This has been a year where there have been uncertainties for all districts, and I have no doubt this will continue into 2019 and beyond as we strive to second guess the Fairer Funding Review, the impact of Brexit and adjust to the automation revolution.

As we near the close of yet another dramatic and busy 12 months, it is apparent that while there remains a national debate regarding the levels of demand placed upon acute services within the public service, there is also a continuation of pressure being placed upon other, often unseen staff, who have to manage increasing complexity and expectation.