This document summarizes priorities and changes for the NHS Cluster in the West Midlands region. It discusses focusing on high quality, safe, and efficient healthcare while managing the transformation of the NHS through strategies like prevention and early intervention. Key priorities include reducing infections, avoidable deaths, and pressure ulcers. The transition plan involves PCTs transitioning responsibilities to clinical commissioning groups and local offices of the NHS Commissioning Board. The future brings more challenges but also opportunities for greater patient and public involvement.