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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 Calderdale. 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 Kirklees and NHS Wakefield District, 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 Calderdale is a Chief Operating Officer, Julie Lawreniuk 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. 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 Calderdale, 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.

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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 Chair

Mike Potts 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, 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. Our CCG is leading and implementing the business plan and operating plan for 2012-13, including leading all QIPP schemes and agreeing their own commissioning intentions. Each CCG has also 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. We already have a jointly appointed Director of Public Health and we have been working with the Council and the Calderdale Clinical Commissioning Group to ensure that plans are in place for an effective transition of staff and programmes,. 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 each 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. Introducing NHS Calderdale Clinical Commissioning Group For the past few years we have worked closely with our GPs to commission services. This means that the Calderdale Clinical Commissioning Group (CCG) already has a wealth of experience and well understands the health needs of local people. 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 in Calderdale. 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. The CCG is chaired by Dr Alan Brook, and the Shadow Board includes GPs, nurse and practice members, a secondary care clinician, as well as lay representatives. The Shadow Accountable Officer for the CCG is Dr Matt Walsh, who is currently the Medical Director for NHS Calderdale, Kirklees and Wakefield District. The vision of the CCG is clear; to achieve the best health and wellbeing for the people of Calderdale within available resources. The specific objectives are to; prevent people from dying prematurely enhance the quality of life for people with a long-term condition (inc work on urgent care pathways) help people to recover and maintain their independence ensure people have a positive experience of care (inc those in care homes, and those accessing primary care) ensure a safe environment and protect people from harm reduce inequalities in Calderdale. 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 Calderdale 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 DRAFT NHS Calderdale Annual Report

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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 Calderdale 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:

Our strategic goals Along with our colleagues across the Cluster 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 cluster PCT QIPP initiatives in 2012/13 (of which £5.5m is through NHS Calderdale initiatives) 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) 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. DRAFT NHS Calderdale Annual Report

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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 tem, 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 into two overarching health and social care transformation programmes, one covering Calderdale and Huddersfield and one covering North Kirklees and 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. Calderdale and Huddersfield health and social care transformation There has been a long-standing Transformational Board operating across this geographical footprint bringing together partners from across the local health and social care economy to drive change. Its main areas of focus have been delivery of system change in planned and unplanned care. Whilst this work has enabled both commissioners and providers to deliver their financial aspirations, it is recognised that, in order to meet the challenges going forward, we need to again review the current configuration of services. This work started back in 2005, when the health community set out its five year vision. The work to refresh this vision has been agreed with all parties, including the Greater Huddersfield CCG, and will be commissioner-led. The aims of the work are consistent with our aspirations, in that they will: •ensure a strategy for the next five years to delivery high quality care in the most appropriate setting •ensure care will be delivered in a system which is in the top 10% nationally for safe, reliable, patient-centred care – maximising technology to deliver and support care •maximise the advantages of the NHS reforms, and respond to demographic changes •focus on meeting the needs of people living with long-term conditions •create an affordable and sustainable model of service, where local leaders are recognised for their approach to partnerships and integrating care. The timeline for this work is being agreed at the time of writing, but it is anticipated that public consultation will begin in November 2012, and that, final decisions on any significant change, will be taken in Spring 2013.

Section 5 DRAFT NHS Calderdale Annual Report

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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, 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 two GP Practices in Ovenden and Showery Bridge opened, offering additional access to medical services for Calderdale residents. Both practices are open from 8am to 8pm Monday to Friday (including Bank Holidays) and 8am to 1pm on Saturdays. 80% of the GP practices in Calderdale continue to offer appointments during extended hours. 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. Enhanced services mean that you can go to your GP for a wider range of services rather than going to another clinic or a hospital. This has received a positive 93% uptake within Calderdale. 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.

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As well as providing NHS sight tests, our optometrists continue to provide local enhanced services for patients with cataracts and raised pressure in the eye. Patients with cataracts are counselled about the risks and benefits of surgery and undergo a thorough examination before being referred. This is to ensure that only patients who have been able to make an informed choice about surgery and are suitable for the procedure are referred to the hospital. We have adopted National Institute for Health and Clinical Excellence (NICE) guidance for those who are found to have raised pressure in the eye during a normal sight test. Patients are now less likely to be referred to hospital unnecessarily, reducing waiting times and costs to the NHS.

Taking your medicine Our Pharmaceutical Needs Assessment provides a detailed picture of our pharmacy services. Since its publication, we have seen an increase in the number of pharmacies providing additional NHS services such as emergency hormonal contraception services and needle and syringe exchange. The Pharmaceutical Needs Assessment can be accessed at Selected pharmacies in Calderdale are currently participating in a Healthy Living Pharmacy initiative. Pharmacy staff are being encouraged, through training and support, to take a proactive approach to health promotion and self-care. This initiative started in January 2011 and it is anticipated that by the end of 2012 that some of the benefits of the Healthy Living Pharmacy initiative will be realised.

Open wide In late 2011/12 the dental suite at St. Johns Health Centre in Halifax was extended and modernised to provide improved services for patients with physical disabilities. Further positive outcomes include: •NHS dentists in Calderdale have continued to accept new patients throughout the year •Any Calderdale resident looking for an NHS dentist can be accepted at a local practice •More patients who are housebound or in residential care are receiving NHS dental treatment.

Living with illness

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Right care, right place, right time Intermediate Tier services help people whose health has deteriorated to remain in their own home, if it is safe to do so, or in the community. They also assist people to become mobile again or independent again after: an operation an accident an illness deterioration in a long-term condition(s). Our Intermediate Tier services have been redesigned because: the number of older people is increasing rapidly which means that there are more people with long-term conditions more people are being admitted to hospital, but not staying overnight more people are receiving help at home more people with long-term care needs are being placed into care homes. Changes to intermediate tier services in Calderdale mean that you will get the right care, at the right place, at the right time and have a better experience of services.

Putting patients in control of their pain A pioneering health programme which has helped hundreds of people in Kirklees manage their long term health conditions has been extended until August 2012. It initially focused on chronic musculo-skeletal pain but because of its success has recently been expanded to cover chronic obstructive pulmonary disease (COPD) and chronic chest problems. Funded by the Health Foundation, NHS Calderdale, NHS Kirklees and the Calderdale and Huddersfield NHS Foundation Trust were one of only eight sites chosen nationally to take part in the Co-creating Health Programme. It helps people develop the skills, knowledge and confidence to manage their long term conditions with the support of a specially trained team of clinicians and tutors. The programme does not just help people with long term conditions, but also helps NHS staff improve the support they are able to provide through training. DRAFT NHS Calderdale Annual Report

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Bowel cancer campaign supported by local residents To save lives and help raise awareness of the signs and symptoms of bowel cancer for the over 50s, residents of Calderdale (community champions) took part in a new campaign in October 2011. They helped to communicate the importance of early diagnosis and educated others of the signs and symptoms. Through this campaign NHS Calderdale, along with the Yorkshire Cancer Network, helped to break down the barriers that stop people from going to see their GP. For further information on bowel cancer, visit . Tackling the harms of alcohol A three year plan, aimed at reducing alcohol misuse, alcohol related crime and disorder and improving community safety in Calderdale has been launched. Calderdale has a higher than average number of problem drinkers: 58,000 people who are at increasing risk because of their drinking, at high risk or who are already dependent on alcohol. The ‘Tackling the Harms of Alcohol’, strategy has been developed by the Calderdale Substance Misuse Partnership which aims to reduce the harms of heavy drinking whilst promoting a thriving and safe community where alcohol is used responsibly. NHS Calderdale, West Yorkshire Police, Calderdale Metropolitan Council, the Alcohol Service, voluntary and community organisations and a range of other partners are involved in this plan. Key priorities of the strategy include: •Increasing awareness of sensible drinking levels •Reduced alcohol-related health problems, anti-social behaviour and crime •Expanding treatment provision •Working with the licensing industry to maintain a thriving night-time economy.

Section 6 Quality counts DRAFT NHS Calderdale Annual Report

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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 Patient Safety Reduction in healthcare associated infection, including a reduction in numbers (maximum of 6 cases) of MRSA. Planned Care Delivered NHS Constitution standards that 90% of admitted patients and 95% of non-admitted patients should start their treatment within 18 weeks of referral. 2-week urgent referrals: cancer 93% of possible cancer patients are to wait no longer than two weeks from an urgent referral to a first outpatient appointment. Urgent care A&E standards and ambulance response time standards delivered, enabling patients to access urgent care when they need it Stroke The national standard states that 80% of people who have had a stroke should spend at least 90% of their time in hospital on a stroke unit. Diabetes 100% of people with diabetes are to be offered Diabetic Retinopothy Screening Mental Health A minimum of 97 cases to be served by early intervention services Choose and Book Giving patients more choice about ‘How, When and Where’ they receive treatment with access to a named consultant given to a minimum of 70% of cases End of Life Care To provide all adults nearing the end of life, regardless of diagnosis, access to high quality palliative care, giving more people the choice to die at home, including in a care home. DRAFT NHS Calderdale Annual Report

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Achieved YES









Smoking Quitters An increase in the volume of people accessing and successfully quitting with NHS Stop Smoking Service


Source: Cluster Board Routine Performance Report 2011/12

Learning from experience Sometimes, however, 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 our Customer Services team received 946 enquiries as well as 310 requests for information under the Freedom of Information Act. In the same period we received and responded to 104 complaints. We also supported GPs, pharmacists, dentists and opticians to respond thoroughly to the complaints they received. Complaints about Primary Care Contractors: GP: 51 Dental: 18 Pharmaceutical: 6 Optical: 0

The other 29 complaints related to other services/organisations from which we commission services, for example, nursing homes and counseling services. Some of the lessons we have learned from the complaints we received resulted in improvements to patient care are: improved communication with patients review of how referrals are made for some diagnostic tests further training for staff to help them improve patient care and experience 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.

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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. 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 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 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, members of the public and other stakeholders for their views on which DRAFT NHS Calderdale Annual Report

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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 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)

Community Dental Service at Laura Mitchell Health Centre All NHS services have moved from the Laura Mitchell Health Centre, Halifax. This includes the Community Dental Service. After looking at a number of alternative buildings a decision was made to provide the Community Dental Service from St. John’s Health Centre, Lightowler Road, Gibbet Street, Halifax HX1 5NB. The dental surgery at St. Johns Health Centre was extended and re-fitted to provide modern improved facilities and patients have continued to receive the same high standard of care. The work at St. John’s Health Centre was completed by the end of March 2012, and the Community Dental Service was open from April 2012. The views of people using the service were taken into account when the new facilities were developed

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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. 81% of our staff completed the staff survey in 2011, which was a 11% increase on last year’s figure. Our top three highest scores showed that our staff: •feel that there is good communication between managers and staff •feel able to contribute towards improvements at work •believe the PCT has a good commitment to work-life balance. We scored less well for the percentage of people receiving health and safety training in the past 12 months but in 30 areas out of 38, NHS Calderdale was average or above average compared with other PCTs nationally. In 13 of those areas we were in the top 20% of PCTs in the country.

Monitoring We continue to monitor sickness data and provide relevant support to staff according to their needs. During this year our sickness rate was 1.7%, which is significantly lower than our target rate of 2.5%. 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.

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Our staff Gender Commisioning PCT Male Female

Count 46 220

% 17% 83%

Count 206 13 47

% 77% 5% 18%

Count 3 52 83 93 35

% 1% 20% 31% 35% 13%

Count 190

% 71%

74 0 2

28% 0% 1%

Disabled Commisioning PCT No Yes Not Declared Age group Commisioning PCT Under 25 25-34 35-44 45-54 55+ Sexual Orientation Commisioning PCT Heterosexual I do not wish to disclose my sexual orientation Gay Lesbian

Ethnic Origin Commisioning PCT A White - British B White - Irish C White - Any other White background CY White Other European F Mixed - White & Asian G Mixed - Any other mixed background H Asian or Asian British - Indian

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Count 244 2 4 1 2 1 3

% 92% 1% 2% 0% 1% 0% 1%

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J Asian or Asian British - Pakistani L Asian or Asian British - Any other Asian background M Black or Black British - Caribbean N Black or Black British - African



1 2 2

0% 1% 1%

Religious Belief Commisioning PCT Atheism Buddhism Christianity Hinduism I do not wish to disclose my religion/belief Islam Other

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Count 26 1 130 2

% 10% 0% 49% 1%

89 5 13

33% 2% 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. Within our own properties we do everything we can to reduce energy consumption: •Brighouse health centre has had new boilers, windows, door, roof and low energy lighting fitted. •Allen House has had the ground floor refurbished including new boilers and low energy lighting. •The dental service has relocated from Laura Mitchell into St John’s Health Centre. •Rastrick Health Centre has had a new roof with improved insulation •Access has been improved for disabled people with new automatic doors at Allen House annexe, Rastrick Health Centre and Luddenfoot Clinic.. At NHS Calderdale, we are committed to recycling. Here are just some of the initiatives that we have put in place: •recycle bins are in place for confidential and non confidential paper which is shredded on-site. •all toner cartridges and cardboard are recycled •our printers are defaulted to print double sided and in black and white.

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

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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:

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Section 12 Director of Finance commentary During 2011/12 we invested over £350 million to improve the health of local people through the commissioning of high quality services. Our investment resulted in: A new intermediate tier model – ensuring patients receive timely care in the right setting though a new single point of access New models of care for patients with COPD to provide patients with a better pathway from acute to primary care and to support reductions in exacerbations and admissions Improved re-ablement services, to ensure more people get better access to aids and adaptations Better access to palliative care at Martin House and Overgate Hospices Additional funding in Age UK to support older people remain well and independent Additional funding into carers support to enable carers to access breaks, preventing breakdowns of care packages.

In the last 12 months, as well as managing the transition to the new NHS we have had some very challenging targets to meet and I am pleased to say that by working with our partners we have delivered these within our financial resources available. We have in 2011/12 and will continue our focus on maintaining quality and safety whilst achieving value for money across all the services we commission, successfully this year delivering our share of the national ‘QIPP’ challenge by working more efficiently to contribute to the £20bn savings which the NHS has to achieve by 2015. To achieve this we have delivered a range of schemes designed to reduce expenditure whilst at the same time maintaining quality. Over the next few years we will continue to face financial challenges due to the increases in demand but we and the emerging new commissioning group are committed to working with patients and partners to ensure we maximise the most of the money we spend on public services for local people. NHS Calderdale has fully prepared the accounts in accordance with International Finance Reporting Standards.

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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 Angela Monaghan Sandra Cheseldine

Role Chair Non Executive Director

Roy Coldwell

Non Executive Director

Tony Gerrard Roger Grasby

Non Executive Director Non Executive Director

Ann Liston

Non Executive Director

Keith Wright.

Non Executive Director

Mike Potts

Chief Executive

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Interests Declared None Chair of the Trustees Board for Wakefield District Citizens Advice Bureau. 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. Director of Tony Gerrard Associates Ltd. 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. Independent Member of West Yorkshire Police Authority. Counsellor and external training manager Leeds Counselling. Treasurer, Hope Baptist Church, Hebden Bridge. Director of ICATs Ltd. (a dormant company). NHS consultancy support to NHS organisations. None

Ann Ballarini Sue Cannon Sue Ellis (until January 2012)

Peter Flynn Dr Andrew Furber

Gill Galdins June Goodson Moore (from January 2012) Dr Judith Hooper

Julie Lawreniuk Carol McKenna Jonathan Molyneux Graham Wardman Matt Walsh

DRAFT NHS Calderdale Annual Report

Executive Director of Commissioning and Service Development Executive Director of Quality and Governance (Nursing) Director of Human Resources and Organisational Development

Director of Performance and Commissioning Intelligence Executive Director of Public Health – NHS Wakefield District Chief Operating Officer – NHS Wakefield District Executive Director of Public Health – NHS Kirklees

Chief Operating Officer - NHS Calderdale Chief Operating Officer – NHS Kirklees Interim Executive Director of Finance and Efficiency Executive Director of Public Health – NHS Calderdale Medical Director

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None None Spouse is an Employee at Gilthwaites First School, Denby Dale. Church Council Secretary and worship leader Denby Dale Methodist Church. None Trustee – North to North Health Partnership. Honorary Senior Clinical Lecturer – Sheffield University. None 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. None None None 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.

Find out more You can find out more about NHS Calderdale on our website

Twitter @nhscalderdale

Or search on Facebook for NHS Calderdale If you have any questions about local health services, you can call our Customer Services team on . ………..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 01484 464000.

DRAFT NHS Calderdale Annual Report

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