 (649,978)

Net Parliamentary funding 654,876 654,876

Balance at 31 March 2012 (34,262) 4,611 0 (29,651)

Changes in taxpayers’ equity for 2010-11

Restated balance at 1 April 2010 (37,788) 5,045 0 (32,743)

Net operating cost for the year (651,925) (651,925)

Net gain/(loss) on revaluation of property, plant, equipment 285 285

Net gain/(loss) on revaluation of intangible assets 0 0

Net gain/(loss) on revaluation of financial assets 0 0

Net gain/(loss) on revaluation of assets held for sale 0

Impairments and reversals (684) (684)

Movements in other reserves 0 0 0

Transfers between reserves 34 (34) 0

Release of Reserves to Statement of Comprehensive Net Expenditure 0 0

Transfers to/(from) other bodies within the group 0 0 0 0

Reclassification adjustment on disposal of available for sale financial

assets

0 0 0 0

Net actuarial gain/(loss) on pensions 0 0 0

Total recognised income and expense for 2010-11 (651,891) (433) 0 (652,324)

Net Parliamentary funding 650,518 650,518

Balance at 31 March 2011 (39,161) 4,612 0 (34,549)

Page 29

Statement of cash flows for the year ended

31 March 20122011-12 2010-11

£000 £000

Cash Flows from Operating Activities

Net Operating Cost Before Interest (650,268) (651,856)

Depreciation and Amortisation 881 1,435

Impairments and Reversals 0 631

Other Gains / (Losses) on foreign exchange 0 0

Donated Assets received credited to revenue but non-cash 0

Government Granted Assets received credited to revenue but non-cash 0

Interest Paid 0 0

Release of PFI/deferred credit 0

(Increase)/Decrease in Inventories 360 (94)

(Increase)/Decrease in Trade and Other Receivables 4,371 1,408

(Increase)/Decrease in Other Current Assets 0 0

Increase/(Decrease) in Trade and Other Payables (11,583) (3,278)

(Increase)/Decrease in Other Current Liabilities 0 0

Provisions Utilised (902) (40)

Increase/(Decrease) in Provisions 1,861 2,558

Net Cash Inflow/(Outflow) from Operating Activities (655,280) (649,236)

Cash flows from investing activities

Interest Received 0 0

(Payments) for Property, Plant and Equipment (109) (1,282)

(Payments) for Intangible Assets 0 0

(Payments) for Other Financial Assets 0 0

(Payments) for Financial Assets (LIFT) 0 0

Proceeds of disposal of assets held for sale (PPE) 513 0

Proceeds of disposal of assets held for sale (Intangible) 0 0

Proceeds from Disposal of Other Financial Assets 0 0

Proceeds from the disposal of Financial Assets (LIFT) 0 0

Loans Made in Respect of LIFT 0 0

Loans Repaid in Respect of LIFT 0 0

Rental Revenue 0 0

Net Cash Inflow/(Outflow) from Investing Activities 404 (1,282)

Net cash inflow/(outflow) before financing (654,876) (650,518)

Cash flows from financing activities

Capital Element of Payments in Respect of Finance Leases and On-SoFP PFI and LIFT 0 0

Net Parliamentary Funding 654,876 650,518

Capital Receipts Surrendered 0 0

Capital grants and other capital receipts 0 0

Cash Transferred (to)/from Other NHS Bodies (free text note required) 0 0

Net Cash Inflow/(Outflow) from Financing Activities 654,876 650,518

Net increase/(decrease) in cash and cash equivalents 0 0

Cash and Cash Equivalents ( and Bank Overdraft) at Beginning of the Period 5 5

Opening balance adjustment - TCS transactions 0

Restated Cash and Cash Equivalents ( and Bank Overdraft) at Beginning of the Period 5 5

Effect of Exchange Rate Changes in the Balance of Cash Held in Foreign Currencies 0 0

Cash and Cash Equivalents (and Bank Overdraft) at year end 5 5

IFRS 5 Discontinued Operations

2011-12 2010-11

£000 £000

Discontinued Operation Cashflow

Net operating cost before interest 0 (6,614)

Movements in working capital 0 264

Net cash outflow from operating activities 0 (6,350)

Net Parliamentary Funding 0 6,350

Cash and Cash Equivalents (and Bank Overdraft) at year end 0 0

The Statement of Cash Flows above includes cashflows for both continued and discontinued operations. The cashflows

relating to discontinued operations are summarised below. This represents the directly provided services which transferrred to

Spectrum, a community interest company on 1st April 2011. The cashflows relate to 2010/11.

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Staff Sickness Absence

2011-12 2010-11

Number Number

Total Days Lost 10,201 13,555

Total Staff Years 1,055 1,385

Average working Days Lost 9.67 9.79

The 2011/12 figures represent the calendar year 1st January 2011 to 31st December 2011.

The 2010/11 figures represent the calendar year 1st January 2010 to 31st December 2010.

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Exit packages agreed 2011/12

2011-12 2010-11

Exit package cost band (including any

special payment element)

*Number

of

compulsor

y

redundanc

ies

*Number

of other

departure

s agreed

Total

number of

exit

packages

by cost

band

*Number

of

compulsor

y

redundanc

ies

*Number

of other

departure

s agreed

Total

number of

exit

packages

by cost

band

Number Number Number Number Number Number

Less than £10,000 5 5 10 4 3 7

£10,001-£25,000 2 2 4 3 6 9

£25,001-£50,000 1 2 3 2 1 3

£50,001-£100,000 0 3 3 2 2 4

£100,001 - £150,000 0 0 0 1 0 1

£150,001 - £200,000 1 1 2 1 0 1

>£200,000 0 0 0 0 1 1Total number of exit packages by type (total

cost 9 13 22 13 13 26

£000s £000s £000s £000s £000s £000s

Total resource cost 311 478 789 609 587 1,196

This note provides an analysis of Exit Packages agreed during the year. Redundancy and other departure costs have been paid in accordance with the provisions of the NHS

Scheme. Where the PCT has agreed early retirements, the additional costs are met by the PCT and not by the NHS pensions scheme. Ill-health retirement costs are met by

the NHS pensions scheme and are not included in the table.

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Better Payment Practice Code

Measure of compliance 2011-12 2011-12 2010-11 2010-11

Number £000 Number £000

Non-NHS Payables

Total Non-NHS Trade Invoices Paid in the Year 11,268 82,055 21,298 79,451

Total Non-NHS Trade Invoices Paid Within Target 10,941 79,927 20,927 79,307Percentage of Non-NHS Trade Invoices Paid Within Target 97.10% 97.41% 98.26% 99.82%

NHS Payables

Total NHS Trade Invoices Paid in the Year 3,078 416,729 3,237 383,762

Total NHS Trade Invoices Paid Within Target 2,967 416,490 3,119 382,545Percentage of NHS Trade Invoices Paid Within Target 96.39% 99.94% 96.35% 99.68%

The Better Payment Practice Code requires the PCT to aim to pay all valid invoices by the due date or within 30 days of receipt of a valid invoice,

whichever is later.

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PCT Running Costs

Commissioning Public Health Total

Services

PCT Running Costs 2011-12

Running costs (£000s) 15,429 728 16,157

Weighted population (number in units) 385,616 385,616 385,616

Running costs per head of population (£ per head) 40.01 1.89 41.90

PCT Running Costs 2010-11

Running costs (£000s) 18,219 1,144 19,363

Weighted population (number in units) 393,213 393,213 393,213

Running costs per head of population (£ per head) 46.33 2.91 49.24

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About the remuneration report

Section 234B and Schedule 7A of the Companies Act, as interpreted for the public sector, require NHS bodies to prepare a remuneration report containing information about the remuneration of directors. In the NHS, the report will cover those senior managers “having authority or responsibility for directing or controlling the major activities of the NHS body”. This means those who influence the decisions of the entity as a whole rather than the decisions of individual directorates or departments.”

Membership of the Cluster Remuneration and Terms of Service Committee The Cluster Remuneration and Terms of Service Committee (RTSC) comprises the Chair (Ann Liston) and two nonexecutive directors: (Mehboob Khan and Roger Grasby), Cluster Chief Executive (Mike Potts), Executive Director of Workforce and Corporate Development (June Goodson-Moore) and Director of Finance and Efficiency (Ian Currell). The non-executive director who chairs the Audit Committee does not attend in order to make sure separation of duties. The Chief Executive is in attendance (except when his own terms and conditions are considered). The committee is supported by the Directorate of Human Resources and Organisational Development.

The role of the Remuneration and Terms of Service Committee

The role of the RTSC is to make decisions about appropriate remuneration and terms of service for the Chief Executive, directors, Clinical Executive members‟ allowances and in exceptional circumstances individual issues arising for staff on Agenda for Change terms. This includes the determination of basic pay for the Chief Executive and other directors, together with any annual uplifts and performance bonuses.

Statement of the policy on remuneration of higher paid employees for current and future financial years

NHS Wakefield works within the Pay Framework for Very Senior Managers in Strategic and Special Health Authorities, Primary Care Trusts and Ambulance Trusts as set out by the Department of Health and which became operable from 1 April 2007. This helps to make sure that NHS Wakefield is able to recruit, retain and motivate high calibre staff and is consistent, competitive and comparable to other PCTs.

Page 35

Explanation of methods used to assess whether performance conditions were met and why those methods were chosen The RTSC reviews appropriate levels of pay for the Chief Executive and other directors under the Very Senior Managers Framework. In line with best employment practice, where performance should be assessed by the line manager, the Chief Executive conducts the performance assessments for the directors. The Chairman assesses the performance of the Chief Executive. Assessments are conducted using established appraisal and personal development review processes, which include clearly defined responsibilities with measurable objectives. The discretionary element of pay is covered by performance bonus arrangements as referred to above in the section on the statement of the remuneration of higher paid employees.

Explanation of relative importance of the relevant proportions of remuneration which are, and which are not, subject to performance conditions

Please refer to information on the role of the Remuneration and Terms of Service Committee.

Summary and explanation of policy on the duration of contracts, notice periods and termination payments

Chief Executive and director appointments are made on a substantive basis, with notice provisions normally six months clearly identified and articulated in the contract.

Significant awards made to past senior managers during 2011/12

All payments are disclosed in the table on pages 35-36.

Salary and pension entitlements of senior managers for 2011/12 See table on page 38.

Page 36

Page 37

CKW CLUSTER REMUNERATION REPORT (Full Costs)

Page 38

Page 39

Page 40

APPENDICES

Statement of the Chief Executive’s responsibilities as the

Accountable Officer of the Primary Care Trust

The Chief Executive of the NHS has designated that the Chief Executive

should be the Accountable Officer to the primary care trust. The relevant

responsibilities of Accountable Officers are set out in the Accountable Officers

Memorandum issued by the Department of Health. These include ensuring

that:

there are effective management systems in place to safeguard public

funds and assets and assist in the implementation of corporate

governance;

value for money is achieved from the resources available to the primary

care trust;

the expenditure and income of the primary care trust has been applied

to the purposes intended by Parliament and conform to the authorities

which govern them;

effective and sound financial management systems are in place; and

annual statutory accounts are prepared in a format directed by the

Secretary of State with the approval of the Treasury to give a true and

fair view of the state of affairs as at the end of the financial year and the

net operating cost, recognised gains and losses and cash flows for the

year.

To the best of my knowledge and belief, I have properly discharged the

responsibilities set out in my letter of appointment as an Accountable Officer.

Date.......................................................

Signed.....................................................................................

Mike Potts, Chief Executive

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CLUSTER BOARD DECLARATIONS OF INTEREST REGISTER 2011/12

Board Member Role Interests Declared

Angela Monaghan Chair None

Sandra Cheseldine Non Executive Director Chair of the Trustees Board for Wakefield District Citizens Advice Bureau.

Roy Coldwell Non Executive Director Trustee and Company Secretary of Catalyst Science Discovery Centre. Director of RS Clare and Company Lubricants manufacturer. Non-Executive Director PICME-Business Improvement Consultancy. Risk Management Consultant – HFL Risk Services.

Tony Gerrard Non Executive Director Director of Tony Gerrard Associates Ltd.

Roger Grasby Non Executive Director Independent Member – West Yorkshire Police Authority. Justice of the Peace – Wakefield/Pontefract Bench. Non-legal member – Employment Tribunal. Chair/Director, Spectrum Community Health CIC Ltd.

Ann Liston Non Executive Director Independent Member of West Yorkshire Police Authority. Counsellor and external training manager - Leeds Counselling. Treasurer, Hope Baptist Church, Hebden Bridge.

Keith Wright. Non Executive Director Director of ICATs Ltd. (a dormant company). NHS consultancy support to NHS organisations.

Mike Potts Chief Executive None

Ann Ballarini Executive Director of Commissioning and None

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Service Development

Sue Cannon Executive Director of Quality and Governance (Nursing)

None

Sue Ellis (until January 2012) Director of Human Resources and Organisational Development

Spouse is an Employee at Gilthwaites First School, Denby Dale. Church Council Secretary and worship leader Denby Dale Methodist Church.

Peter Flynn Director of Performance and Commissioning Intelligence

None

Dr Andrew Furber Executive Director of Public Health – NHS Wakefield District

Trustee – North to North Health Partnership. Honorary Senior Clinical Lecturer – Sheffield University.

Gill Galdins Chief Operating Officer – NHS Wakefield District

None

June Goodson Moore (from January 2012)

Dr Judith Hooper Executive Director of Public Health – NHS Kirklees

Employed by GP contractor to CKW PCT – GP assistant Meltham Road Surgery. Partner provides services under contract to CKW via Bradford Hospital Trust – Tier 2 Pain Service South Kirklees.

Julie Lawreniuk Chief Operating Officer - NHS Calderdale None

Carol McKenna Chief Operating Officer – NHS Kirklees

Jonathan Molyneux Interim Executive Director of Finance and Efficiency

None

Graham Wardman Executive Director of Public Health – NHS Calderdale

None

Matt Walsh Medical Director Ownership of a 2/7 share of premises at Thornton Medical Centre, Bradford (a PMS practice with a Bradford contract) Spouse is an employee of Calderdale and Huddersfield Foundation Trust.

Page 43

Find out more

You can find out more about Wakefield District on our website

www.wakefielddistrict.nhs.uk

Twitter

@NHSWakefield

Or search on Facebook for NHS Wakefield District.

If you have any questions about local health services, you can call our Patient

Advice and Liaison Service on 0845 602 4832. Or by email to

………………………….

If you require this report in another format such as large print, audio tape or

other language, please contact The Communications Team on 01924 213050

Page 44