April brings the spring and is a time for renewal and growth. For us at NHS Wandsworth CCG, it is of course the start of a new financial year and it is also the start of our new closer working with Merton CCG and also Kingston and Richmond CCGs as part of a new South West London Alliance of CCGs.

Happily, many of our Board members will be providing continuity for the CCG and I remain as Chair, but we were sad to say goodbye to our Accountable Officer, Graham Mackenzie and Director of Commissioning, Lucie Waters. We have a new accountable officer, Sarah Blow who is the AO for Wandsworth, Merton, Kingston and Richmond with Sutton; due to join the Alliance in 2018.

We will be welcoming our new managing director, James Blythe, when he starts in May 2017.

These changes will bring opportunities for us to work with colleagues across south west London to make the big changes that need to happen to deliver our Sustainability and Transformation Plan. But we won't lose our clinically led local focus and with that in mind I was really pleased to hear about the work of our Wandle Locality Team at our last Board meeting on 22 March.

Mike Lane, GP clinical lead, Marion Endicott, Patient Consultative Group Chair and Claire Frampton, Locality Manager outlined some of the main areas of work for the locality over the past year. This included the Community Advice and Referral Service. This is a great service that identifies patients who have non-health needs relating to issues such as benefits, debt, housing, employment, family or immigration. Between March 2015 and September 2016, the service helped 425 patients from across 17 surgeries across the Wandle area. The practices found that the service reduced the number of people frequently attending their practice for non-health issues because they have better support from appropriate services.

This is just one of several impressive projects and it was really heartening to hear about work going on at a local level. These individual interactions make a difference.

The Board discussed and approved the CCG's operating plan for the next two years. This is the nuts and bolts of how we will commission services to support our Sustainability and Transformation Plan and ensure that people in Wandsworth have the right care. We also have plans to make the savings needed to ensure the future quality of NHS services.  We heard in detail about some of the initiatives that we will build on in the next couple of years.

A big part of the plan is the next stage in the development of the Multi-Specialty Community Provider (MCP) model of care. From 1 April, the first phase, including our enhanced care pathway and primary care enhanced services are being implemented. The second phase of the MCP takes on community adult health services and will start mid-year.

As well as the initiatives, we discussed the risks to delivering our plan. The financial situation is highly challenging and we have to make greater savings in the coming years than we have ever had to before while retaining a 0.5% reserve.

All of us on the Board, are concerned about the financial challenge and there was agreement that we need to look across south west London and work more closely with provider trusts. The Board also focused on the urgency with which we need to act so that we can make savings in this financial year.

This led us to two decisions about how we make best use of our budget. The first was to agree some changes to our Effective Commissioning Initiatives to bring them into line with clinical guidance and the policies of other south west London CCGs. This means that patients will have access to care which is evidence-based and most likely to be of benefit to them.

The second was to agree to review our guidance for some of the medicines, supplements and treatments available on the NHS in Wandsworth. The Board agreed that this should be done but that it would need robust engagement and consultation with patients and all others with an interest.

The Board also looked at a proposal for new governance arrangements for South West London Alliance. The Board approved the proposal but with caveats such as more clarity about the role of CCG governing bodies.

This was a meeting of goodbyes. Cathy Kerr, Director of Adult Social Care, Richmond and Wandsworth Councils, retired at the end of March. She has been a fantastic asset and will be greatly missed. Liz Bruce will be taking over her role.

Lucie Waters left at end of March to go to Sutton CCG. Lucie had been with us since we set up as a CCG and brought a huge wealth of experience fantastic commitment. We'll miss her energy and sense of fun.

Di Caulfield-Stoker, our nurse member, has also retired. There isn't a nurse in Wandsworth who hasn't been influenced either directly or by the systems Di put in place. Patient care is all the better for Di's input for which we are thoroughly grateful.

Finally, we formally thanked Graham. The CCG team has hugely valued his leadership and we wish him well for the future.