Merthyr Tydfil Rhondda Cynon Taff + CWM TAF COMMUNITY HEALTH COUNCIL Annual Report 2011/2012 CONTENTS PAGE Chairman’s Foreword 2 1. What is Cwm Taf Community Health Council? 3 Who are we? What are our duties? How do we do this? 2. Who is involved in the work of the CHC? 5 CHC Members CHC Staff 3. Chief Officer’s Report 7 4. What did we achieve in 2011/12? 8 Monitoring your local NHS services Listening to your views on local NHS services Providing an Advocacy service 5. How was the CHC’s budget spent? 20 6. Working with others 21 7. What are our plans for 2012/13? 23 8. How can you contact us? 24 Page | 1 CHAIRMAN’S FOREWORD 2011/12 has been a year of real progress for Cwm Taf Community Health Council (CHC). The reorganisation of 2010 brought together two separate CHCs and this last year has seen members and staff alike work closely together to deliver a major work programme. Cwm Taf still contains some of the most socially deprived communities in Wales as well as some of the highest levels of chronic and long term illness. This poses challenges for local health services, but also means our role as the independent patient voice remains as important as ever. This Annual Report sets out in more detail what we as a CHC achieved in 2011/12, but some areas are worth highlighting: The hard work of CHC members, not least in visiting, inspecting and monitoring services and listening to the views of people in the local communities we serve The work of the CHC staff, whether in providing high quality Advocacy support to patients and families or supporting the work on inspection, visiting and public engagement The major piece of public engagement work relating to proposals for changes in local adult mental health services. The CHC played a key role in influencing an outcome that reflected public views and concerns The continuing success of the Local Health Forums, enabling the CHC and Health Board to hear the views of local people The CHC itself has seen changes in 2011/12. Some excellent and longstanding Members left us – many of whom have come to the end of their term of service – and I would like to thank Mr Jeff Moore, our outgoing Chairman, as well as Councillor Brian Mansbridge, Councillor Jane Ward and Councillor John Daniel for their dedication and contribution to the work of the CHC. Page | 2 And if I may be so bold as to look forward, 2012/13 has already brought progress in a number of areas: The CHC has recruited a number of new Members, including filling the Voluntary Sector member vacancies from Rhondda Cynon Taff Links have already been established with new partner agencies, including the Valleys Race Equality Council. Indeed, engaging with a wider range of our local communities is a key priority for us in 2012/13 An increased CHC presence at community events such as The Big Bite Festival in Pontypridd We are, however, aware that major challenges are looming. The Welsh Government programme ‘Together for Health’ is driving proposals for major service change in our local and regional health services. We are already working closely with Health Boards and neighbouring CHCs to make sure there is effective and open public engagement over any proposed changes. To achieve that, we are committed to becoming more visible and more accessible to our local communities. Our aim remains to make a real and positive difference to the quality and range of your local health services. Mel Jehu, Chairman, Cwm Taf Community Health Council 1. WHAT IS CWM TAF COMMUNITY HEALTH COUNCIL? a) Who are we? Cwm Taf Community Health Council (CHC) is the independent voice for patients and the public within Cwm Taf which is made up of Rhondda Cynon Taff and Merthyr. There are 8 CHCs across Wales, serving their own local communities. Page | 3 b) What are our duties? We have four main statutory duties: To keep under review, from a patient and public perspective, local NHS services To work with local people, patients and communities, ensuring your views are heard on proposals for major change to local health services To enable local people to have a say about your health services To provide an independent advocacy service for those who wish to voice concerns or make a complaint about the NHS. c) How do we do this? We undertake a range of activities including: Regular monitoring visits by CHC Members, looking at NHS premises. We make recommendations for improvement where we think they are needed. Advising local NHS organisations on services and service proposals, making sure the views of local people and patients are taken into account Being consulted by the NHS on proposed changes to services or health premises Finding out patient’s views and perspectives on local health services through surveys, questionnaires or patient fora Providing an independent advocacy service You can help us too By sharing with us your experience of local NHS services – whether good or bad By letting the CHC know your views on any changes or developments that are being proposed in your local health services If you would like to contact us, you can find our details on page 24 of this report. Page | 4 2. WHO IS INVOLVED IN THE WORK OF THE CHC? Some of the Members of Cwm Taf CHC a) CHC Members CHCs are made up of local people – all unpaid volunteers - who monitor and scrutinize your local health services. Cwm Taf CHC has 24 Members (12 from Merthyr and 12 from Rhondda Cynon Taff). Our Members are appointed by the Welsh Government (12), local authorities (6) and the third (voluntary) sector (6). In 2011/12, the CHC membership was: Chair Vice-Chair Mr Jeff Moore Miss Laura Guard Welsh Government Appointments Miss Laura Guard Mr Mel Jehu Mrs Merryl Jones Ms Sandra Jones Mr Jeff Moore Page | 5 Mr Jeff Morgan Miss Dora Powell Dr Andrea Thomas Mrs Mary Williams (3 vacancies for Rhondda Cynon Taff) Local Authority Appointments Councillor Allan Jones Councillor Brian Mansbridge Councillor Glen Price Councillor Aurfron Roberts Councillor Jane Ward Councillor Dennis Weeks Third (voluntary) Sector Appointments Mrs Shelagh McCarthy Mrs Helen Thomas Mrs Yvonne Wood (3 vacancies for Rhondda Cynon Taff) The CHC also appointed a number of co-opted Members for 2011/12: Councillor John Daniel Mrs Jacqueline Jones Mr Elfed Lewis Mrs Ann Morgan Mrs Anne Williams Mrs Carol Withey b) CHC Staff (2011/12) The CHC Members are supported in their work by a team of CHC staff, who are based at the CHC offices in Pontypridd. Chief Officer Deputy Chief Officer Deputy Chief Officer Complaints Advocate Complaints Advocate Office Manager Office Manager PPI & Scrutiny & Monitoring Management Officer PPI & Scrutiny & Monitoring Management Officer Complaints Advocacy Support Officer Complaints Advocacy Support Officer Dr Paul Worthington Mr Gordon Harrop Mr Clive Barnby Mrs Joanne Harris Mrs Helen Hardcastle Mrs Jan Adams Mrs Helen Davies Mrs Emma Lewis Mrs Susan Haines Mrs Amelia Mansfield Mrs Tania Molloy Note: PPI – Public and Patient Involvement Page | 6 3. CHIEF OFFICER’S REPORT I came into post as Chief Officer in November 2011; many of the achievements and much of the progress set out in this report had already been secured or set in train by the time I arrived at Cwm Taf CHC. For this, I must pay significant credit to my predecessor as Chief Officer, Mr Gordon Harrop, as well as the Chair Mr Jeff Moore, Vice-Chair Miss Laura Guard, CHC Members and CHC staff. This is my opportunity to express my gratitude for their work and the support they have given me in my short time in the role. I feel as a CHC we have achieved much in 2011/12, and will continue this into the future. I would also like to highlight two other areas of real strength in the CHC that I have inherited: The strong yet challenging relationship between the CHC and Cwm Taf Health Board. I would like to thank both their Chairman, Dr Chris Jones and their Chief Executive, Mrs Allison Williams, for their continued work in ensuring the relationship remains constructive, courteous and businesslike The bringing together of two separate CHCs into the single Cwm Taf CHC in 2010/11 has brought forth a new, distinctive and strong organisation, which aims to enable the voice of Cwm Taf patients to be heard Dr Paul Worthington, Chief Officer, Cwm Taf CHC Page | 7 4. WHAT DID WE ACHIEVE IN 2011/12 4.1 Monitoring your local health care Visiting hospitals and other health care premises remains a central feature of our work. In 2011/12 CHC Members made 33 visits to hospital wards and departments, as well 15 visits in carrying out the national HPE (Hospital Patient Environment) assessment and 5 visits to GP Practices. Following monitoring visits, the Members involved will write up a report which picks up both good practice and areas which they think need attention or improvement. These reports are sent to the Health Board for their comments, response or action, and a copy of the report and response is made publicly available in the papers going to the CHC monthly Full Council meeting and on the CHC’s website. We are committed to making the results of this work accessible and open to the communities we serve. The HPE exercise takes place annually in the autumn and includes Prince Charles Hospital, Royal Glamorgan Hospital and two local community hospitals. The visits look in detail at the quality of the care environment for patients, and the Health Board are tasked with responding to any areas need improvement. CHC Members have also continued to join the ‘walkabouts’ with Health Board Directors, which look at the quality of care and the patient environment. The programme of visiting is an important part of the work of Members, and Cwm Taf CHC is fortunate in having Members who have delivered an extensive and high quality programme of visiting and reporting. We have seen improvements in hospital cleanliness and patient dignity as a result. However, we know we need to improve our monitoring of how well the specific actions and recommendations from our visits are acted on. Page | 8 The table below sets out the programme of visits undertaken in 2011/12 Figure 1: Monitoring Visits by Cwm Taf: April 2011-March 2012 Date of visit Type of activity Tuesday 5 April 2011 Prince Charles Hospital (PCH), Ward 34/ Medical Assessment Unit Friday 15 April 2011 St Tydfils Hospital, Ward 1 Friday 15 April 2011 St Tydfils Hospital, Ward 2 Wednesday 20 April 2011 Dowlais Medical Practice Thursday 28 April 2011 Royal Glamorgan Hospital (RGH), Diabetic Unit Thursday 5 May 2011 Dewi Sant Hospital, Ward 1 Thursday 12 May Aberdare Hospital, Amman Ward 2011 Tuesday 17 May 2011 Prince Charles Hospital, Day Surgery Unit Wednesday 18 May 2011 St Johns Medical Practice, Aberdare Wednesday 8 June 2011 PCH, Endoscopy Thursday 16 June 2011 Pontcae Medical Practice, Merthyr Tydfil Monday 20 June 2011 Aberdare General Hospital, Ward C Tuesday 12 July 2011 St Tydfils Hospital, Trecynon Assessment Unit Tuesday 12 July 2011 St Tydfils Hospital, Penderyn Ward Friday 22 July 2011 Maendy Place Surgery, Aberdare Friday 22 July 2011 PCH, Ward 11 Friday 22 July 2011 PCH, Ward 12 Monday 8 August 2011 PCH, A & E Tuesday 9 August 2011 PCH, Emergency Care Centre Wednesday 10 August Aberdare Hospital, Minor Injuries 2011 Wednesday 10 August Aberdare Hospital, Physiotherapy 2011 Thursday 11 August 2011 RGH, Rhondda Ward Thursday 11 August 2011 RGH, Taff Ely Ward Thursday 11 August RGH, Perinatal Intensive Care Unit 2011 Wednesday 31 August Hirwaun GP Practice Page | 9 2011 Wednesday 7 September RGH, Endoscopy Unit 2011 Tuesday 13 September PCH, Renal Dialysis Unit 2011 Thursday 29 September HPE- Dewi Sant Hospital 2011 Thursday 6 October HPE – Ysbyty Cwm Rhondda 2011 Tuesday 11 October HPE – PCH External (Evening) 2011 Wednesday 12 October HPE – Velindre 2011 Thursday 20 October HPE – PCH 2011 Thursday 27 October HPE – RGH External (Evening) 2011 Monday 31 October 2011 HPE - RGH Tuesday 22 November St Tydfils Hospital, Trecynon Ward 2011 Thursday 8 December HPE - Dewi Sant Hospital 2011 Wednesday 28 December St Tydfils Hospital, Cyfartha Ward 2011 Wednesday 11 January HPE follow-up, Ysbyty Cwm Rhondda 2012 Tuesday 17 January 2012 PCH, Podiatry & Orthotics Wednesday 18 January HPE follow-up (evening), PCH 2012 Tuesday 24 January 2012 HPE follow-up (evening), RGH Friday 3 February 2012 HPE follow-up, Dewi Sant (Outpatients & Ward 4) Friday 10 February 2012 HPE follow-up, RGH Friday 17 February 2012 RGH, Outpatients Friday 17 February 2012 HPE follow-up, PCH Wednesday 14 March PCH, Ward 8 2012 Thursday 15 March 2012 Ysbyty George Thomas, Cambrian Ward Page | 10 Thursday 15 March 2012 Ysbyty George Thomas, Physiotherapy Thursday 15 March 2012 Ysbyty George Thomas, Day Unit Thursday 15 March 2012 Ysbyty George Thomas, Fernhill Ward Thursday 15 March 2012 Ysbyty George Thomas, Dinas Ward Thursday 15 March Ysbyty George Thomas, Recovery 2012 Support Unit Wednesday 21 March HPE follow-up, PCH, Ward 4 2012 Key: Standard CHC Visit HPE Visit Primary Care Visit 4.2 Listening to your views on local health services a) Why your views are important Another key duty as a CHC is finding out what the people of Cwm Taf think of the health services they use. Hearing your experiences – good and bad – of GP practices, dentists, optician, pharmacists, hospitals, community health, ambulance services and other health service is important to us; it helps to inform what monitoring visits we do and what we should be looking for; it helps us to identify and support good care and good practice; it also helps us to point out to the Health Boards and other health service bodies where they need to improve. The people and communities of Cwm Taf use the full range of health services every single day. As a CHC, we are committed to improving the way we engage with the people we serve and find out their views and experiences. b) Local Health Forums These are one of the main elements of the CHC public and patient engagement activities has been the locality –based Health Forum meetings delivered in partnership with Cwm Taf Health Board. They Page | 11 are held usually every two months, open to any member of the public. The meetings have focused on a number of issues including: Minor injuries services in Ysbyty Cwm Rhondda A&E services at Royal Glamorgan Hospital Merthyr Health Park The new Ysbyty Cwm Cynon Reshaping of adult mental health services Updates on ‘Together for Health’ and future strategies for healthcare in Cwm Taf The Forum meeting in Cynon Valley, Rhondda and Merthyr Tydfil have attracted good numbers and passionate discussion. The Taff Ely Forum has had smaller numbers, although the meetings in 2012/13 have shown a noticeable increase in attendance. c) National Consultation The CHC has also been involved in a number of national or joint exercises including: Access to GP practices Welsh Government consultation on organ donation legislation General Medical Council consultation on guidance for professional standards d) Local consultation A major piece of public engagement work for the CHC in 2011/12 was concerned with Cwm Taf Health Boards proposals for service changes in local adult mental health services. The CHC secured agreement to a longer and broader consultation process, including an extensive programme of consultation meeting with patients, carers, local communities and their interested groups. Crucially, the CHC and Health Board maintained constructive joint working throughout; CHC members also played a key role in listening to feedback from the public and offering a constructive challenge to the proposals. Through this public consultation over the summer of 2011, the CHC was able to hear patient and carer concerns about some aspects of Page | 12 the proposals. To their credit, the LHB responded to these concerns with a revised set of proposals which were consulted upon during September 2011, receiving public and CHC support. The consultation went well and was strongly influenced by Cwm Taf CHC. We believe the process and outcome demonstrated: The CHC was able to serve its public well by enabling proper scrutiny of the proposals The robust but effective working relationship between the CHC and Health Board The CHC working with local communities and patients The ability and willingness of the CHC to test and challenge service change proposals, in the light of public opinion The ability of the CHC to secure positive service change which reflects public views 4.3 Providing an Advocacy Service a) What is the Advocacy Service? CHC Advocates offer independent support and advice to people who have a concern or complaint about NHS services. We provide assistance through the various stages of the NHS Complaints Procedure. Cwm Taf CHC’s Advocacy Service is a highly valued, respected and essential element of our work, and one whose importance and profile has continued to grow. It is significant to the CHC in a number of ways: It provides direct support to people who have concerns or complaints about the care they have received It enables very direct customer contact between the CHC and the people we are set up to serve Its work informs other care elements of our work, such as visiting and monitoring and identifying strengths and weaknesses in local services The Advocacy service is an integral part of the CHC, provided exclusively by CHC staff, a number of whom who are working towards professional qualifications and external accreditation. Page | 13 From 01st April 2011 the new ‘Putting Things Right’ guidance had been in place for the handling of NHS complaints. This has also been accompanied by a more standardised approach across all Welsh CHC’s to advocacy and the supporting documentation. b) Issues and challenges The Advocacy Service saw a number of issues emerging in 2011/12: The cases coming to the service are becoming more complex; it is not unusual for complainants to raise concerns involving both hospital and primary care services, and complaints often involve a number of consultants or clinical staff At the same time, the Advocacy Team remains small in number , and the increasing complexity of the caseload is a big challenge to the CHC There have been increased delays in the response times by service providers on complaints following the introduction of Putting Things Right. This has created additional work for the Advocacy Service in chasing progress on complaints and getting a timely and satisfactory resolution to complaints The complaints and concerns received by CHCs throughout Wales are recorded and monitored on a specialist database called Customisable Analysis Management System (CAMS). However, CAMS is becoming outdated and a new system called Datix, which produces better reporting information, will be in place by 2013 c) Feedback on the Advocacy Service Client satisfaction questionnaires are completed at the conclusion of a complaint, and the results from these questionnaires for Cwm Taf CHC are set out below. By far the majority of clients report they are happy with the quality, timeliness and level of support provided by the service. We are told regularly by clients that the support of the Advocacy Service enabled them to follow up their concern through the complaints process. The Health Board have also signposted patients and families to the service, indicating the benefit some can gain from having the support of an independent CHC Advocate. Page | 14 Figure 2: Summary of feedback on the Advocacy Service How did you feel you were supported by the advocate? 3% 0% Very Well 14% Well Average 83% Poor Would you have pursued your complaint without the Advocates help? 0% Yes 40% No 60% Not Answered Did the advocate deal with your complaint promptly throughout the course? 0% Yes No 100% Page | 15 Not answered Were you happy with the advice/help you were given? 0% Yes No 100% If the Advocate accompanied you to a meeting or hearing did we give you Enough Help 43% Not enough Help 57% N/A 0% Was there a satisfactory outcome to your complaint? 7% yes No 37% 56% Page | 16 Not answered Would you recommend the CHC Advocacy Service to other people? 0% Yes No 100% Not Answered ` For the Advocacy Service, it is paramount that patients or family members have a satisfactory outcome to their concerns. This is not always achieved. However, one of our major aims is to ensure that clients have as much information as possible on their options from the outset; this can mean their concerns are addressed and possibly resolved at an early stage. The Advocacy Service has made good progress in helping to do this, and continues to provide timely, expert and professional support to all who seek our help. However, the continued number and increased complexity of complaints with which the Advocacy Service is dealing does indicate there are still real service issues that we as a CHC need to be alert to. d) Analysis of complaints Each concern or complaint we deal with is, by its very nature, individual and unique to that patient or family. However, a number of main themes emerge from the concerns brought to us: Clinical practice: concerns regarding diagnosis, treatment and follow-on care Communication: poor quality of communication with patients, poor information or staff attitudes Timeliness of service: including cancellation of operations, appointments or treatment, difficulty in getting treatment or appointments and long waiting times for treatment Standards of care: including privacy and dignity issues and access to appropriate support Page | 17 Patient care environment: including issues of cleanliness, hygiene, hospital and other healthcare facilities The most common non-clinical cause of complaint remains communication issues, and this is an area where the CHC will continue to focus attention. We will press for clear and consistent patient/carer information and make sure our visiting and monitoring teams are alert to ensure that patients are treated with respect and dignity, but kept well informed about their care and treatment. Figure 3: Summary of complaints Complaints Report April-June 2011 100 80 60 40 20 0 Number of active Number of complaints Enquiries received & complaints(data not received this quarter cleared collected-computer error) Complaints Report July-Sept 2011 100 80 60 40 20 0 Number of active complaints Page | 18 Number of complaints received this quarter Enquiries received & cleared Complaints Report Oct-Dec 2011 100 80 60 40 20 0 Number of active complaints Number of complaints received this quarter Enquiries received & cleared Complaints Report Jan-March 2012 100 80 60 40 20 0 Number of active complaints Page | 19 Number of complaints received this quarter Enquiries received & cleared 5 . HOW WAS THE CHC BUDGET SPENT IN 2011/12? Figure 4: Analysis of Cwm Taf CHC budget 2011/12 CHC Budget Budget Expenditure 192, 585 16, 106 63, 745 Over/(Under) spending £ 182, 755 (9, 829) 27, 441 11, 335 62, 239 (1, 505) £ Fixed costs Variable costs Cwm Taf Advocacy Service Total £ £ 272, 436 272, 436 0.00 Note: there is some rounding up of figures As the table sets out, we achieved a balanced budget in 2011/12. There are some points worth highlighting: The overspend in variable costs is due largely to costs incurred in the CHC’s relocation to its new offices in Pontypridd. This has, however, brought significant benefits, with all staff working together in an improved environment, better parking for staff, visitors and Members and good value running costs. We underspent on staff costs as a result of periods where we had some vacancies. However, we hope to be up to full complement in 2012/13, and have also funded additional advocacy hours. We feel the CHC achieved real value for money against a challenging financial position and increasing demands on both Members and staff. The Advocacy Service in particular has a low level of funding when set in an all-Wales perspective. Page | 20 6. WORKING WITH OTHERS Good working relationships with other organisations are critical to our work. The relationship with Cwm Taf Health Board has been extremely constructive but robust, with the CHC acting as a critical and independent friend; prepared to both challenge and support the Health Board. CHC staff and members have regular contact with Health Board staff. Similarly, Health Board representation at CHC meetings – and vice versa – remains strong and engaged. CHC members and staff are also involved in a significant amount of work with other groups and agencies, and we bring back regular reports to Full Council. Details of this involvement are set out below: Figure 5: Involvement in external groups 2011/2012 Group Cwm Taf LHB (Board meetings) Cwm Taf LHB Quality, Patient Safety & Public Committee Cwm Taf LHB Diabetic Planning Group Cwm Taf Maternity Services Liaison Group Cwm Taf LHB Catering & Nutrition Group Cwm Taf LHB Audiology Group Cwm Taf Pharmacy Group Cwm Taf Medical Advisory Group South East Wales Ambulance Liaison Group Board of CHCs Ambulance Group Page | 21 CHC Representatives Chair and Chief Officer Miss Laura Guard Miss Laura Guard Mrs Sandra Jones Mrs Merryl Kay Jones and Mrs Shelagh McCarthy Mrs Shelagh McCarthy Mr Jeff Moore Dr Andrea Thomas Mr Gordon Harrop (Deputy Chief Officer) – till 30 May 2012 Mr Mel Jehu and Chief Officer Group Stakeholder Reference Group CHC Representatives Mr Jeff Morgan, Mrs Helen Thomas and Chief Officer Board of CHCs Disability Equality Mrs Helen Thomas Sub Group Board of CHCs Visiting & Miss Laura Guard Monitoring Group Cwm Taf LHB Free to Lead Dr Andrea Thomas (Dignity & Care) Group Cwm Taf LHB Voluntary Steering Mrs Helen Thomas Group Cwm Taf LHB Mental Health Mrs Anne Williams and Mrs Redesign Group Sandra Jones Voluntary Action Merthyr Tydfil Mrs Dora Powell Health and Social Care Forum Interlink (RCT) Health and Social Mr Clive Barnby (Deputy Chief care Forum Officer) Merthyr Health Park Project Chief Officer Team RCT Health Social Care and Chief Officer Wellbeing Partnership Cwm Taf LHB Transforming Mr Clive Barnby (Deputy Chief Transport Project Board Officer) Board of CHCs IT Steering Mrs Helen Davies (CHC Office Group Manager) All-Wales Management Team Chief Officer Member of Individual Patient Chief Officer Funding Review Panel Cwm Taf Security and Violence Mr Mel Jehu Strategic Steering Group and the Operational Working Group Page | 22 7. WHAT ARE OUR PLANS FOR 2012/13? We intend to focus our attention on a number of key areas: Raising the profile and increasing public awareness of Cwm Taf CHC Engaging more extensively with our local communities, local organisations and patients Continuing to visit, inspect and monitor health services, with an increased focus on a number of agreed themes, including primary care, older people, cancer and mental health Seeking to ensure equitable access to services across Cwm Taf Continuing to deliver a high quality Advocacy Service to local people Making sure we see a real impact on services from the work of the CHC Continuing to challenge and work constructively with Cwm Taf Health Board Being more accountable to the people we serve The CHC will also need to focus on two specific and major areas of work: The conclusions and outcome of the review of CHCs, initiated by the Minister for Health and Social Care in early 2012, and due for publication in Autumn 2012 The significant proposals on the future shape of health services in South Wales which we are anticipating from Health Boards in autumn 2012; it is anticipated that these will be the subject of extensive public engagement and consultation later in 2012/13. We will work with the Health Board to ensure people of Cwm Taf are involved in this process fully, meaningfully and in a way that is structured, accessible and open about the issues involved. Page | 23 8. HOW CAN YOU CONTACT US? Cwm Taf Community Health Council Unit 10 Maritime Offices Woodland Terrace Maes-y-Coed Pontypridd CF37 1DZ Tel: 01443 405830 E-mail: [email protected] Website: www.communityhealthcouncils.org.uk/cwmtaf/ Chair: Chief Officer: Page | 24 Mr Mel Jehu Dr Paul Worthington
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