The health board is predominantly a commissioning organisation, buying services on behalf of the population from a wide range of providers, including from primary care contractors, independent sector care homes, ambulance services, district general hospitals and other specialist hospitals. There are a range of directly provided services across Powys, including a network of community hospitals, a health and social care centre, community services such as district nursing, midwifery and health visiting, therapies, mental health and services for people with a learning disability. Increasingly, services are jointly provided by the health board and Powys County Council, working together and pooling resources. Importantly, we have a highly engaged workforce, as demonstrated in the outcome of the national staff survey. PTHB staff have a positive view of their work and their employer and furthermore, they are being increasingly recognised for their innovative achievements.