You can find details of any previous involvement exercises which have closed. 

If you click on the relevant section you are interested in, you will find relevant feedback or reports when these are made available.


Walsall CCG commissioned a pilot Prescription Ordering Hub in 2018, for nine GP practices, to handle requests for repeat prescriptions as another option to the GP practice repeat prescription ordering system. The POD service operated a telephone line for practices as a single point of contact for prescriptions. The aim was to reduce medicine wastage and associated high costs. 70,000 patients from Modality practices had access to this service from the following practices: 

  • Collingwood Practice  
  • Forrester Street Practice  
  • Harden Health Centre/Blakenall Practice  
  • Keys Family Practice  
  • Kingfisher Berkley Practice  
  • Modality Darlaston Practice  
  • New Invention Practice  
  • Pleck Medical Centre.  
  • St John's Medical Centre.  

The ICB carried out regular reviews of the service and these showed that the cost of the pilot outweighed the savings made and so it was not meeting the original aims. It was therefore decided that it did not make sense to extend the pilot to other areas of Walsall.  

A decision was taken to cease the pilot from the 31 May 2024 with the pilot GP practices instead, managing repeat prescriptions in line with their GMS/APMS contract and in line with all other practices across the Black Country. 

Whilst patients can still access prescriptions via a telephone call, the number would be changing, and it was therefore important for patients to understand how this decision impacted upon the way they arranged a repeat prescription.  

The ICB worked closely with the provider and practices to communicate the changes and the range of ways to order repeat prescriptions on the NHS App, by logging into their NHS account at, by completing a Prescription Request Form on their GP practice website or by contacting their GP practice via telephone. It also presented an opportunity to give advice about the best time to contact GP practices for repeat prescriptions (after 10am), to avoid the morning demand for appointments.  

To ensure patients from the nine practices and local stakeholders such as Healthwatch and third sector community groups were aware of the changes, a detailed plan set out the key messages for consistency and who to inform and when. A project group containing members of the ICB and Modality, was set up to ensure the changes were managed.  

A full suite of messaging was delivered to affected patients and stakeholders to ensure that patients were aware of the alternative arrangements. Communications were issued via text message to all affected patients who had a mobile number registered, via the POD service with current patients, POD telephone service (out of hours message, and holding message) practice website, via Healthwatch and third sector groups and nearby practices and pharmacies. 

In addition, the following took place: 

  • The ICB’s Digital team delivered NHS App train the trainer workshops to GP practice staff to support their patients.  
  • Communication support to patients that encouraged sign up for the NHS App, general access support for digital tools, and understanding the offer in line with the ICB digital strategy was fully embedded in the exit plans and delivered to patients. 
  • The service has retained an answer phone message until the end of 2024 to advise patients who may not have been made aware of any changes to the service. 

The POD service is now closed. Patients from the nine practices affected can order their repeat prescriptions on the NHS App, by logging into their NHS account at, by completing a Prescription Request Form on their GP practice website or by contacting their GP practice after 10am, to avoid the morning demand for appointments, for support with their repeat prescription request. 

If you, or someone you know, need support using the NHS App, they can seek guidance online at NHS App and your NHS account - NHS (, or they can contact their GP practice, weekdays after 10am.  

Only one known complaint was received through Time2Talk, the ICB’s customer services team. The patient was unable to get through to the service and no messaging was provided. This was quickly resolved.

The provider did not report any concerns from patients about the transition following the sharing of messaging. 

The four acute provider trusts in the Black Country (Sandwell and West Birmingham NHS Trust, The Dudley Group NHS Foundation Trust, The Royal Wolverhampton NHS Trust and Walsall Healthcare NHS Trust) are proposing to make changes to the urology services provided by the hospitals. 

To safely meet the demand of the local population, the four acute trusts, propose to:

  • Develop a centralised Renal Surgery Centre (Nephrectomies, and Partial Nephrectomies) (preferred site Dudley)
  • Expand the existing Pelvic Surgery Centre (Bladders and Prostatectomies) (preferred site Wolverhampton)
  • Develop a centralised service for Percutaneous Nephrolithotomy (PCNL) at a designated centre (preferred site Sandwell).

These proposals mean we will have urology departments operating across The Dudley Group NHS Foundation Trust, Sandwell and West Birmingham NHS Trust and The Royal Wolverhampton NHS Trust’s hospital sites, dedicated to delivering safe, responsive and high-quality care to the residents of the Black Country.

Under this approach, cross-site urology departments will ensure that patients with a planned service will have access to experts in their area of surgery, a reduction in waiting times and access to services faster.

Thank you to everyone who shared their views and experiences. We are currently analysing the responses and a report will be published here once it is finalised.

Read more about the proposed changes by visiting the Black Country Provider Collaborative website.

Our ICB involvement team supported HealthWatch Dudley in their project that teamed up with a local provider of supported accommodation for homeless and vulnerably housed people for six months in the second half of 2022. Healthwatch worked with Midland Heart Housing Association, to establish a monthly breakfast club at Saltbrook Place in Lye.  

Healthwatch attended regular drop-in sessions over tea and toast, where they signposted residents to services and listened to the barriers the tenants experienced accessing health and social care within the Dudley borough. Healthwatch added value to our visits with creative workshops, funded by Dudley Council for Voluntary Service (CVS) “What it’s like to be me” programme. The arts-based workshops enabled residents to holistically share their stories.  

Through being consistent and building trust, Healthwatch have been able to gain valuable insight on the things that matter most to them, which have been collated to improve services that will aim to improve peoples, health, well-being, and happiness.  As well as recognising there is still work to be done to improve access to further opportunities.

Read through the report here.

An involvement report detailing the findings from this exercise is currently being developed and will be shared here soon.

Read about the involvement exercise that took place, and the refreshed document here.

Risk stratification is a process used in healthcare, to assess and categorise people based on their level of risk. The goal is to identify and prioritise risks, allowing for more effective management and healthcare resource allocation. Risk stratification involves evaluating patient data to determine their likelihood of developing certain medical conditions or experiencing an adverse event such as an emergency hospital admission. 

The use of heath data in this way helps the local NHS to tailor services and allocate resources more effectively and efficiently. It also helps to focus resources on preventative health measures that reduce the risk of deteriorating health or the risk of an adverse event.

The ICB needs to ensure that it has made arrangements to ensure that the public understand the proposed use of data for risk stratification purposes between a commissioner and a provider of NHS funded health services. In order to test the appetite for sharing patient data in this way in the Black Country an involvement plan was developed with consideration of the wider programme of activity in this space across the Black Country, our statutory duties as an ICB and our approach to working with people and communities.

Over a course of 8 weeks, the ICB involvement team held focus groups with PPGs, carried out an online survey and held conversations at People Panels.

The report and findings can be found here.

​​In July 2022, a change in the law created our new organisation, NHS Black Country Integrated Care Board (ICB), to take over local healthcare planning from the former clinical commissioning group (CCG) serving the areas of Dudley, Sandwell, Walsall, and Wolverhampton. 

​​Since the ICB establishment we have been reviewing our clinical policies. This includes:

  • reviewing the four existing CCG policies to harmonise them into one new position for the ICB
  • implementing new policies to take into account national clinical guidelines and best practice.

This has been taking place in stages. At each stage people from the Black Country could share their views on each policy and the process. 

Stage 2

The involvement exercise for stage 2 took place between 28 February and 19 March 20024. The proposed clinical policies and changes for each area, can be found here.

The policies included for stage 2 were:

  • Hernias inguinal
  • Cholecystectomy
  • Use of diagnostic MRI (Magnetic resonance imaging) scan in the hip for arthritis
  • Helmet therapy for treatment of positional plagiocephaly/brachycephaly in children
  • Knee MRI (Magnet resonance imaging) when symptoms are suggestive of osteoarthritis
  • Knee MRI (Magnet resonance imaging) for suspected meniscal tears in primary care.

The medical or surgical interventions, test and treatments included for stage 2 were:

  • Blood transfusion
  • Liver function, creatinine kinase and lipid level tests (Lipid lowering therapy)
  • Pre-operative chest x-ray
  • Pre-operative Electrocardiogram (ECG)
  • Surgical Intervention for Benign Prostatic Hyperplasia (BPH)
  • Troponin tests
  • Vertebral augmentation for painful Osteoporotic vertebral fractures
  • Surgical removal of kidney stones
  • Prostate specific antigen (PSA) test
  • Cystoscopy for uncomplicated lower urinary tract symptoms
  • Diagnostic coronary angiography for low risk, stable chest pain
  • Exercise ECG (Electrocardiogram) for screening for Coronary Heart Disease (CHD) - outpatients
  • Appendicectomy without confirmation of appendicitis
  • Upper GI (gastrointestinal) endoscopy - inpatients
  • Upper GI (gastrointestinal) endoscopy - outpatients
  • Early endoscopic retrograde ERCP (Endoscopic retrograde cholangiopancreatography) in acute gallstone pancreatitis without cholangitis
  • Appropriate colonoscopy in the management of hereditary colorectal cancer - inpatients
  • Appropriate colonoscopy in the management of hereditary colorectal cancer - outpatients
  • Repeat colonoscopy

An involvement report detailing results of this exercise and feedback from the Clinical Policy Development Group (CPDG) can be downloaded and viewed here.

Building on the insights from the Joint Forward Plan involvement activity in early 2023, NHS partners in the Black Country, with support from a number of voluntary, community & social enterprise (VCSE) and patient and public involvement partners, conducted a listening exercise in November and December 2023, to help understand residents’ experiences, attitudes, and views regarding urgent, emergency and elective care services, and to gauge appetite for doing things differently.  

Our involvement approach was designed in such a way that we started with the people and communities often furthest away from services, or who face the greatest levels of disadvantage and poorest health outcomes. Activities consisted of a series of focus group discussions and a microgrant scheme, which resourced VCSE sector hosted ‘community conversations’.

  • 58 local residents took part in the eight facilitated focus groups held across Dudley, Sandwell, Wolverhampton and Walsall
  • 202 individuals took part in 19 community chats or activities led by voluntary and community groups representing communities identified in an equality analysis

A range of themes emerged during the activities. The following were the most prevalent:  

  • Person-centred care and the attitude of staff – ensuring patients feel listened to, taken seriously and treated with dignity and respect, whilst being cared for by supportive and experienced staff.  
  • Communication and understanding – patients want clear and concise information, in a way that they understand. Numerous challenges were identified in achieving this, including having a learning disability or autism, language barriers and being hard of hearing / deaf. Additionally, participants referred to the communication between different services/providers and the importance of ‘joined-up care’.  
  • Waiting and appointment times – patients want to be seen as soon as possible in urgent and emergency care settings, and be seen within a reasonable timeframe, and on time, for planned care. Whilst waiting, patients want to be kept informed.  
  • Access to good quality care for all – patients want good quality and the right care and treatment for their concerns. To ensure accessibility for all, services must be inclusive of family members, carers and other support structures that patients rely heavily upon.  

Without the support and assistance of our VCSE partners, it’s unlikely the NHS in the Black Country would have been able to capture the insights and experiences of people facing the worst health outcomes and greatest health inequalities. 

A full involvement report along with an analysis of the findings is now available. The report has been presented to the ICB and the Black County Provider Collaborative and used to decide on next steps around developing a case for change and if service change is needed.

Welcome to Wolverhampton is an event led by the OneWolverhampton partnership, with support from the Black Country ICB, the City of Wolverhampton’s public health, Refugee and Migrants Centre, and Absolute Interpreting. It will initially focus on vulnerable migrants and asylum seekers who have arrived within the last six to twelve months. This cohort of people is the most vulnerable and will have different needs to those that have been housed and are integrating into the community. The focus of the event is to understand the UK healthcare system and to provide health literacy that is culturally sensitive and translated professionally.  

This event was an information session for vulnerable migrants and asylum seekers as well as a vehicle for understanding the barriers new communities experience when arriving in Wolverhampton. Understanding the barriers will help to inform us and contribute to any co-production projects within this area.  

The event was held in February at one of the hotels currently offering emergency accommodation, with interpreters for the top ten languages and digital translation available for all others. Findings from the event will be shared with OneWolverhampton colleagues to improve working with newly arrived migrants to the area.

​​In July 2022, a change in the law created our new organisation, NHS Black Country Integrated Care Board (ICB), to take over local healthcare planning from the former clinical commissioning group (CCG) serving the areas of Dudley, Sandwell, Walsall, and Wolverhampton. 

​​Since the ICB establishment we have been reviewing our clinical policies. This includes:

  • reviewing the four existing CCG policies to harmonise them into one new position for the ICB
  • implementing new policies to take into account national clinical guidelines and best practice.

This has been taking place in stages. At each stage people from the Black Country could share their views on each policy and the process. 

Stage 1

The involvement exercise for stage 1 took place between 5 and 26 February 2024. The proposed clinical policies and changes for each area, can be found here.

The policies included for stage 1 were:

  • Hysterectomy for heavy menstrual bleeding
  • Carpal tunnel
  • Tonsillectomy
  • Varicose veins
  • Dupuytrens contracture
  • Trigger finger
  • Vasectomy
  • Anal skin tags removal
  • Tattoo removal
  • Reversal of female sterilisation
  • Hair removal
  • Surgery for snoring
  • Botox for Hyperhidrosis
  • Reversal of male sterilisation
  • Botox for cosmetics
  • Alopecia - hair replacement
  • Spider Angiomas and veins
  • Skin resurfacing

An involvement report detailing results of this exercise and feedback from the Clinical Policy Development Group (CPDG) can be downloaded and viewed here.

In August 2023, the involvement team were asked to assist Lockstown GP practice, Willenhall as their landlord had given them notice to vacate the building that their branch surgery Fisher Street, operated from. The involvement team provided the practice with advice, support, information, and templates to assist them with their involvement with local patients and stakeholders to obtain views about the  proposed closure of the branch surgery on Fisher Street. These views were taken on board by the practice to help patients with any difficulties. The practice was also advised to complete a Heat Assessment Tool (HEAT) to highlight the stakeholders who may be affected by the proposed closure.  A report of the involvement activities to support the application for the proposed closure was submitted in November 2023 which was approved in January 2024.   

The Chair of the Primary Care Sub-Committee complimented the practice on the involvement activities that they had undertaken to obtain views and to keep patients and stakeholders involved.  The application was approved and the practice then contacted patients and stakeholders again to inform them of the decision via a letter and other communication methods before the practice closed on 19 January 2024.  

The practice manager, Lisa Wolverson , said: “I am really grateful to the Black Country ICB involvement team for their support and step-by-step guidance to support our practice with the closure of our branch surgery”.


From Monday 27 November, through to Friday 1 December, DIHC hosted a pop-up health and wellbeing shop at the Churchill Shopping Precinct in Dudley town centre.  

Before this event, the Dudley Involvement Specialist supported the planning of this event by visiting the venue to ensure it met the needs of the public who were attending throughout the week. The Dudley Involvement Specialist also promoted the event to other key stakeholders and our key supporters in helping to raise awareness of this event.  

The Healthy Heart Hub was held every day from 9.30am until 3.30pm and offered free blood pressure checks with tailored support and advice from Health and Wellbeing Coaches. Throughout the week, local partners joined the pop-up shop to provide information and practical advice on a range of health and wellbeing topics, including mental health, addiction, sexual health, living independently, ageing well, cancer screening and support services, strokes, learning disabilities, digital access, adult learning and more.  

The event was well received by members of the public and around 500 people engaged with the event throughout the week. Feedback was overwhelmingly positive with comments around it being a positive experience and great to get your blood pressure checked without making an appointment.  

The Healthy Hearts Hub (including Health Coaches, Pharmacists, and University Pharmacy students) connected with over 300 individuals and approximately 230 individuals had their blood pressure taken by the hub and cardiovascular related health education was provided.  

University of Birmingham School of Pharmacy students and foundation year trainee pharmacists from Dudley Group NHS Foundation Trust helped to assist the Healthy Hearts hub by checking blood pressure and producing literature for health education. The literature included advice on high blood pressure, healthy kidneys, cardiovascular disease and diabetes. Students enhanced their communication skills whilst interacting with members of the public. 

Dental services across the West Midlands are commissioned by the Office of the West Midlands, on behalf of the ICB. They are keen to understand what’s important to local people when accessing orthodontic treatment to shape how these services are provided in the future.  

Thank you to everyone who contributed to the survey, we will update this page with the results once they have been analysed.

The new Hatherton Medical Centre opened in November 2023. Earlier in 2023, the involvement team assisted Umbrella Medical (a partnership of GP practices, some of which would be moving into the new building) by providing advice and guidance on involving patients and local stakeholders.  

The new building had been built following a consultation in 2017 and the Umbrella group contacted the involvement team for advice on updating their patients about the move to the new building and also the back-office merger of the GP practice lists to become one list. The group was required to undertake involvement in the back-office merger of practice lists to be able to provide evidence as part of their application to be presented at the Primary Care Sub-committee meeting  

The involvement and communications team worked with practice staff to advise them on involvement and communication activities to keep patients, PPG members, and local stakeholders informed of the move.

An online survey was conducted between 5 and 19 September 2023​ to understand the behaviours of our local population when accessing urgent and emergency care services in the Black Country. Participants of the survey all lived within the Black Country ICB footprint, in either Dudley, Sandwell, Wolverhampton or Walsall. ​The survey data was weighted to reflect local population sizes by age and gender and to ensure that the data was representative by these variables. ​628 people completed the survey.

See the full urgent and emergency care survey report here. The key findings from the survey were:

  • In terms of actual behaviour, visiting a GP service is what people do when they need urgent care. While NHS 111 telephone was the most used NHS service for urgent care, it was not frequently used. Most frequently, pharmacies and GP services were used to access urgent care. This data could suggest that in urgent care situations, people prefer to speak to someone. In volume terms, GP services accounted for the most visits (combining GP surgeries, GP out-of-hours and walk-in centres these accounted for 34% of all urgent care visits). However, a fifth of all urgent care visits were accounted for by emergency services (999 – 10%; A&E 11%).
  • People are reasonably informed on which service to use. Respondents were reasonably well informed about what to do in given situations. For all the hypothetical situations given the top choice was a valid choice. For example, GP surgeries were the first choice for a rash, a urine infection, or a persistent cough. A third (37%) of people would call 999 if they had difficulty breathing, which is an appropriate choice in this situation. A quarter (26%) would look after themselves if they had a high temperature, which is a valid choice.
  • Awareness of Urgent Treatment Centres (UTCs) is good, but knowledge could be better. Knowledge of UTCs was relatively good but could be better. There are differences in knowledge of UTCs by area. Those living in either Sandwell or Wolverhampton tend to know a lot more about UTCs compared to populations in Walsall and Dudley. A third (35%) of those who live in Dudley had only heard the name before. There is a gap in knowledge levels among those aged 55+ years. Only 8% of this group know a lot about UTCs and a quarter (25%) of over 55s have never heard of them before. Awareness of UTCs is strongest among 16–34-year-olds, with 22% knowing a lot about them. The most popular time for accessing a UTC was on a weekday outside of GP opening hours (43%). 4 in 10 (39%) people have accessed UTCs on weekdays during GP opening hours.
  • There is evidence that accessing NHS 111 services by telephone is a barrier to some ethnic minorities. Overall awareness of NHS 111 is strong, with 99% of respondents having (at least) heard the name. However, knowledge can still be improved. While 83% of the sample know something about the service, only a quarter (25%) know a lot. Awareness of NHS 111 telephone (69%) services was higher than NHS 111 online (60%). However, usage of NHS 111 telephone was almost double that of online methods (30% to 54%). This suggests that people prefer to talk to someone in urgent care situations. Usage of NHS 111 services was broadly similar by sub-groups. However, older respondents were less likely to access NHS 111 services online than younger respondents. Also, there was some variation by ethnicity. Ethnic minorities were less likely to access NHS 111 services by telephone – this could suggest that there are barriers to accessing services by telephone. Overall awareness of what services NHS 111 can provide was moderate and slightly lower than similar surveys we have conducted. This suggests that depth of knowledge of what services NHS 111 can provide could be improved. The two most known services were checking symptoms (69%) and advice on what NHS service to contact (60%).
  • Opinion of NHS 111 is good, but many see it as inferior to face-to-face. Sentiment to NHS 111 was relatively positive, with high agreement across all statements. There was strong trust in the advice given by NHS 111 and four out of ten (40%) strongly agreed that the advice given by NHS 111 can be trusted. Satisfaction with the range of services was also high (74% agreed). However, a large minority (21%) disagreed that NHS 111 services are as good as receiving them in person. 

These key findings helped to inform our system-wide winter communications plan for 2023/24. It also supported the approach to our ‘Think Which Service’ campaign which aims to inform local people of the services available to them, so they can choose the service that best suits their needs. Visit our dedicated ‘Think Which Service’ webpage to see how some of these insights have been addressed.

In developing a new dementia strategy for the Black Country, the Black Country Integrated Care Board (ICB) sought advice and assistance from the involvement team to capture the experiences and views of local people living with dementia.    

The involvement team visited dementia groups and other voluntary, community and social enterprise (VCSE) groups across the Black Country throughout September and October 2023. We were able to hear first hand the stories of those living with dementia, and their carers, family and loved ones. We also hosted 1-1 interviews with people living with young onset dementia with the support of admiral nurses. Overall, the involvement team visited 16 groups that supported families with dementia, and spoke to over 150 people.  

The top themes are:

  • Preventing Well – The belief that active healthy people won't get dementia and not knowing how dementia can be prevented. Misdiagnosis or missed diagnosis can cause significant delays to people accessing the right support.
  • Diagnosing Well – Most said they received support through diagnosis at a memory clinic, but once diagnosed were given too much information to digest and were left unsupported, unsure what to do next.
  • Supporting Well – Most support comes from carers, who themselves feel unsupported and forgotten, with no time for themselves or respite, impacting their own wellbeing. Other support comes from dementia cafés and groups, and potentially admiral nurses and community dementia services who are highly regarded
  • Living Well – More support is needed for carers, particularly when they are in crisis and have no[1]one to contact. Until the later stages people with dementia are left to self-manage.
  • Dying Well – There is not enough information or support in planning end of life care, arranging a Power of Attorney or encouraging conversations around dying and preferences, these need to be early on but often go ignored until the later stages of dementia, when it may be too late.

“The engagement/listening work that the involvement team has done to support the dementia strategy is fabulous. It was really well received and we had some really positive feedback from the Alzheimer’s society. Sadly the feedback was quite stark, showing that people with dementia and their carers are often struggling to get the help they need at the right time. It’ll be hugely important in shaping the strategy and making a difference for people in receipt of services and support and shaping the ongoing work in each of the four Places.” Senior Commissioning Manager – Mental Health & Learning Disabilities and Autism

 The dementia strategy will be added here when published, and a full report of our involvement findings to support the dementia strategy can be viewed here and views from people taking part in this involvement exercise can be read on the Community Conversations section of the ICB’s website.

Following on from the involvement work and coproduction of Black Breasts Matter, commissioners were keen to invite the group to attend the Wolverhampton Cancer Education Event to spread these key messages to general practitioners and primary care providers. The work was presented, and we facilitated difficult and restorative conversations, challenging current ways of working to increase breast screening uptake in black African and Caribbean women.     

In the follow-up survey of attendees that we conducted, the event received solely positive feedback, being described as, “enlightening”, “engaging” and “informative” numerous times by the GP and clinical directors in attendance. This cancer education event is soon to be replicated across Dudley, Sandwell, and Walsall.

Research has shown that women from Black African and Caribbean communities are known to develop breast cancer at a much younger age compared to white women. It also shows that seeking help and health advice at an earlier stage can contribute significantly to reducing inequalities in breast cancer outcomes.  

Using funds awarded to us from West Midlands Cancer Alliance, the involvement team worked with ICS colleagues to design and commission a two-stage project to understand the barriers to attending screening appointments, and, co-design solution-focused initiatives which have consisted of a four-week listening period and four co-design workshops. 

Six local VCSE organisations were commissioned to host conversations with local women to understand the barriers and stigmas in attendance at screening appointments or presenting at GPs with early symptoms. The insight gathered during the period of conversation and listening, was used to co-design solutions and interventions which was led by Dr Martin Bollard from the University of Wolverhampton. We learned about cultural beliefs surrounding cancer and the myths that are deeply rooted within communities, such as speaking about cancer wishes it upon someone, or that if no one in your family has had cancer, you can’t get it. 

The solutions the group designed are three fold; an infographic that tells their story, a talking head video of a mother and daughter myth busting through a conversation, and a culturally competent cancer champion and train the trainer programme. The infographic and video are currently in production, and the groups have been invited to attend the first round of cancer champion training to provide their feedback on what needs to be added or to design a new module to supplement the training to ensure its cultural competency. 

The system-wide cancer team is now looking to bid for funding to repeat similar projects using this methodology as a blueprint to focus on other communities facing poor health outcomes, and different cancers.

Feedback from the organisations involved

“The project has been beneficial because, through the representatives, it has allowed Black African and Caribbean women the opportunity to have a voice.  For too long, I feel policy makers have just assumed that they know best and have designed services to, generally, a one size fits all approach however, clearly people and communities are impacted in various ways be it cultural, social, physical, etc and therefore, their experiences and concerns should be listened to and their issues taken into account.” Caroline Webb, White House Cancer Support.

“It has been an educational and enjoyable experience, but it has only made me more determined in ensuring that whichever cultural or community you are from, everyone should receive good healthcare experiences.” Caroline Webb, White House Cancer Support.

“It has been very instrumental in all organisations that were successful with the bid to come together to feedback their findings, and share good practice. The exercises and group work was enjoyable and enhanced my skills and confidence to start to implement the co-production process with ease to implement change.” Member of THIA community interest company (CIC).

“I feel the project was short but effective in the approach allowing the team to engage with the women without restrictions and excessive paperwork. The resources provide, enabled us to have the tools and confidence to deliver parts of the workshops ourselves to the group.” Member of THIA community interest company (CIC).

Read more about this work and the Black Breasts Matter campaign.

In Wolverhampton, the commissioning team have rewritten the good practice guides for primary care, which details reasonable adjustments that should be made to address health inequalities at a local level. Before writing these, views, experiences, and ideas were sought from people and communities including people with a learning disability, severe mental health issues, dementia, people experiencing hearing loss, vulnerable migrants, Gypsy, Roma, and travellers, people experiencing homelessness, sex workers and people in contact with the criminal justice system.   

To ensure that the recommendations in these guides really reflect what people need, we visited each of the groups across the city to discuss their experiences, and understand the barriers they experience to accessing primary care and what they need to overcome these. Each of the groups we met had very different and specific needs, for example, refugees need to be able to book appointments in advance to allow time to arrange a translator, while people experiencing homelessness need to be able to walk in to book appointments. These were included in the guides which are an iterative process and open to changes dependent on what we hear people and communities need to improve their experience when accessing primary care. 

Work to support the recovery of Patient Participation Groups (PPGs) has continued. At the Health Scrutiny Committee in June, when a paper on PPGs was presented, it was outlined that there were eight practices who had not fully returned to delivery of PPGs. Out of those eight practices, all but one have recommenced and have held meetings or have meetings planned in the very near future. A new suite of resources has been produced on the ICB website and a training course, commissioned by OneWolverhampton place partnership, for practice managers and patient participation group chairs recently concluded. The training consisted of six virtual modules and all sessions were recorded as training videos and have been uploaded to the ICB website as a future resource. 

Work is being undertaken to procure a new contract for residential short breaks in Dudley. Representatives of the Parent Carer Forum are key members of the project group, and parents who use the service have also been involved in sharing feedback, and reviewing the service specification and will be involved in the assessment of any bids received. 

During August and September 2023, we asked members of the public about keeping themselves happy and healthy. Here is a summary of the responses we received from our August People Panels and our Black Country Voices membership, and what we have done with these views.

Responses from the August People Panels

Participants who attended the August 2023 People Panels in Dudley, Sandwell, Walsall, and Wolverhampton shared their views on what keeps them happy and healthy. Their responses can be found in the August People Panel records - there is one record for each People Panel.

Responses from Black Country Voices

In September 2023, we shared a survey with our Black Country Voices membership. 83 members responded to the survey, and responses to each question are detailed below:

  1. Who is responsible for your health and happiness? The most popular answer was Me (72%) and me and NHS (10%) with some people selecting more than one option such as me, friends and family, me and nurse and me and GP (between 1% and 5%.)
  2. Tell us about a time when you were really happy and healthy. The main response involved people’s families, such as bringing up their children or family holidays. Most of the respondents added that they are happy and healthy now.
  3. What in particular was it that supported you in being happy and healthy? Most people said their friends and family offered the support to be happy and healthy. Other factors included eating healthily and exercise.
  4. Based on this experience what do you wish we had more of in our community? What do you dream possible? The most popular answer was having access to free exercise and weight loss advice, closely followed by having more community group and support services available.

What have we done with your views?

All views have been analysed and results will be shared with partners across the Black Country.

One example included Active Black Country - we shared one of the themes from the survey around having access to free exercise and weight loss. Active Black Country shared information about ways to access free exercise and weight loss advice, called Black Country Moving, and Black Country Activation Academy, which will be shared with the Black Country Voices membership.

We will continue to share views from the survey with partners and different programmes of work locally, to support ongoing positive changes.

The City Lifestyle Survey has been commissioned by the City of Wolverhampton Council to provide information about the lifestyle choices people make, and to enable the council and organisations across the city to make even more informed decisions about services that could improve the health of the local population.  

We promoted the survey and sent it out to our Black Country Voices participants living in Wolverhampton which includes over 200 people interested in taking part in involvement activities to shape services.  

When the report has been written it will be published here: City Lifestyle Survey | City Of Wolverhampton Council  

On 20 April, we teamed up with the University of Wolverhampton and Healthwatch Wolverhampton on their week-long health campaign. Our involvement team hosted a drop-in session listening to students about their health matters and experiences of health care as a student in Wolverhampton. One of the recurring themes was how much students would like more work placements in the NHS but find these very hard to find. Some spoke about health inequalities and found our roles at the ICB interesting. Since then, we discussed with OneWolverhampton who have coordinated a work experience programme with the University, rotating around different roles across the ICB, City of Wolverhampton Council and Royal Wolverhampton Trust to get a flavour for the wide variety of work across the place-based partnership. The first four students will enrol on this placement in February 2024. 

In March 2023, the ICB worked with partners from a local hospital trust to shape the way services are offered at a Midwife Led Unit ahead of its refurbishment. Local women and families have had the opportunity to have their say on facilities within the unit and other ideas for improvements to help the Trust plan for the refurbishment, but also to understand what matters most to families when using maternity services and identify common issues or themes. 

The ICB have supported in developing a survey in collaboration with the trust and their Maternity Voices Partnership, but also supported targeted community conversations with local parent and baby groups. 

Comments from the survey can be read on the Walsall Healthcare Trust website.

In May 2023, we shared the below narrative to each question as set by NHS Assembly. These contributions will help inform the executive team at NHS England and wider partners about the NHS' recent past, where we are today, and set out the key future development. The full report, containing feedback from a range of NHS organisations, will be published for the NHS 75th birthday on 5 July.

Our contributions, from NHS Black Country Integrated Care Board (ICB), included the following:

1. What NHS features, developments or services are most important to celebrate and strengthen?

People and staff recognised the NHS being accessible to all and free at the point of need as key to the sustainability, longevity, the health of everyone and something which we should treasure and celebrate.

The NHS workforce, it’s resilience and dedication, and diversity was a strong theme, too. We frequently heard that the ‘NHS wouldn’t be here without them’ and that further investment and training was key to retention and sustainability.

Participants also recognised the improvements to health and care providers collaborating and working in a more joined up fashion. The view was that increased efforts here would further improve personalisation of care, access to services and support that would keep people well in the community and bring care and treatment closer to where people live.

Other themes arising included advancements in the use of digital and it’s role in reducing inequalities, the role of health education and research in innovation, improvements in mental health service provision – particularly for children – and the focus on prevention especially in relation to diabetes and nutrition.

2. Today, in which areas do you think the NHS is making progress?

People welcomed the strides taken to improve the development of partnerships and scope of collaboration. Embracing community-based solutions was seen as key to tackling health inequalities. But it was also noted that there remains much to do and complex barriers to overcome.

Advancements in biomedical and technology came through strongly in conversation with staff. Innovation in diagnostics and robotics, ground breaking advancements in medicine and clinical services leading to better support for people with LTC’s and comorbidities resulting in people living longer in better health and illnesses being cured.

The digital theme also featured heavily with people also recognising the role AI will have in health and care in the future.

Other themes that came up included the inclusivity of mental health, shared decision making leading to better personalised care, the streamlining of urgent care, greater focus on health inequalities and recognition that one size doesn’t fit all, the shared care record and administrative efficiencies.

3. Today, in which areas do you think the NHS most needs to improve?

The major theme arising here was workforce. Participants flagged the need to increase staffing levels – particularly more nurses and in acute settings – and that recruitment should be targeted in our communities and that fair pay and recognition was vital. Tackling discrimination, burnout and improved wellbeing support is vital. As well as recruiting and promoting a diverse set of leaders who recognise the importance of listening to people and communities by default.

On the other side of the ‘listening’ coin, our people noted that our health and care is ‘for’ citizens and that this must be reflected in all we do. Therefore, involving people with lived experience from a diverse range of backgrounds, listening to their stories and reacting collectively was key.

Reducing waits and restoring services to pre-pandemic levels was also came up in discussion a lot.

Staff and residents were also vocal about the importance of shifting energy and resources into the prevention and early intervention space in order to create a sustainable future for the NHS and where people lived healthier, happier lives.

Other themes included access and accessibility, keep the NHS free (not privitised), the need to increase mental health provision and the range of support available, embedding physical activities into care, the importance of a thriving VCFSE in delivering community groups and activities (rather than services) at ground level, less regulation and more autonomy at system level, digital inequality and the need for improvements in NHS digital infrastructure.

4. What are the important lessons from how the NHS has been changing the way it delivers care?

Our people and staff were in agreement that integration and collaboration was among the key lessons and objectives for changing and improving how care is delivered. Building on what we achieved during the Covid-19 pandemic will increase access to services and patient experience, ensure that the right person/team deliver care that is needed, improve decision making, create efficiencies across the system, reduce competition for resources.

Colleagues also recognised that the health service is more resilient and able to adapt to change at pace but that change needs to be embraced, and that leaders and decision makers must be braver and take controlled risks in order to transform and continuously improve.

Digital was also considered a key area for lessons learned with advancements in virtual consultations, virtual wards and infrastructure seen as positive. But some respondents were also mindful of the inequalities created by the shift services for some people and communities.

Other themes included localism, prevent not react, the importance of doing with not unto people, funding, addressing health inequalities, focus on workforce, the importance of education, training and clear messaging.

5. What should be the most important changes in the way that care is delivered, and health improved in coming years?

More local and more accessible services was the primary theme. Participants were clear that improvements were needed across the social care sector and that the system should have greater focus on care in peoples homes. People would like to see more services delivered in the community (such as diagnostics and testing), supported by greater investment and increased workforce.

Prevention and personalisation were among the most frequent themes we heard, too. A strong commitment to prevent ill health would help to reduce inequalities and therefore reduce the strain on the NHS. Health and care professionals need to understand that a ‘one size fits all’ approach is appropriate to meet peoples needs and systems needs to be more adaptable.

A holistic approach to tackling health inequalities is crucial with participants feeling strongly that it shouldn’t matter where you live or you background, everyone should be entitled to live healthily and happily. It was also noted that more support was needed for LGBTQ+ people.

Others themes included increasing the voice of children and young people in planning and decision making as well as greater awareness of the issues faced by young people in care, staffing and workforce, the need to listen more and broadcast less, involving people in conversations about their health and presenting them with more choice.

6. What would need to be in place to achieve these changes and ambitions?

An effective and diverse workforce that represents our communities with strong leadership (who are willing to be brave and take accountability for driving change) supported by a clear vision, workforce plan and appropriate, long term funding.

Key to integration are strong, meaningful partnerships with joint commissioning leading to a more joined up care pathway for patients.

Our people are our greatest gift. We must listen to our citizens and together, turn what we hear into action. We must trust communities as they have the solutions, and stop expecting them to trust us.

To read about our Joint Forward Plan listening exericse in full, including what it is, what we did and what we heard, please visit our dedicated web page here.

As part of our approach to working with people and communities, our co-designed principles acknowledge that we need to work harder to recognise the reasons behind the issues communities face and understand their needs, experiences, and priorities for health care. We committed to ensuring that insight from groups and communities who experience health inequalities is sought effectively and used to make changes to care and we know that the only way to do this, is to work with our voluntary and community sector, and to resource them to have these conversations.

The ICB are currently developing their Joint Forward Plan which will describe how we intend to use NHS budget to ensure local services meet local need, give investment to areas to tackle health inequalities and set out the challenges which we face today and those that we recognise are affecting local people. To get this plan right, and to have the best impact on local people and communities, we need to hear what matters to them.

Over the past few months, we have reviewed feedback which local people have already given via surveys, and we have asked HealthWatch colleagues what they think are the main issues facing local people. We have also reached out to community and voluntary sector organisations, who we awarded small grants to host their own community conversations and events, and we have been out talking to local people.

What we heard

With the support of Voluntary and Community Sector (VCSE) partners working with and supporting underserved communities, we heard from groups working with or supporting victims of domestic violence, people in the criminal justice system/ex-offenders, sex workers, homeless and rough sleepers, asylum seekers, refugees or people who’ve recently settled in the UK, children and young people, people living with a sensory impairment, people living with autism or a learning disability, people recovering from drug or alcohol addiction, people approaching end of life, Gypsy/Roma/Travellers, LGBTQ+, long term unemployed, Black, Asian and/or minority ethnic communities. 

We asked people three questions:

  1. What’s worrying you and how will this impact your health now or in the future?
  2. What should the NHS be focussing on, today and in the future?
  3. What steps could health and care leaders take to support people and communities to manage their own health and happiness?

Cost of living is a major concern for people and our team, partners and community contacts are increasingly hearing stories of people who are struggling to make ends meet. Rising costs, coupled with things like housing conditions, unemployment, long term health conditions and an increasing sense of isolation and loneliness for some are having a detrimental impact on people’s physical and mental health. Free car parking, free dental services and getting funding to where it’s needed were suggestions for reducing financial pressures.

Another theme that continues to come up is ‘communication’ as both a barrier and enabler to health – language barriers, lack of accessible information, not knowing who to speak to, or being able to understand information when we do get through to someone due to the use of jargon. We know that people who don’t speak English as a first language or who find reading difficult tend to experience poorer healthy life expectancy and quality of life, so it’s key that we make changes to how we communicate.

The nature of care and treatment pathways can be complicated and overwhelming for some people, particularly those who have additional needs such as a learning disability or sensory impairment. Personalisation, more choice and better continuity of care were all high on the list of priorities.

Waiting times and access to services, especially face to face appointments, with a GP or mental health support, when people need them, is a key priority for the people we’ve heard from. Mental health support for people with a learning disability, children and young people and the NHS workforce came through as something people feel health and care leaders should be focusing their energy and resources.

People also felt that population health would improve if the health and care workforce improved its knowledge and understanding of the support needs of people with disabilities, refugees and migrant people, as well as the role the voluntary community sector plays in providing local support, information, advice and guidance. Education and training for frontline staff and senior officials came up repeatedly.

By improving the ways in which we communicate, reducing language barriers and investing further in preventative support and the voluntary, community and social enterprise sector, people and communities can have greater control over their own health and happiness, which in turn could reduce reliance on health and care services.

What next?

Throughout January, a public conversation is happening to understand the views of a wide range of people and communities across the Black Country.

These views, combined with the feedback from our VCSE organisations, will influence the content and priorities for the plan. The plan will be published in Spring 2023.

The Involvement team have helped with the launch of the new Black Country 0-18 years website to support pregnant women, children and young people in the Black Country. This website has been created in partnership with local healthcare professionals and contains a range of health advice in one place.  

The team have shared the website with key stakeholders such as Healthwatch, safeguarding leads, children and young people’s team at local authorities and via our connections within communities such as Aspire4U, Sport4LifeUK, and Street Games. 

All feedback is  being analysed and  report is being developed which will be publicly available following Dudley Integrated Health and Care (DIHC) NHS Trust's Board meeting in February 2023. Go to DIHC website for more information: High Oak Surgery Our Public Conversation - Dudley Integrated Health and Care NHS (


In 2022, the Black Country and West Birmingham Clinical Commissioning Group (CCG) commissioned 11 voluntary, community, and social enterprises (VCSE) organisations to act as primary care ambassadors in their local communities providing information on accessing primary care and assisting people with downloading and using the NHS app. The pilot was a real success, with 421 local people being involved in the project, with 106 supported to download the app and 165 people signposted to receive support with digital skills and accessing digital devices and connectivity. The Primary Care Ambassador report can be viewed and downloaded here with more information.

In 2023, triggered by feedback from a patient participation group (PPG) Chair in Wolverhampton, the evaluation of the 6-week pilot NHS Ambassadors scheme, and survey results from the Joint Forward Plan, we have convened a group of ICB colleagues, patient representatives, and partners from the VCSE and Healthwave to discuss how we might improve patient/public awareness of the new Additional Roles Reimbursement Scheme (ARRS) roles in primary care in a similar style to the ambassadors pilot. The group intends to support the local communications plan around modern general practice and the extended healthcare team by working with trusted voices and members of communities who face barriers to accessing primary care.

Building on the conversations and work that went into the development of the ICS People and Communities Involvement Approach earlier this year and the development of the place-based involvement models during 2020-21, the ICB Involvement Team committed to hosting purpose-led, citizen spaces that motivate participation through involvement and ownership. Where collective intelligence, from the ground up, helps to inform and shape place and system priorities.

In late September/early October, the team hosted community leaders, advocates, spokespeople, trusted voices, champions, campaigners, activists etc in World Café style workshops in Dudley, Walsall, Wolverhampton and Sandwell. World Café promotes collaborative, mutual conversations that matter and are a great format for surfacing the collective wisdom in any room. The focus for all of the Cafes centred around the question ‘What does it really mean to start with people and genuinely work together to build healthy communities? How do we create the conditions for it to happen?’  

More than 100 people joined and contributed to the 4 Cafes at community venues across the Black Country and early feedback suggests that participants welcomed the fresh, alternative listening spaces. One participant in Dudley shared the following feedback ‘The Cafe was exceptional. I felt able to “say it like it was” with no fear of come-back. I learned that there is a wealth of knowledge, skill and enthusiasm that can be harvested to make a significant difference to support within the community and to influence decision makers that are of a practical and “low cost” implications.’

A small group of hosts and participants from the four Cafés are reconvening to reflect on the conversations heard, make sense of the insight shared and lift out the key themes, deeper questions for group consideration and actionable intelligence which we might co-design solutions to. Analysis has indicated Digital and Communication as prominent themes so the hosting team have liaised with system workstream leads and will be sharing info about the Black Country Connected device sharing scheme and convening a co-design group to begin addressing communication barriers.

A record of this round of World Cafes can be found here.

Find out more about People Panels and records from previous events.

The impact of COVID-19 has highlighted the need for greater digital development and data sharing across health and social care. One Health and Care, our NHS shared care record, is an exciting initiative that will improve the care provided to patients across the Black Country and surrounding areas.

A number of live events were held to capture people's views and questions about One Health and Care, as well as a short survey. All of this feedback has helped shape the content on our website, which explains more about how shared care records like One Health and Care work, and how the NHS and its partners keep your data safe. Please visit our webpage to learn more.

Following the merger of CCGs across the Black Country, a Clinical Policy Development Group was established to work through harmonising the former policies in each place into single polices to be adopted across the Black Country area.

The first stage of this work was to develop the Principles which would be used in the harmonisation of the policies. An engagement exercise was carried out in December 2021 to ask for views on the proposed principles and here you can read the principles report containing the feedback received.

In total 118 policies were reviewed for harmonisation and equity across the local area. This required patient and stakeholder engagement alongside engagement with clinicians.

The second stage of engagement commenced in February 2022 which contained the first group of 16 policies which went out for engagement to both clinicians, local people and partners.

This engagement took place through a variety of methods:

  • Digital: on-line survey, website, social media
  • Virtual meetings: four place-based virtual meetings for the public and stakeholders (Dudley, Sandwell, Walsall and Wolverhampton). Two specific clinician meetings for the Black Country
  • Opportunities for telephone and email feedback.
  • Paper copies of the survey distributed upon request and returned in a pre-paid envelope for entry onto the survey system.
  • Individual emails from the Clinical Lead for the policy work to encourage participation
  • The clinical lead also took part in a number of clinician-to-clinician discussions

This engagement concluded on Friday 4 March 2022 and the reports from the public meetings are detailed below:

So far, the engagement feedback particularly influenced the BMI threshold for the policies covering hip and knee surgery. Clinicians also gave numerous comments about the ASD (Arthroscopic Shoulder Decompression) policy. Patients who attended meetings were overall pleased that the proposed changes had a positive impact on healthcare services in the local area. Comments were also received regarding the Gamete Retrieval and Cryopreservation Policy which were also taken into consideration. It has been highlighted that the Black Country are leading the way with the harmonisation of clinical policies nationally.

Nottingham and Nottinghamshire CCG have recently been in touch with the CCG to learn about how the matrix team commenced this piece of work and to seek learning and good practice. Clinical lead, Dr Abrar Malik said “When we started the harmonisation of policies across the Black Country, it was important to provide equity of services to all our patients across the four local places. As part of this work, it was also essential for us to listen to the views of patients, clinicians and other stakeholders when we developed these policies.

Engagement on the remaining policies will take place in the Autumn 2022 and more details will be available on our website shortly.

As an ICB, we have high levels of opioid prescribing within our population – opioid dependence may be more likely to occur if a patient suffers with chronic pain. To effectively explore this, people living with chronic pain in the Black Country were invited to attend a series of free events to help understand and manage their pain.

Hosted by Flippin Pain™ - a public health campaign with a clear goal to change the way people think about, talk about, and treat persistent pain - the events included an interactive Brain Bus experience as well as a free public seminar.

The Brain Bus experience took place at local shopping sites over a 2-day period from Wednesday 28 September to Thursday 29 September and hosted multiple interactive activities for Black Country residents. Displayed throughout the Brain Bus were optical illusions, sensory experiments, and a virtual reality experience - all of which enabled a first-hand experience at some of the lesser-known phenomena of the human brain and our senses. Members of Flippin Pain™ were also readily available to discuss their campaign, providing expert knowledge and understanding of pain and pain management.

The public seminar took place at the YMCA Western Gateway in West Bromwich on Thursday 29 September and aimed to offer a fun, informative, and easy to understand exploration of pain and how to manage it. People from across the Black Country were able to share their own views and experiences of pain with a panel of experts.

This series of events helped us to better understand the people in our local communities who are suffering from chronic pain and/or long-term conditions. Moving forward, we are able to bring patient education into the pain work stream to explore, develop and procure key resources to support our local population.

The Involvement Team is currently working to co-produce place-based Engagement and Participation Models of Engagement. Work started on this piece of work in December 2020 and is ongoing in our four individual places.

Each involvement lead, together with the Managing Director in each Place, is with partners, voluntary sector, patients and members of the public to hold individual workshops to discuss a new model of engagement. These workshops are being held virtually via Zoom due to coronavirus.

Feedback from each workshop is used to develop the next workshop plan. Each Place is different and the end goal is to co-produce local models of engagement, with local people and partners. To view specific activity for one of our Places, please visit this page.

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