The document summarizes health service reforms and their local implementation in NHS West Midlands and the Black Country Cluster. It discusses the establishment of Clinical Commissioning Groups to manage local budgets and buy health services. Within the Black Country Cluster, several CCGs have been declared for areas including Dudley, Sandwell, Walsall and Wolverhampton. It also describes the newly formed Dudley Health and Wellbeing Board and its roles in developing a joint health strategy through collaboration between the local authority and CCGs.