the work we do for a better bolton€¦ · black minority ethnic (bme) communities to help improve...

Annual Report Summary

2018-19

The work we do for a Better Bolton

Report SummaryReport Summary

ARS_2019_20.indd 1 16/09/2019 11:19

Since our last Annual Report we have seen some exciting developments to health and social care in Bolton, and NHS Bolton Clinical Commissioning Group (CCG) has worked hard to embrace these changes.

The past year has had its challenges, but the CCG has built on its relationships with partners to enhance collaborative working to help patients receive health and care closer to their own homes.

Bolton’s GP registered population has increased year on year since 2013 and by more than 3,500 since March 2018.

Overall, this has a significant impact on demand for healthcare services in Bolton but we are all adapting to these circumstances and there is more focus on early intervention and prevention.

Even more practices have signed up to using the Bolton Care Record, which is designed to safely and swiftly share information to ensure the best care for patients. Since the introduction of General Data Protection Regulations (GDPR) in 2018, patients no longer have to give consent as it is considered in their best interests to share important details about their care.

The Bolton Quality Contract (BQC)continues to be a valuable asset to practices in Bolton, providing them with a set of quality standards to ensure they are all striving for the sameoutcomes across the town.

As we approach the end of our Transformation Fund period, we can reflect on a number of improvements that – together as partners – we have delivered for the population of Bolton.

This is reflected in the rating of ‘outstanding’ achieved by Bolton CCG in the national Improvement Assessment Framework (IAF): a fantastic achievement reflecting the hard work of the CCG and member practices as well as our providers and partners.

One major achievement has been the progress we have all made with the Integrated Care Partnership and Strategic Commissioning Function strands of our wider agenda for integrating health and care for the town.

We thank everyone for their commitment to make Bolton a vibrant, healthy and engaged community.

To download our full annual report, please visit: www.boltonccg.nhs.uk/about-us/

Welcome to a summary of our annual report.This covers the work of NHS Bolton Clinical Commissioning Group (CCG) during 2018-19.

2. Annual Report Summary 2018-2019

Dr Wirin Bhatiani Chair NHS Bolton CCG

Su LongChief OfficerNHS Bolton CCG

ARS_2019_20.indd 2 16/09/2019 11:19

Annual Report Summary 2018-2019 3.

Who we are and what we doThe purpose of Bolton CCG is to design, arrange and buy the most effective health services possible for local people, with the NHS funding available.

To do this, we must balance the triple aim of:

DD Improving health outcomes by reducing the gap in life expectancy

DD Improving the quality and experience of care

DD Delivering best value for money.

In addition, Bolton CCG had three strategic objectives for 2018/19:

DD Deliver year 3 of the Bolton Locality Plan, including forming a Strategic Commissioning Function and developing capacity for integrated care in neighbourhoods

DD Ensure compliance with NHS statutory duties and NHS constitution

DD Deliver financial balance

Decision making and accountabilityNHS England scrutinises our work to make sure we’re improving patient care and meeting national NHS standards - all within the budget allocated to us.

Bolton CCG received an overall rating of ‘Outstanding’ from NHS England for 2018-19. We also received the highest ‘Green Star’ rating for Quality and Leadership, and Patient and Community Engagement.

We were judged to have performed particularly well in a number of national priority areas, including:

DD Cancer referrals and cancer patient experience

DD Dementia care and diagnosis

DD Regular health checks for people with learning disabilities

DD Access to a GP outside of usual opening hours

DD Quality of hospital provision and General Practice services

The CCG is led by our board (governing body), which is legally accountable to the people of Bolton for the work of the organisation.

Our board makes decisions on which health services to commission. It is necessary for us to prioritise the services that have good evidence of benefit for local people. GPs are involved in the day to day work of the CCG, overseeing delivery and leading on important projects.

Most of our board members also work as GPs and this is set out in our constitution. The board is headed by our Chairman, Dr Wirin Bhatiani and made up of eight GPs (four elected by member practices), two senior managers, a hospital doctor, a nurse, and three people who do not work in the NHS (our lay members). The Director of Public Health at Bolton Council also attends board meetings.

Our board meetings are open to the public and the board papers are published online a week before the meeting. To find out more, visit www.boltonccg.nhs.uk/about-us/our-board/board-meetings

We keep registers of interests and hospitality and gifts for board members, GPs, and members of staff. These registers are reviewed regularly and updated as necessary. They are available on our website: www.boltonccg.nhs.uk/about-us/declarations-of-interest

ARS_2019_20.indd 3 16/09/2019 11:19


different backgrounds: age, gender, carers, disability, gender re-assignment, race, religion/belief and sexual orientation.

We aim to remove any barriers to accessing health services and take steps to help support those who may have difficulties, ensuring that Bolton’s health services are culturally sensitive, inclusive, accessible, and appropriate for our residents.

Throughout 2018 ETAG members have been involved with the following subjects:

DD The PREVENT agenda

DD Using equality information to improve services

DD Cancer champions and the living with and beyond cancer project

DD Community Asset Navigators

DD New roles within Primary Care

DD Greater Manchester Equality Commission Roadshow

DD Importance of the Flu vaccine

DD Winter communications campaign

DD Bolton Deaf Society and sensory advocacy service.

DD The Giving Back in Bolton programme

DD Outpatients Improvement Programme

CCG RoadshowsOn July 4, 2018 and October 23, 2018 we held two roadshows on Victoria Square and spoke to around 400 people. The first one was held to mark the NHS 70th birthday and we asked people what mattered to them about their health. The second enabled us to talk to people about flu and if they’d had the flu vaccine. We were particularly interested if they knew about the free nasal spray for 2 and 3 year olds.

ByDengagingDwithDlocalDpeople,DBoltonDCCGDseeksDtoDunderstandDtheDneeds,DconcernsDandDexperiencesDofDresidentsDsoDitDcanDdeliverDtheDbestDpossibleDhealthDservices.DWeDunderstandDthatDpositiveDhealthDoutcomesDforDtheDpeopleDofDBoltonDcanDonlyDbeDachievedDifDpatientsDandDlocalDpeopleDremainDatDtheDheartDofDeverythingDweDdo.Over the past year we have continued to build on previous achievements, alongside a consistent approach to public engagement. We have worked closely with local people to understand what works well, what can be improved, as well as gathering patient stories to inform our commissioning team.

We work hard to reach those who wouldn’t usually get involved and groups who may find it harder to get their voice heard. We have done this whilst strengthening existing relationships with community organisations and groups.

We continue to work in partnership with Healthwatch Bolton and Bolton Community and Voluntary Service (CVS) to engage with local people and to support their wider health and wellbeing.

Equality Target Action Group (ETAG)Our Equality Target Action Group (known as ETAG) provides information on a number of services that are accessible to a wide range of individuals in the borough. ETAG is made up of a diverse range of people from

Patient and public involvement

ARS_2019_20.indd 4 16/09/2019 11:19


Engagement activityWe continued to involve the people of Bolton in a number of different ways, from small community groups to large public events. Our engagement topics have predominantly focused on the flu vaccine, local health and social care developments, and alternative options to A&E. Over the past year, the CCG has:

• Presented information to 55 community and voluntary groups

• Had information stalls at 7 public events

• Attended 9 public meetings

• Attended 15 community and voluntary sector meetings

• Held 12 ETAG meetings

• Held 2 Roadshow events.

We have spoken to people about their experiences and gathered their views on:

D The Deaf community accessing primary care and hospital services

D The Child and Adolescent Mental Health Service (CAMHS) new provider launch

D Carers experiences

D Health and social care developments

D Alternative options to A&E information in different languages

D Mental Health experiences

D Winter pressures on the NHS – in particular visits to A&E

D Raising awareness of the flu vaccine

D Mental health support over the festive season

D Extended GP hours services

D Dermatology services

D Dementia awareness

Our engagement work enables us to include people’s views when we come to make decisions and shape our plans for the year ahead.

ARS_2019_20.indd 5 16/09/2019 11:19


Links with BME communities

We are committed to engaging with our Black Minority Ethnic (BME) communities to help improve knowledge around health and wellbeing in Bolton. In 2018, we developed exciting new networks in this area.

Members of the BME community identified that there was a need for leaflets to be translated into commonly used languages. We used these comments to create new resources which have been disseminated in the community and are also available to download on our website.

Browsealoud

People said that NHS Bolton CCG information needed to be available in various languages. Using this feedback we commissioned an online translation tool called Browsealoud.

Browsealoud has been installed to help Bolton’s non-English speaking communities access our website more easily. From the homepage, visitors can access a range of functions, such as the translation of text to 99 languages; they can hear text read aloud in English or 40 commonly spoken languages.

Other examples...

• The public said they would like to see a GP during weekends and evenings without traveling across town. We made changes to the GP extended hours and out of hours services and improved accessibility by offering three hubs

• Mental health service users highlighted that patients wanted a platform to be able to engage in a more open and meaningful way about mental health services. Using their feedback, this work has now commenced and a new forum is being developed

• Patients felt that they shouldn’t need to give their life story to a GP receptionist. We used this feedback to create an informative poster that explains why a receptionist may need to ask more questions. These posters are displayed in GP waiting rooms

• Patients highlighted how waiting for a cancer diagnosis or being told that results were negative could be very worrying. We made this a priority and have been able to successfully reduce waiting times for tests and a diagnosis for upper and lower gastrointestinal and lung cancers

• Young people told us they wanted an anonymous online mental health resource for their age group and using this feedback we commissionedthe service Kooth and launched the campaign ‘Be kind to mind’

You said, we did...

download on our website.

ARS_2019_20.indd 6 16/09/2019 11:19


Performance against objectives

BoltonDCCGDhasDsetDorganisationalDobjectivesDtoDmonitorDtheDdeliveryDofDtheDtripleDaim.DPerformanceDagainstDourDoverallDorganisationalDobjectivesDisDsummarisedDinDtheDfollowingDpages.

BoltonDtopsDtheDperformanceDleagueDacrossDGMDandDtheDNorthDofDEngland,DandDisDtheDsecondDbestDperformerDinDEnglandD(PHE,DDecD2018)DwithD71.8%DofDtheDeligibleDpopulationDhavingDhadDanDNHSDHealthDCheck.

• Preventing Diabetes - 87% of Bolton’s eligible population, aged 40 years and over, has been screened for diabetes/being at risk of diabetes over the last five years. People identified at risk are offered a comprehensive lifestyle intervention. Patients can choose to be supported by either a Health Improvement Practitioner based in their GP surgery, or be referred to the National Diabetes Prevention Programme (NDPP)

• Raising awareness of alcohol harm - over the last 2 years, 61.6% of patients aged 16 years and over have undertaken an alcohol screen in their GP surgery

Recent national figures for life expectancy have seen a downturn despite the targeted work we have done to focus on the biggest causes of death in Bolton:

• The current life expectancy for males, at 79.6 years has improved by only one month since 2013

• The current life expectancy for females, at 83.1 years, has not improved since 2012

Strategic Objective 1: ImproveDHealthDOutcomes

One of the CCG’s main aims is to improve health outcomes through reducing the gap in life expectancy – both in comparison to the England average and between the most affluent and most deprived populations within Bolton.

Reducing health inequalities enables everyone to have the same opportunities to lead a healthy life for longer, and we have a duty to reduce inequalities for patients in accessing our health services.

One of the ways we strive to achieve health equality, is through the Bolton Quality Contract (BQC).

The BQC is a unique arrangement between the CCG and GP practices and includes 17 standards for 2018/19 aimed at improving the quality of services and population health.

A range of programmes have contributed to local people living longer. Examples include:

• The NHS Health Check – the aim is to prevent heart disease, stroke, diabetes and kidney disease. GP practices are supported to provide a comprehensive health check to all eligible patients aged 40 – 74 years old

ARS_2019_20.indd 7 16/09/2019 11:19


This underlines the importance of working together with our partners across the town to prevent ill health and influence the wider determinants of health, such as education, employment and housing.

Strategic Objective 2: ImproveDQualityDandDExperienceDofDCare

This is measured by our compliance with NHS statutory duties and constitution targets. Areas where performance has been positive:

• One of the strongest performing CCGs for achievement of the cancer standards nationally

• Mental Health Liaison Service (MHLS) performance has continued to achieve above the national target of 75% of A&E emergency referrals being seen within one hour

• Improving Access to Psychological Therapies (IAPT) performance has improved and is on track to achieve the national target of providing timely access to treatment. Recovery rate and waiting time performance for IAPT has been strong throughout the year.

Areas where performance could be improved:

• Urgent care demand remains challenging. A&E performance and ambulance response times have failed to meet the required performance standards throughout 18/19

• Although achievement of the 18 week referral to treatment (RTT) target for patients on an incomplete pathway has remained consistent during 2018/19, the CCG failed to meet the target for the year

• There have been 95 mixed sex accommodation (MSA) breaches in 2018/19, related to estate limitations at the hospital

• There have been 17 C.difficile infections (against a target of 18) and 1 MRSA infection (against a target of 0) reported in 2018/19.

Strategic Objective 3: DeliverDBestDValueDforDMoney

Bolton CCG has met all statutory financial requirements and delivered financial balance for 2018/19

We have focused on delivering value for money and making commissioning decisions which prioritise services that have the strongest impact on health

The formation of a Strategic Commissioning Function (SCF) with Bolton Council will enable us to jointly commission health and care services for adults and older people from a pooled budget of circa £160 million.

ARS_2019_20.indd 8 16/09/2019 11:19


Community heart failure serviceThe CCG has used Transformation Funding to fund a community heart failure service, provided by Bolton NHS Foundation Trust.

The key aim of this service is to optimise the physical, psychological and social functioning of people with heart failure, enabling them to live longer and better in the community.

This service is developing integrated ways of working between the heart failure multi-disciplinary team with GP practices, particularly in neighbourhoods with a high population of patients registered with heart failure.

Care homes contractBolton CCG and Bolton Council worked together to develop a single care home contract which will align quality standards and reporting requirements. Care homes will have one contract that is jointly monitored by the CCG and Council teams.

The recent co-location of CCG commissioning teams with council teams at the town hall will help teams to work together.

Our successes this yearCommissioningIt’s been another busy and productive year for our Commissioning Team, with many new projects and ways of working introduced.

The CCG approved funding for the implementation of the Early Years Delivery Model across the borough as part of the new jointly commissioned 0-19 Children’s Health and Wellbeing Service. The contract was awarded to Bolton NHS Foundation Trust.

Working collaboratively with our colleagues at Bolton Council and Greater Manchester Health and Social Care Partnership (GMHSCP), Bolton CCG is developing a new website dedicated to Personal Assistants, who manage personal health budgets for individuals. The website aims to raise awareness of this area of work and to support further development of the Personal Assistant role as a potential career option. It is hoped this will assist potential employers with recruitment, training and retention of staff. Service users are involved with the co design of this project which potentially could be adopted by the wider Greater Manchester network.

Bolton Council and the CCG are working together to align systems and processes for personal budgets brokers. The aim is to simplify jointly funded packages of care for individuals.

Bolton CCG and Bolton Council continue to work collaboratively with Care Homes to improve quality of care and client experience. This includes the Care Home Excellence programme and providing specific support and guidance regarding falls, nutrition and hydration, and medicines management.

by the wider Greater Manchester network.

Bolton Council and the CCG are working together to align systems and processes for personal budgets brokers. The aim is to simplify jointly funded packages of care for individuals.

Bolton CCG and Bolton Council continue to work collaboratively with Care Homes to improve quality of care and client experience. This includes the Care Home Excellence programme and providing specific support and guidance regarding falls, nutrition and hydration, and medicines management.

ARS_2019_20.indd 9 16/09/2019 11:19


Honeysuckle Lodge A new mental health inpatient ward for women funded by Bolton CCG and Greater Manchester Mental Health NHS Foundation Trust (GMMH) opened in May, 2018.

Honeysuckle Lodge, based on the Royal Bolton Hospital site, provides rehabilitation and recovery services for women with mental health issues, who may otherwise receive care out of the local area.

The new facility aims to give women continuity of care as they prepare to leave inpatient mental health services and reduce the number of people being placed outside the borough.

The £2 million facility is run by staff from GMMH and Alternative Futures Group.

It has 14 en-suite bedrooms, a large day room, kitchen and dining facilities, therapy rooms and open garden space, providing a welcoming, homely environment for service users.

Managing demand for Urgent CareThe last 12 months has seen improvement and further embedding of ‘Home First’ principles across the system.

This has enabled patients to be supported in their own homes, preventing the need to attend hospital or a hospital admission.

This has been supported by the development of community services and frailty pathways in the community, preventing the step-up of patients through the urgent care system, equally supporting the timely step-down of patients following a hospital admission.

In addition, a re-design of the Intermediate Tier service has led to more people being able to return home sooner and retain their independence.

In 2018, the Bolton Macmillan Cancer Information and Support Service (MCISS) won an Integration Excellence Award from Macmillan Cancer Support for its ‘exceptional integrated partnership’.

The award was testament to the hard work undertaken by all partners involved to ensure the service was a successful partnership and it highlighted the commitment to truly improve the service for patients.

The MCISS was formed in 2014 as a result of a partnership between Macmillan, Bolton Hospice, and NHS Bolton CCG and has gone from strength to strength.

The Bolton People Affected by Cancer user involvement group was also fully involved in every aspect of co-designing and co-producing the service.

AsDaDresultDofDthisDpioneeringDpartnership,DanyoneDinDBoltonDcanDnowDaccessDtheDveryDbestDcancerDsupport,DfromDbenefitsDadviceDtoDwalkingDgroupsDandDcanD‘dropDin’DtoDanyDofDtheDthreeDinformationDDandDsupportDcentresDacrossDBolton.

Bolton Macmillan Cancer Information and Support Service (MCISS)

ARS_2019_20.indd 10 16/09/2019 11:19


Primary care locality service - Extended AccessIn July 2018, the Primary Care Locality Service (PCLS) was launched.

This new model delivers extra GP appointments outside of core hours.

The Extended Access service now operates across three hubs in different areas of Bolton, offering urgent and planned primary care access to patients.

This has increased the planned access to evening and weekend appointments for patients, offering an additional 30 mins per 1000 population. It also supports the urgent care system, providing urgent primary care access as an alternative to A&E and 999 services.

Patients can access this through their GP practice and has been promoted through the CCG’s Winter communications and engagement programme which focused on the message ‘Your GP, not A&E’.

ARS_2019_20.indd 11 16/09/2019 11:19


This year saw the fruition of a major project to improve the experience of young people with mental health worries and help to reduce the stigma surrounding the subject.

Finance Skills Development Towards Excellence Level 3 re-accreditationLast year we became the first CCG in the country to attain the highest level of NHS accreditation from the North West Skills Development network: Future Focused Finance (FFF) Level 3 accreditation.

This lasts for three years until we have to be accredited again.

This year the finance team were re-accredited for Finance Skills Development (FSD) Towards Excellence Level 3 which was last awarded in 2016.

The accreditation is awarded to organisations that demonstrate an embedded high quality NHS finance function, sharing of good practice and continuous development of organisational financial competence.

Back in 2016, a group of young people identified a gap in early intervention services locally and wanted to gain an understanding of what support was available to them.This led to Bolton CCG agreeing to fund an anti-stigma project with the aim of creating an information hub for young people, now known as #Bekindtomymind.

The CCG and Bolton’s Healthy Minds Youth Project co-produced a microsite www.bekindtomymind.co.uk which aims to combat the stigma around mental health.

Aimed at 14-18 year olds, the site also includes information on local mental health services, where to go if they need to access urgent help, and a poignant video of young people talking about their personal experiences.

The campaign to support the launch of the website went live across the borough in April 2019.

ARS_2019_20.indd 12 16/09/2019 11:19


Informatics awards and accreditation‘Informatics’ is the term used to describe the broad spectrum of information, intelligence and technology developed to provide better care for patients.

This can include IT systems, telephony, emerging technologies, data collection and electronic care records like the Bolton Care Record.

This year Bolton became the first CCG in the country to achieve Level 2 accreditation in the Excellence in Informatics standards, as part of Informatics Skills Development Network.

The accreditation means that the CCG has been externally validated and assessed as an Informatics function, including IT and Business Intelligence (BI), and found to be achieving our professional standards.

In addition, the BI team jointly won team of the year with the BI team at Bolton NHS Foundation Trust at the Informatics Skills Development awards 2018, for providing intelligence and support to NHS teams in the Bolton locality, in order to help them make the best decisions for patients.

Transformation FundIn 2016, health and care partners in Bolton received a budget of £28.8 million over three years called the Transformation Fund. The money was to support large scale transformation of the health and care system.

Now that the funding period has come to an end, the CCG has carried out evaluation of the 40 plus schemes included in this programme of work. Some of the schemes were designed to deliver transformation through non-recurrent funding; some will receive continued funding identified by commissioners, while some will need to provide outcome-based evidence in order to be considered for priority funding.

The principles of co-design work have successfully been embedded into our partnership work. Some good examples include: the redesign of Intermediate Care Team; the re-commissioning of the 0-19 service; Bolton Thrive Alliance; Lived Experience Panel.

Better to be in Bolton recruitment eventOctober also saw the locality’s first ever partnership recruitment event for the health and care sector.

Bolton CCG, NHS Bolton FT and Bolton Council collaborated on the event, which had the strapline ‘It’s Better to be in Bolton’.

Around 200 members of the public attended the event to find out about a career in health and care in Bolton.

ARS_2019_20.indd 13 16/09/2019 11:19


InDOctober,DtheDCCGDorganisedDaDlargeDscaleDeventDtoDshowcaseDtheDprogressDmadeDbyDtheDhealthDandDcareDsectorDinDBoltonDsinceDtheDdevolutionDofDhealthDtoDGreaterDManchester.

TheDeventDwasDattendedDbyDtheDChiefDOfficerDofDtheDGreaterDManchesterDHealthDandDSocialDCareDPartnershipD(GMHSCP),DJonDRouse,DandDmoreDthanD100Dguests.

AsDwellDasDaDnumberDofDpresentationsDfromDkeynoteDspeakers,DtheDeventDfeaturedDvideoDcaseDstudiesDshowingDhowDtheDTransformationDFundDhadDmadeDaDdifferenceDinDBolton,DandDaD‘marketDplace’DrepresentingDworkDfromDacrossDtheDhealthDandDcareDsystem.

TheDvideoDcaseDstudiesDandDaDdiaryDroomDvideo,DwhereDpeopleDgaveDtheirDopinionsDonDhowDhealthDandDcareDcouldDbeDimprovedDfurtherDinDtheDtown,DfeatureDonDtheDCCGDwebsite.

Power of Partnerships Event

Integrating health and care in BoltonDuring the Summer of 2018, Bolton CCG, Bolton NHS FT and Bolton Council all approved proposals to form an integrated care partnership to deliver the health and care system for the borough, with support from Greater Manchester Mental Health Trust (GMMH) and the voluntary and community sector.

The aim was to radically change the way health and care was provided, by working together at a community level and with local residents at the heart of any care they may need to receive. There was also an emphasis on early intervention and prevention to try and reduce the number of people needing to be admitted to hospital.

The two main components of achieving this shared vision was the creation of a Strategic Commissioning Function (SCF) and an Integrated Care Partnership (ICP).In order to drive forward the plans for integration, representatives from all organisations involved formed the Bolton Health and Care Partnership Shadow Board towards the end of 2018.

The Shadow Board is a decision-making committee responsible for leading the design and delivery of the new integration model.

Strategic Commissioning Function (SCF)From April 2019, the budgets held by Bolton Council and Bolton CCG to commission health and care services for adults and older people will be pooled to create a total budget of circa £160 million.

partnership

ARS_2019_20.indd 14 16/09/2019 11:19


Providers include hospital and community health services, primary care (including GPs), adult social care, mental health services and the voluntary, community and social enterprise sector (VCSE).

It will work on a neighbourhood model of care, which is based on a 1-3-9 formation: one locality (Bolton), three districts (North, South, West) and nine neighbourhoods (Turton, Breightmet/Little Lever; Crompton/Halliwell; Deane/Rumworth; Central/Great Lever; Farnworth/Kearsley; Chorley Roads; Horwich, Westhoughton) – each with a population of approximately 30,000-50,000.

This will enable the partnership to provide the most appropriate services to local residents to help them to stay well for longer and in their own homes, as part of a strong, connected and engaged community.

The commissioning teams from both the CCG and the Council have co-located in Bolton Town Hall, and joint decisions will be made across the teams on how best to spend the new combined budget on health and care services for adults in Bolton.

Su Long, Chief Officer of Bolton CCG, has been appointed Accountable Officer for health and care in Bolton and will oversee the work of the SCF.

Integrated Care Partnership (ICP) - Bolton Health and Care Partnership The ICP will enable the different providers of health and care in Bolton to work together for the benefit of local communities.

We are team...

ARS_2019_20.indd 15 16/09/2019 11:19

Want to know more?

Visit our website: www.boltonccg.nhs.uk

Follow us on Twitter: @BoltonCCG

Like us on Facebook: Search for NHS Bolton CCG

Visit our YouTube page: www.youtube.com/BoltonCCG

ARS_2019_20.indd 16 16/09/2019 11:19

the work we do for a better bolton€¦ · black minority ethnic (bme) communities to help improve...

Documents