Public Document Pack

Date of meeting Wednesday, 11th January, 2012

Time 7.00 pm

Venue Committee Room 1. Civic Offices, Merrial Stree t, Newcastle-under-Lyme, Staffs ST5 2AG

Contact Julia Cleary 01782 742227

Health Scrutiny Committee

AGENDA

PART 1– OPEN AGENDA

1 Apologies 2 Minutes of Previous Meeting held on 7th November 2011 (Pages 1 - 4) 3 Declarations of Interest 4 Update from the Chair of the Committee (Pages 5 - 6) 5 Infant Mortality in Newcastle under Lyme (P ages 7 - 12) 6 PHASE II CONSULTATIO N ON MENTAL HEALTH S ERVICES Further information regarding this will be distributed closer to the date of the meeting.

7 CARDIAC REHABILITATI ON UPDATE AND WALK F OR LIFE (Pages 13 - 14) To receive a verbal update from the Executive Director (Operational Services) regarding cardiac rehabilitation in the Borough.

8 Bus Routes to Bradwell Hospital (Pages 15 - 18) 9 PART 2 To resolve that the public be excluded from this meeting because it is likely that there will be disclosure of exempt information as defined in Schedule 12A of the Local Government Act 1972.

10 Response to questions regarding Interventional (Pages 19 - 36) Neuroradiology raised at the Accountability Session 11 URGENT BUSINESS To consider any business which is urgent within the meaning of Section 100 B(4) of the Local Government Act 1972.

Members: Councillors D Becket (Chairman), J M Cooper, S Hambleton, H Johnson, Loades and Taylor

‘Members of the Council: If you identify any personal training / development requirements from the items included in this agenda or through issues raised during the meeting, please bring them to the attention of the Committee Clerk at the close of the meeting’

Officers will be in attendance prior to the meeting for informal discussions on agenda items. Agenda Item 2 Health Scrutiny Committee - 07/11/11

HEALTH SCRUTINY COMMITTEE

Monday, 7th November, 2011

Present :- Councillor David Becket – in the Chair

Councillors J M Cooper, H Johnson and Loades

4. APOLOGIES

5. MINUTES OF PREVIOUS MEETING

The minutes of the meeting held on Thursday 29 th September 2011 were agreed as a correct record.

6. DECLARATIONS OF INTEREST

There were no declarations of interest.

7. CLOSURE OF THE HIGH STREET PRACTICE

The Committee considered a report regarding the closure of the High Street Practice in Newcastle under Lyme; the Practice had a list of 5000 patients. The practice had been open since 2004 and currently had a PCTmS contract managed on behalf of the PCT by North Community Healthcare.

Sue Price advised the committee that changes to health policy beyond the control of the PCT meant that it was no longer possible for the PCT or Community Trust to hold or manage the contract, which had resulted in the practice being put out to tender in November 2011.

Sadly, negotiations with the preferred bidder had broken down as a consequence other options for the practice had had to be considered and were outlined by Sue Price and her colleagues at the meeting as follows:-

• Negotiate with the second placed bidder • Re-tender the practice ( a lengthy process) • Disperse all patients to other practices ( there were 4 within one mile of the High Street practice)

The PCT had concluded that list dispersal was the only viable option and that every effort should be made to enable patients to be transferred to a GP practice of their choosing. Patients had been consulted on the closure and were being helped through the process by PCT staff with about 850 already organising their own alternative arrangements to transfer. Tracey Shewan indicated that the PCT was also preparing a communications plan to aid the dispersal exercise and that a Patient Helpline had been set up.

In response to a question from a member Jan Butterworth confirmed that the transfer of patients would not overload the lists of other practices where spare capacity existed. In fact, the future of some practices may be helped by the receipt of additional patients.

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The PCT was committed to a dispersal programme that was acceptable and appropriate for all patients with patient choice being the main focus throughout the process. Those patients who had still to be dispersed in three months time would be written to again urging them to contact the practice to arrange a transfer of their choice. The PCT representatives confirmed that all communication with patients would emphasise that they had a choice and should use it.

Those patients who failed to contact the practice would be transferred alphabetically to alternative practices but would not necessarily get a transfer that was acceptable to them. In those cases the patient could de-register and then apply to be added to a list of a practice nearer to where they lived. A member asked that special consideration and help be offered to elderly and vulnerable patients who often found it difficult to deal with changes of this nature.

In terms of PCT staff working at the practice they were currently being consulted on redeployment with the final decision being with the individual staff members. It was quite possible that some staff could move to those practices accepting patients from High Street.

It was also possible that some interest may be expressed in running specific clinics from the High Street practice although this was not currently being considered as an option for the future.

The question of patient access to GP’s was raised by the Chairman in response to which an assurance was given that the problem did not exist in Newcastle. Concern was also expressed that closure of the High Street practice may result in more patients presenting themselves at UHNS Accident and Emergency Department. It was indicated that this was unlikely to happen as transferred patients would all have access to their new GP’s although it was difficult to legislate for those who chose to go to A/E when it was not necessary.

In conclusion the Chairman thanked Sue, Jan and Tracey for their attendance and advice given to the committee.

Resolved:

(a) That the report be received.

(b) That the PCT be asked to provide regular updates on the progress made on the dispersal of patients from the High Street Practice.

(c) That the PCT be asked to keep the Committee advised of any proposals to run clinical services from the High Street premises.

8. SERVICES PROVIDED BY GPS AND PUBLICITY

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Following concerns expressed at a previous meeting of the committee consideration was given to a report outlining arrangements that were in place to enable patients to access phlebotomy services other than at the University Hospital of North Staffordshire.

Members were provided with a list of those practices currently offering blood testing services and advised that where a practice did not offer the service it was usually provided in an outreach clinic to avoid hospital visits.

It was agreed that more publicity was necessary to inform patients of the above emphasising that the service was now available at locations within the community and that a hospital visit was not always required.

It was agreed that in general new and improved publicity was desirable outlining the whole range of services available in the community with existing leaflets etc being updated.

In conclusion, it was agreed that greater efforts were also required to advise patients of how to use public transport to access the services offered in the community in addition to details about the frequency of services to the hospital.

Resolved:

(a) That the information be received.

(b) That the PCT be asked to look at updating current information on the availability of services in the community and providing improved information on how to contact NHS Direct.

9. NEURORADIOLOGY SERVICE REVIEW FINAL REPORT

The committee received an update on the Service Review of the Neuroradiology Department at the University Hospital of North Staffordshire.

The Chairman indicated his intention to raise questions on this matter at the Accountability Session that was to be held with representatives of University Hospital of North Staffordshire later in the week. He also took the opportunity to advise members of the format to be followed at the session.

Resolved: That the information be received.

10. SUMMARY OF THE MAIN ISSUES OF BUSINESS FORM THE STAFFORDSHIRE HEALTH SCRUTINY COMMITTEE HELD ON 3RD OCTOBER 2011

The committee received a summary that outlined items of business discussed at the meeting of the County Council’s Health Scrutiny Committee on 11 October 2011.

During consideration of this matter the Chairman referred to his attendance at the recent Cabinet Members Accountability Session at and to his alarm at the high infant mortality rate in the Borough. He asked that a report on this matter be submitted to a future meeting of this committee for consideration and that the situation be closely monitored in consultation with the PCT.

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The PCT representatives indicated that a number of factors contributed to the problem and that work was ongoing to improve outcomes for pregnant mothers.

Resolved: (a) That the information be received.

(b) That the PCT be asked to monitor the situation and to bring a report to a future meeting of this committee for consideration

11. CARDIAC REHABILITATION PHASE IV

The committee considered information submitted by the Executive Director- Operational Services outlining the four stages of the rehabilitation process for cardiac patients.

Phase IV Cardiac Rehabilitation was the long term maintenance of health behaviour and change, including the provision of support from patient and carer groups and long term follow up in primary care. It was indicated that both phase III and phase IV cardiac rehabilitation could be provided by the Council at Jubilee 2, which could provide ongoing, long term support to those who had either had cardiac surgery or a cardiac event. The programmes were run by advanced fitness instructors who had undergone specialist training with the British Association for Cardiac Rehabilitation.

It was indicated that patients could only progress to Phase IV after satisfactorily completing the first three phases provided by the health service.

It was agreed that action was required to get more people onto Phase IV and that further discussions would be held on this issue with the health experts.

RESOLVED : That the information be received.

12. HEALTH AND WELLBEING STRATEGY UPDATE

The Council’s Executive Director-Operational Services referred to the Project Initiation Document previously considered by the committee and indicated that a first draft of the Health and Wellbeing Strategy would be available in the New Year.

He explained that the Strategy would sit alongside those for Economic Development and Crime and Disorder and be outcome focused.

During consideration of this matter the Chairman expressed the view that the Borough Council should have two representatives on the County Council’s Health and Wellbeing Board and that through the development of our own Strategy document demonstrate that we were making positive steps regarding this issue.

Resolved: That the information be received.

COUNCILLOR DAVID BECKET Chair

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NEWCASTLE-UNDER-LYME BOROUGH COUNCIL

EXECUTIVE MANAGEMENT TEAM’S REPORT TO THE HEALTH SCRUTINY COMMITTEE

11 th January 2012

1. Update from the Chair of the Committee

Submitted by : Elections and Licensing Manager

Portfolio : Culture and Active Communities

Ward(s) affected : All Wards

Purpose of the Report

To update the Committee of developments since its last meeting.

To inform the Committee of responses received to questions asked by the Chair of the Committee and the Committee at its last meeting.

Recommendations

That the Committee note the actions and responses and that any comments be fed back to the service providers.

1. Health and Wellbeing Strategy

A report regarding this would be brought to the next Committee Meeting on Tuesday 21 st February 2012

Contraband Alcohol and Tobacco

A request was made by the Chair of the Cleaner, Greener and Safer Overview and Scrutiny Committee that this Committee carry out a piece of work regarding the health implications of the sale of contraband alcohol and tobacco in Newcastle under Lyme. Your Officers have contacted the County Council Trading Standards Department regarding this and a meeting will be arranged in the New Year with the Chair and Vice Chair of this Committee and the Chair and Vice Chair of the Cleaner, Greener, Safer Scrutiny Committee to discuss the way forward.

2. Questions from the Chair and Responses received to date:

How has the movement of patients from the High Street Practice in Newcastle under Lyme progressed since the last meeting of this Committee?

This is on track. The Primary Care team has held patient surgeries within the practice for those who want further information and a poster and information about other practices are available in the practice. December has been a quieter month for people registering with other practices because of Christmas preparations but this has been used to give the receiving practices some time to summarise the records of the their new patients and to enter all the details onto their systems. The High St Practice now has 3, 700 patients on their list, with 1300 patients having been transferred. There will be a second letter sent out to patients in the second week of January advising them to register with the practice of their choice. The practice will be working

1 Page 5 with the PCT to ensure that their vulnerable patients are matched to a suitable practice for their needs. The allocation of patients will take place on March 18th to ensure that all clinical records are transferred in time for the practice to close on March 31st. The PCT have been working closely with unions and HR to support the staff of the practice in seeking alternative employment.

Why does there appear to be an excessive number of ambulance trips to the hospital?

The ambulance service only conveys to hospital those patients that require treatment within the emergency department. Where it is appropriate and safe to do so, the ambulance service treats patients where they are or where transport to an emergency department within an acute hospital is not appropriate, takes them to another treatment setting within the community such as a minor injuries unit or walk in centre. In the period April to November, 35% of Staffordshire patients that received a response by the ambulance service were not taken to an acute hospital.

The ambulance service is working closely with its health service partners to increase the number of patients that can be treated in the community by using alternatives to A&E and earlier this year introduced a new triage system, NHS Pathways, within its Emergency Operations Centres to help identify patients where this is possible. Treating more patients in the community is largely dependent on increasing the availability of alternative care pathways from other community providers. Considerable joint working is continuing in this respect.

Phlebotomy Services and Publicity

Progress has been made on this:

• Letter issued to GPs • Updates to GPs via GP Bulletin – two separate issues now, reminder issued yesterday to encourage use of this service now live • Leaflet produced to attach to blood test cards promoting Bradwell walk in service • Poster produced for surgeries and Phlebotomy department • Press Release issued early October • Positive media coverage in the Sentinel (full page article 7 October – link below) http://www.thisisstaffordshire.co.uk/End-90-minute-blood-test-wait/story-13502908- detail/story.html

Next steps – Meir walk in service due to open in February – similar plan in development.

Questions still awaiting responses .

Information regarding the complaints procedure for the hospital

Written response regarding the attempted transfer of an elderly patient with pneumonia on Monday 12 th December 2011.

Concerns regarding potential bed shortages at the new Accident and Emergency Department.

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NEWCASTLE-UNDER-LYME BOROUGH COUNCIL

EXECUTIVE MANAGEMENT TEAM’S REPORT TO THE HEALTH SCRUTINY COMMITTEE

11th January 2012

1. Investigation into Infant Mortality Rates in Newcastle under Lyme

Submitted by : Elections and Licensing Manager

Portfolio : Culture and Active Communities

Ward(s) affected : All

Purpose of the Report

At its meeting on 31 st October 2011, the Staffordshire County Council Health Scrutiny Committee requested that Newcastle Borough Council Health Scrutiny Committee carry out a piece of work regarding infant mortality rates in the area.

Recommendations (to be in bold)

That the Committee consider the Scrutiny Brief attached at Appendix A

That the Director for Public Health be invited to attend the next meeting of the Committee on 21st February 2012.

Reasons

Request from Staffordshire County Council Health Scrutiny Committee.

1. Background

Scrutiny Brief attached at Appendix A .

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Page 8 Brief for Scrutiny – Infant Mortality

Topic to be scrutinised The incidences of infant mortality in the Borough, including the data produced on the subject; the causes behind infant mortality and the work being done to tackle the issue and bring the number of incidences down. Questions to be addressed 1. What is the latest position in terms of the level of infant mortality in the Borough? What are the trends in terms of levels of infant mortality in Newcastle Borough? 2. What are the identified causes behind infant mortality, and what is the situation in Newcastle in terms of the reasons for the levels of infant mortality at the present time? 3. What work is being done by different agencies to combat infant mortality? 4. What barriers are there to this work? Are any opportunities being missed? 5. What are the long-term goals of agencies? Are there any targets in place for reducing levels of infant mortality? 6. Can agencies work together more effectively in tackling this issue? 7. What support is offered to families who have suffered infant deaths? Can more be done? 8. What work is being done elsewhere and what benchmarking work can be done to understand this work and apply lessons from elsewhere in Newcastle Outcomes 1. A clear picture of the issue in terms of levels of infant mortality and also those geographical areas most affected. 2. An understanding of the issue, including its causes and also its effects 3. An understanding of the work being done to deal with it by agencies in the public sector and elsewhere 4. An analysis of service provision and any gaps which exist in terms of education/prevention and support for families 5. Construction of an action plan – in conjunction with key partners – aimed at dealing with the issue and its aftermath 6. Consideration of the implementation issues connected to the development of an action plan, including the main issues of resources and prioritisation 7. Consideration of work done elsewhere and how lessons learnt could be applied to Newcastle in dealing with this issue 8. Establishment of a clear vision for the way forward and a set of clear targets for reducing the levels of infant mortality in the Borough over a specified time period. Background materials 1. NHS Data/Area Profiles (monthly) 2. Reducing Health Inequalities in Infant Mortality: A Good Practice Guide (2007) 3. ONS Child Mortality Statistics 4. Our Future Health Secured? (King’s Fund, 2007) Evidence and witnesses

Page 9 1. Portfolio Holder for Safer & Stronger Communities 2. Executive Director (Operational Services) 3. Head of Service Business Partnerships & Improvement 4. Director of Public Health 5. Representatives from National Health Service/Staffs County Council (public health teams) 6. Business Improvement & Partnerships – Research/Partnerships Manager Method of scrutiny 1 Task & Finish Group – to oversee any review and change process and consisting of Chair of Health Scrutiny Committee, as well as Chair of Cleaner, Greener, Safer Scrutiny Committee (plus Vice-Chairs) 2 Consideration of partner evidence and views 3 Consideration of LAPs/community views 4 Consideration of elected Member views and evidence Timetable Start date January 2012 Dates of meetings TBA Draft report TBA Final report TBA Report to Council TBA Constraints • Partner buy-in to the processes and capacity of all bodies to take part in the scrutiny process • Availability of relevant data Members to undertake the scrutiny Cllr Becket Cllr Cooper Cllr Loades Cllr Johnson Cllr Taylor Cllr S. Hambleton Others as identified Support Executive Director (Operational Services) Head of Business Improvement & Partnerships Partnerships Manager Business Improvement Officer (Research & Equalities) Elections & Licensing Manager Newcastle Borough Council Corporate Plan Priority area (s) o Creating a cleaner, safer and sustainable Borough o Creating a Borough of opportunity o Creating a healthy and active community o Transforming our Council to achieve excellence CfPS Objectives: • Provides and critical friend challenge to executive policy makers and decision makers • Enables the voice and concerns of the public to be heard

Page 10 • Is carried out by independent governors who lead and own the scrutiny role • Drives improvement in public services Brief approved by Overview and Scrutiny Co -ordinating Committee Signed Date

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Page 14 Agenda Item 8

NEWCASTLE-UNDER-LYME BOROUGH COUNCIL

EXECUTIVE MANAGEMENT TEAM’S REPORT TO THE HEALTH SCRUTINY COMMITTEE 11 th January 2012

1. Newcastle under Lyme Bus Routes to Bradwell Hospital

Submitted by : Elections and Licensing Manager

Portfolio : Culture and Active Communities

Ward(s) affected : All

Purpose of the Report

To inform the Committee of the current situation regarding bus services to and from Bradwell Hospital.

Recommendations

That the Committee receive the report and consider whether to take any further action regarding bus routes to Bradwell Hospital.

Reasons

Concerns have been raised by Members that there appears to be no direct bus route to Bradwell Hospital.

1. Background

Concerns have been raised by the Chair and other members of the Committee regarding the apparent lack of a regular and direct bus service to Bradwell Hospital.

The following information has been provided by the County Council regarding the current bus routes.

Bradwell Hospital is served by :

Service 35 Newcastle-Chesterton a Staffs CC sponsored service operated by Wardles Transport, consisting of 4 round trips hourly from 10am .

Service 321 Newcastle-Alsager morning and afternoon peak hour service sponsored by East Council operated by Stanways.

The nearest regular service is service 34A Hanley-Newcastle-Chesterton- that would drop off passengers in Wolstanton Road a 5 to 10 minutes walk, crossing the A34. Service 17 operates in Hanbridge Avenue at the back of the Hospital.

The following services operate close to or into University Hospital:

Service 101 Hanley Newcastle-Hospital (London Road entrance)-Stone-Stafford operates every 20 minutes during the day. (by )

1 Page 15 Service 22 Newcastle-Hospital Grounds-Trentham--Longton, operates half hourly during the day. (by First Potteries)

Service 24 Hanley-Stoke--Hospital Grounds-Newcastle operates half hourly during the day (by First Potteries)

Service 41 -Hanley-Stoke-Penkhull-Hospital Grounds-Newcastle-Clayton approximately half hourly during the day (by )

Service 58 Hanley-Stoke-Penkhull-Springfields-Hospital Grounds-Newcastle operated approximately hourly during the day (by Wardle Transport)

2. Issues

The main concern is the fact that service 35 operated by Wardles Transport only runs four buses each day on a circular trip and that these trips do not start until 10.00am.

3. Options Considered

That the Committee request the service to commence at an earlier time.

That the Committee request additional services

That no action be taken

14. List of Appendices

Appendix A: Map of bus networks in North Staffordshire.

Page 16 2 The following operators are Bus routes shown using dashed lines : (arranged by frequency of service Your bus network in 6A 99 99B Pennine Way on common sections of route): 99 Bakerbus At least every 10 minutes 99A 9 94 94A Biddulph Copelands 1 1A 2 Mow Cop Moor North Staffordshire D&G 5 Brown New Street Plumline (Wardle) Lees Park Lane 18 Procters 6 6A 99A Haregate Scraggs 8 8A 8B 6. 34A 6A Knypersley Wardle Kidsgrove Whitehill Newchapel 94 20 20A to and from Packmoor 99B All other services are run by First Trentham Alsager 99B 8B 21 21A and Leighton Hospital 20 99 16 6 99A 94A Brown Edge School Leek 23 23A 8 98 Alsager Kidsgrove 29 Longsdon 25 Turnhurst Brindley Ball Green Mitchell Fegg Ford Avenue Hayes 34 34A Leekbrook Many additional routes operate 8B 20A Sandyford Endon 98 99 99A 99B but it has not been possible to Butt Lane 8A 34A Mill Hill Brown Edge 8A show them all at this scale. For full see overleaf At least every 20 minutes for local buses 99 Norton times and details, please call Chell 21 Chell 9 Norton 3 Traveline or log on to stokebus.info Talke 21 Heath Stockton 94 94A 99B Green 18 Tunstall 29 Brook to and from 94 62.62A Bradeley 62 18 Cheddleton Cheadle, 21 94A Pittshill 21 62A Alton Towers 26 26A 99 Haywood Baddeley Green and Uttoxeter 62A Hospital 3 16 99A 62 29 Talke Pits Bus route terminus 21 20A 99B 98 32 32A Stops in blue 98 Leek New 40 are outside the Stone Holden Bridge Ralph Drive Road Wetley Rocks Smart Ticket boundary 39 39 18 Milton 72 Red Middleport Train line & station Street North Road Birches Head 101 Shopping Centre 5 54 32 Longport 37 38 At least every 30 minutes Museum 32A 34A 38 40 41 40 41 Cellarhead 4 Produced by 7.5.10 www.fwt.co.uk Festival Townsend Ash Bank 37 Turner 3 9 94 Heights 20 20A Street Crackley Bank 94A City Centre 62 for Parkhouse Werrington 31 17 34 94 98 (Hanley) 62A 99 Festival Park 22 22A Wereton Audley Wood Lane 21 1.1A.2. 3. 4. 5. 8.8A.8B 99A Beverley Drive 1A. 26A 99B 9. 16. 17. 18. 20.20A 2 Adderley Weston 24 24A Green Coyney 34 34 Etruria 21A. 23.23A. 24.24A 1 1A Coalville Crackley Valley 25. 26. 29. 32.32A 31 34A Bradwell 34.34A. 37. 38. 39. 40 94 Dawlish Drive 1A 26 26A 33 33A Chesterton 50. 62.62A. 101 Halmerend Etruria Eaton 4 26 1 2 38 Hempstalls Wolstanton 164. 350. P. X1 Dividy Road Park see overleaf 26 Lymedale 40 Pool Dole Saxonfields for local buses Meir Hay 26A 6A 40 Alsagers Bank 24.24A Joiners Square 50 6 Fenton 1.2 Blythe 54 Knutton 6A 6.6A. 26.26A 22.22A 6A6 17 Stoke-on- 24A Bridge Scot Hay Milehouse 50 23.23A 56 Cliffe Trent Station 40 Meir Basford 62 94A 96 24 24A Vale 23 King Street Longton Park Site Silverdale 94 94A 94 96 Newcastle Blythe 101 Stoke Bridge 164 23.23A 22.22A Normacot 94 96 25 Keele under Lyme 23 23A 26 26A 23A 40 25 Mount 40 Meir Park 6 Keele Village University Poolfields 17. 22. 26.26A Pleasant Selected hourly services 25 26 26A 31 22 350 P Newstead 31. 33.33A. 56 16 72.85. 94.96 Meir Heath to and from 25 85 98.99.99A.99B Trentham Dresden 50 37 Page 17 Barlaston 22A. P Crewe 33 33A Hartshill 350 P Lakes Blurton to and from for Outpatients 39 85 164 41 Stone Stafford General Hospital 56 and Pathology University 33A Westlands Penkhull X1 Britannia 41 72 University X1 33 Stadium X1 Barlaston Hospital Hospital 24.24A 350 50 164 41 33A 33.33A X1 Stone Sandon 85 21 21.21A Baldwins Gate Clayton 56 56 Harpfields Oakhill 101 Trentham 164 33 Buckmaster 21A 164 22 Trentham Monkey Forest to and from Guernsey Avenue Stafford 350 to and from Drive Gardens (Plumline) Westbury Park 41 to and from P Market Drayton 33 101 and Shrewsbury Hanford Eccleshall Ferndown Drive 72 350 and Newport X1 This page is intentionally left blank

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