Aneurin Bevan Community Health Council Annual Plan 2021-2022 - Aneurin Bevan Community ...
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Aneurin Bevan Community Health Council Annual Plan 2021-2022 Aneurin Bevan CHC Annual Plan 2021-2022 1
Community Health Councils (CHCs) are the independent voice of people in Wales who use NHS services. We are made up of local volunteers who act as the eyes and ears of patients and the public. There are 7 CHCs covering different parts of Wales. Aneurin Bevan Aneurin CHC Bevan Annual CHC Plan Annual 2021-2022 Plan 2021-2022 2 2
This document is available in Welsh. An electronic copy of this document can be found on our website: www.aneurinbevan.wales If you would like this publication in an alternative format and/or language, please contact us: Aneurin Bevan Community Health Council Raglan House Llantarnam Business Park Cwmbran NP44 3BD Tel: 01633 838516 Email: enquiries.aneurinbevanchc@waleschc.org.uk Twitter: @bevanchc Aneurin Bevan CHC Annual Plan 2021-2022 3
Contents Chair’s introduction .......................................................................................................... 6 About your Community Health Council ................................................................................ 9 Our approach to equality ................................................................................................ 10 Our resources .............................................................................................................. 12 Our governance ............................................................................................................ 13 Making a difference through our activities .......................................................................... 14 Deciding what we do and how to do it ............................................................................... 16 Key themes and priorities................................................................................................ 17 All Wales key priorities (undertaken by all CHCs in Wales) ................................................... 27 Responding to issues as they rise ..................................................................................... 28 How can you get your voice heard or become involved ........................................................ 29 How to contact us .......................................................................................................... 31 Appendix 1 – Full Council Membership............................................................................... 32 Appendix 2 – CHC support staff ....................................................................................... 35 Appendix 3 – Finance ..................................................................................................... 36 Appendix 4 - Equality Impact Assessment ......................................................................... 37 Aneurin Bevan CHC Annual Plan 2021-2022 5
Chair’s introduction As Chair of the Aneurin Bevan Community Health Council, I am pleased to share with our population the forthcoming plans and details of our 2021-2022 operational plan. The plan is ambitious, public- led and reflective of our new ways of working, which we have redeveloped to hear from the public that we represent throughout the Coronavirus pandemic. Before I move on, I believe it is extremely important to pay recognition to the previous twelve months. Throughout 2020 and going into 2021, we have all been faced with significant health, social and economic challenges. We recognise that many lives and livelihoods have been put on hold, and for many people; NHS care has been both a lifesaving service and a system under extreme pressure as a result of the Coronavirus pandemic. As we move into this new year of operational service planning, we will continue to factor this extraordinary circumstance into our work, and will continue to monitor and scrutinise the positive and negative effects on access to and care within NHS services for the people living within our community. The Aneurin Bevan Community Health Council is committed to the continuity of monitoring and scrutinising the NHS’ plans within the Clinical Futures programme, as well as actively seeking the views of people who have experienced care within the newly opened Grange University Hospital, Aneurin Bevan CHC Annual Plan 2021-2022 6
Chair’s introduction Chair’s introduction local general hospitals and within community and primary care settings. The CHC will also continue to play an important role in representing the patient voice in NHS service change and service reconfiguration processes locally, regionally and nationally. We recognise that the work undertaken in the last 12 months has opened up greater opportunities for the CHC to continue to engage with people in the community and in hospital in digital ways. We will take this learning into 2021/2022 to hear from as many people as possible and hear about their NHS experiences. When developing this plan and our schedule of activity for the next 12 months, we publically engaged with key stakeholders such as; members of the public, CHC volunteer members, Members of the Senedd, Third Sector organisations and community representatives to ensure our activity reflected what people in the Aneurin Bevan area wanted us to focus on. Our plan reflects the thematic interests and issues brought to us by people in the community or community representatives, and also reflects activity that we had hoped to undertake in the previous year, but were unable to due to the understandable restrictions put in place to help manage the pandemic. Aneurin Bevan CHC Annual Plan 2021-2022 7
Chair’s introduction We believe it is important to set this plan around our genuine intentions to complete activities that the public have asked us to focus on. If these plans require redevelopment or amending throughout the year due to on-going pandemic restrictions, we will update our plans accordingly and ensure that any postponed activity is moved forward and not lost. We have therefore mapped our activity schedule in preparedness for any future redevelopment or postponement that may be required. In our last operational plan, we shared the wider Community Health Council movement position, where we anticipated an organisational transition into a new statutory body that would have a remit over both Health and Social Care services. This organisational change is still moving forward, albeit with some delay due to the impact of the pandemic disruption. In closing, I wish to express grateful thanks to everyone who engaged with the Aneurin Bevan Community Health Council and shared areas of interest, which influenced the development of this plan. I also thank the Aneurin Bevan Community Health Council staff and volunteer membership for their continued, extraordinary hard work and commitment to ensuring our populations’ needs and wishes remain at the heart of all NHS services. Thank you Alan Davies, Chair Aneurin Bevan CHC Annual Plan 2021-2022 8
About your Community Health Council Our vision People in Gwent know that they can share their views and experiences of the NHS easily and recognise that doing so can have a real influence on the shape of healthcare services. People are increasingly understanding of and value the role played by Aneurin Bevan Community Health Council in supporting them to be heard and in representing the collective interests of patients and the public. Aneurin Bevan CHC Annual Plan 2021-2022 9
Our approach to equality We have identified these 5 equality aims: 1. We will work with others to find better ways to hear from everyone, including those who are in the most vulnerable situations and those whose voice might not otherwise be heard. 2. We will adapt our approaches to reach those whose care is delivered in and out of hospital and develop our resources and advocacy services to ensure that they are widely accessible, available and relevant. 3. We will develop our plans with the public and with our partners so that they focus on the things that matter most and have the best chance of making a difference. 4. We will build on our existing partnerships and forge new ones where working together increased our chances of making a difference. 5. We will develop targeted and more inclusive ways to attract new members so that we better reflect the diversity of the communities we serve. You can find out more about our equality objectives and actions in 2021-2022 in our Equality Plan Aneurin Aneurin Bevan Bevan CHCCHC Annual Annual PlanPlan 2021-2022 2021-2022 1010
Aneurin Bevan CHC Annual Plan 2021-2022 11 1.
Our resources Our members We currently have 42 lay members who choose to volunteer their time to help the CHC to achieve its aims and objectives. Our current membership is made up of 13 public appointments, 9 Local Authority appointments, 6 Third Sector appointments and 14 co-opted members. Our staff Within Aneurin Bevan CHC we have a small team of paid staff whose role is to provide advice and support to the members in carrying out the statutory functions of the organisation. Our staff include senior officers, administrators and a team of complaints advocates. A full list of our members and staff is provided at appendix 1 and 2. Our money We are funded by the Welsh Government. You can find out more about our budget in 2021-2022 at Appendix 3. Aneurin Bevan CHC Annual Plan 2021-2022 12
Our governance Our Executive Committee is responsible for deciding our plans and priorities and making sure we carry out our activities in a way that responds to the things that matter most to people locally, and meets our legal and other responsibilities. We are one of 7 Community Health Councils which exist across Wales and are overseen by the Board of Community Health Councils. This Board provides us with advice and support, sets standards for the way CHCs carry out their work and manages our performance in line with these standards. Aneurin Bevan CHC Annual Plan 2021-2022 13 Aneurin Bevan CHC Annual Plan 2021-2022 13
Making a difference through our activities Community Health Councils have 4 main functions: continuously engaging systematically visiting and with the communities we scrutinising local health represent and the health services service providers serving those communities Aneurin Bevan CHC Annual Plan 2021-2022 14
Making a difference through our activities enabling users of the NHS to raise concerns about the representing the interests of services they receive through patients and the public in the an Independent planning and agreement of Complaints Advocacy NHS service changes Service Aneurin Bevan CHC Annual Plan 2021-2022 15
Deciding what we do and how to do it We want to make sure we focus our activities on the things that matter most to people in our local communities, in a way that makes the best use of our resources so that we can make the biggest difference. To inform our plans for 2021-22, we thought about information from a range of different sources. This included: Seeking the views of members of the public Engaging with Members of the Senedd Engaging with Town and Community Councils Engaging with Third Sector organisations Monitoring NHS annual plans and Integrated Medium Term Plans (IMTPs) Aneurin Bevan CHC Annual Plan 2021-2022 16
Our key themes and priorities Feedback from the public and other stakeholders highlighted a number of common themes, which have been incorporated in to this plan. Other areas of interest are ongoing from previous years, which require continued monitoring and scrutiny. We have mapped our plans against the potential for further disruption caused by the on-going pandemic. Our priorities below reflect our full intention of activity should restrictions ease. Activity that we have identified which could be negatively affected by the pandemic, will either be redeveloped and undertaken in a new way, or if redevelopment is not possible for particular activity, we make a commitment to move this work forward into the next operational plan to ensure the activity is not lost. Visiting, Patient & Public Engagement This year we will implement a redeveloped visiting and engagement programme due to the ongoing infection control measures and national restrictions needed to manage the pandemic. Our traditional approach of face-to-face site visits to hospital wards, departments and community Aneurin Bevan CHC Annual Plan 2021-2022 17
Our key themes and priorities facilities have adjusted to new methods of reaching NHS service users at the point at which they are receiving care, this can be in a digital, verbal or paper-based survey way. Last year we undertook the first FaceTime calls with inpatients during the height of the pandemic, and we will take learning from this project to reach more people in hospital this year. We therefore continue to make every effort to hear about people’s experiences on inpatient and community care directly, with continued scrutiny so that appropriate recommendations for improvement are made from the service user’s perspective. The pandemic disruption has also affected our approach to engagement events and opportunities, which traditionally involved our Members and staff getting out into the community to talk to members of the public. This is where they would usually raise awareness of what the Aneurin Bevan Community Health Council has to offer, recruiting new Members and obtaining views on a variety of health related topics. As stated above, we have developed a new ways of working in the meantime and extended our reach within community networks to ensure we make every effort to reach our communities and here your feedback. With the fast-paced roll out of virtual groups and meetings within communities, the CHC is committed to engaging with these groups and presenting on the services of the Community Health Council and hearing people’s feedback, as we would have done prior to the pandemic. As soon as it is safe to do so, the Community Health Council will resume face-to-face visiting and engagement opportunities. Aneurin Bevan CHC Annual Plan 2021-2022 18
Our key themes and priorities Public surveys for 2021/22 We will produce the following surveys to gauge the people’s experience of:- Virtual Appointments Maternity, Pre and Post Natal services Dementia Services in the community Diabetes services 111 Service If pandemic pressures ease this year, we will undertake these additional focused surveys to hear about people’s experiences of:- Accident and Emergency services Dental Services (via a mystery shopper exercise) NHS care in prisons In hospital meal time Healthcare for the homeless – Caerphilly Primary Care Mental Health Services Boredom and Isolation In hospital linen supplies In hospital hand hygiene support Aneurin Bevan CHC Annual Plan 2021-2022 19
Our key themes and priorities During 2021/22 we will: We will continue to ensure the public are kept up to date with our activities and have access to the work we carry out in both English and Welsh in line with our Welsh Language Standards order. We will submit press releases to the media and send out a newsletter directly to the public on a bi monthly basis, as well as sharing our activity, surveys and news via our Twitter and Facebook pages. We will continue to work proactively with the Health Board to ensure that appropriate public engagement is carried out in relation to any service changes. Planning of Local Health Services & Monitor Service Changes We are actively involved with the Health Board during the planning stage of local services and during times when changes are being made to services. This allows us the opportunity to ensure the patients’ voice is represented and services are focused on the people who will be using them. During 2021/22 we will: Continue to monitor the Health Board’s Three Year Plan, Annual Plan and Integrated Medium Term Plan (IMTP). Aneurin Bevan CHC Annual Plan 2021-2022 20
Our key themes and priorities Continue to monitor the Health Board’s quarterly COVID-19 recovery plans for urgent and routine services Monitor/scrutinise proposals for service change or variation of GP practices, including any proposed main or branch surgery closures and sustainability. Monitor the Health Board’s ‘A Healthier Gwent’ strategy and implementation. Continue to monitor the Health Board’s staff vacancy position. Scrutinise planned proposals for local, regional and national changes to services throughout the year, this also includes any urgent service changes made by the NHS as a result of service disruption caused by the pandemic. Monitor the plans for the on-going developments of the Health Board’s Clinical Futures programme in relation to; The newly opened Grange University Hospital (also known as; the Specialist Critical Care Centre), Patient flows through the hospital system, The patient flow centre, Inter-hospital patient transfers, External transport support Public understanding of new developments Aneurin Bevan CHC Annual Plan 2021-2022 21
Our key themes and priorities We will also monitor the Health Board’s Care Closer to Home strategy and the reconfiguration of services of Acute and Community Hospitals. Monitor the plans for the development of primary care estates such as resource centres and health centres. Monitoring the Performance of Local Health Service Delivery One of our key functions at the Community Health Council is to monitor the work that is carried out by the Health Board and local NHS. We do this in order to ensure that people are receiving the best healthcare possible and where standards are not maintained, we seek to understand why and what is being implemented to resolve the issues. During 2021/22 we will: Continue to monitor aspects of healthcare performance data. These will include: Ambulance handover times at A&E Waiting times in A&E and Minor Injuries Units The Health Board’s winter pressures planning Delayed transfers of care Cancelled operations Public Health Wales screening services Transgender Services Aneurin Bevan CHC Annual Plan 2021-2022 22
Our key themes and priorities Cancer service – holistic services COVID-19 - Testing COVID-19 – Treatment COVID-19 – Vaccination COVID-19 – Long Covid support We will monitor the waiting times for existing services. These will include: Cancer surgery Elective surgery Ear, Nose and Throat (ENT) Obesity Day surgery We plan to increase the scope of our monitoring to: Bereavement services within Maternity Infant tongue-tie processes Review policies and procedures for Do Not Resuscitate orders When monitoring healthcare services we analyse a range of data including reports produced by the Health Board and partner organisations, statistics and feedback from the public. As a result of Aneurin Bevan CHC Annual Plan 2021-2022 23
Our key themes and priorities the pandemic, much of this data was paused by the NHS and Welsh Government and so our monitoring of the above will resume when the data reporting resumes hopefully towards the end of 2020. Complaints advocacy We have a statutory duty to provide an independent complaints advocacy service to support anyone living in our area to raise a concern about NHS services. Advocacy is about helping people to be heard. Our independent complaints advocacy service is there to help and support people to ensure that their experiences and concerns are not only listened to but are acted upon. Our independent complaints advocacy service offers confidential support, advice and guidance for people who want to raise a concern about any NHS provider. Our Advocates aim to: Enable complainants to submit concise concerns to the appropriate organisation to ensure a comprehensive investigation of the facts is undertaken at the local resolution stage of the complaint. Enable complainants to submit consistent, well-structured applications to ask for independent investigation by the Ombudsman. Monitor the performance of the Complaints Advocacy service to ensure an effective and efficient service is provided in line with the Community Health Council’s Advocacy Case Management Policy. Aneurin Bevan CHC Annual Plan 2021-2022 24
Our key themes and priorities Monitor the outcome of complaints in order to oversee the implementation of recommendations and actions by the NHS. Maximise the use of complaints information to allow for our resources to be focused where issues arise. Work in close collaboration with the NHS to ensure that effective complaints procedures are in place. Our independent complaints advocacy service is provided in a friendly, confidential and supportive manner, encouraging the NHS to learn from individual patient experience to improve the service overall. In developing our work programme we are committed to maintaining a programme of continuous improvement within the service, which consistently delivers excellent feedback from those who use it. Developing ourselves to deliver effectively All of our staff and members complete core training to ensure that they are effective in the delivery of the services that the Community Health Council offers. Staff are also encouraged to attend training courses and take developmental opportunities where possible to enhance their effectiveness in their roles and increase job satisfaction. Aneurin Bevan CHC Annual Plan 2021-2022 25
Our key themes and priorities Our robust programme of training for Members is delivered to ensure that each Member is confident in their ability to carry out their Community Health Council role. We offer mandatory training to Members, which must be completed each year. We have redeveloped our training programmes to be delivered online and through virtual meetings during the pandemic to ensure continuity of training opportunities for; Members Induction Visiting & Public Engagement Equality & Diversity This training equips Members with the skills they will need to carry out future visits to health service premises and engage with the community at public events. Members may also choose to take part in the following training/seminars. This training is offered on a voluntary basis; NHS Service Change training Dementia Awareness (later in the year, pending pandemic pressures) Mental Health awareness (later in the year, pending pandemic pressures) Aneurin Bevan CHC Annual Plan 2021-2022 26
All Wales priorities (undertaken by all CHCs in Wales) Our movement exists to ensure that people’s views and interests are represented at the heart of new developments and that patients and the public have the opportunity to have a direct influence on policy makers and those responsible for designing and delivering NHS services. In the year ahead we will use our local knowledge to help shape the national agenda. We will do this by: Sharing regularly what people in our local communities are telling us. This will help our movement to identify the issues that impact on people living in all parts of Wales, so that collectively we challenge the policy makers and those who deliver our national services to do better where this is needed. This year we will pay particular attention to the impact of the pandemic on healthcare services and people’s experiences during this time. Working with the Board of CHCs to develop and publish regular reports on what people are saying about the NHS across Wales - and how policy makers and those responsible for delivering NHS services nationally are responding Working with the Board of CHCs to identify and carry out any ‘themed’ activity in response to key national issues affecting the NHS. Aneurin Bevan CHC Annual Plan 2021-2022 27 Aneurin Bevan CHC Operational Plan 2021-2022 27
Responding to issues as they rise Because our volunteer members live within the communities they represent, we are often able to listen to local concerns and issues as they arise so that we can respond quickly and appropriately. Some people who contact us need the on-going support of our complaints advocacy service. Others may have a specific matter that can be addressed immediately. We have developed good relationships with the NHS so that we can help resolve problems where possible at an early stage. Sometimes a matter raised with us will need further action, perhaps by finding out more from our health board, through scrutiny at our CHC committee meetings, or by carrying out a visit or survey to see if a concern raised with us is shared by others. Aneurin Bevan CHC Annual Plan 2021-2022 Aneurin Bevan CHC Annual Plan 2021-2022 28 28
How you can get your voice heard or become involved We are always keen to hear from anyone who wants to share their views and experiences of NHS services. You can contact us using any of the details included at the end of this plan. You can also tell us if you would like us to include you on our distribution list for surveys and regular updates. If you are part of a group or organisation and would like to work with us on any of our activities we How can would love you to hear fromget you. your voice heard or become involved We are also happy to hear from any groups who have a story to share about any aspect of NHS services. We publish a calendar of meetings on our website so that you can see when and where we will be discussing key issues affecting NHS services. How you can get your voice heard or become involved Aneurin Bevan CHC Annual Plan 2021-2022 29
How you can get your voice heard or become involved Some of our committee meetings are held in public so you are welcome to attend (virtual attendance is How can you get your voice heard or become involved available). Please let us know if you would like to receive a set of committee papers in advance. We publish an annual report which gives a full account of the work we have done and how it made a difference. And…we are always looking for new members! The vast majority of our work is undertaken by local volunteers who have an interest in helping How you can their communities get to have your a say in howvoice their NHSheard or is designed andbecome delivered. involved Aneurin Bevan CHC Annual Plan 2021-2022 30
How to contact us If you could spare some time over 3-5 days a month please get in touch. Raglan House, Llantarnum Business Park, Cwmbran, NP44 3BD If you write to us in Welsh, we will answer in Welsh. This will not lead to a delay in responding to your correspondence. 01633 838516 How to contact us telephone calls in Welsh. We welcome Enquiries.aneurinbevanchc@waleschc.org.uk www.aneurinbevanchc.wales @Bevanchc How to contact us Aneurin Bevan CHC Annual Plan 2021-2022 31
Appendix 1 – Full Council Membership Monmouthshire Torfaen Local Newport Local Caerphilly Blaenau Local Committee Committee Committee Local Gwent Local Committee Committee Local Authority Local Authority Local Authority Local Local Authority Authority Cllr Alan Davies No representation Cllr Graham Berry Appendix Cllr David Evans 1 – Full CouncilMs Membership Elaine Bryant Cllr Mrs Brenda Cllr Jonathan Miles Millard Cllr Mrs Teresa Cllr Phil Parry Edwards Cllr Julian Simmonds Appendix 1 – Full Council Membership Aneurin Bevan CHC Annual Plan 2021-2022 32
Third Sector Third Sector Third Sector Third Sector Third Sector No representation Mrs Lesley Perry Mrs Lesley Thomas Mrs Judith Mrs Cheryl Pritchard Merrick Miss Bernadette Rowlands Mrs Wendy Thomas Public Public Public Public Public Appointments Appointments Appointments Appointments Appointments Mr George Clemow Mr John Harris Ms Caroline Mr Peter Allen Mr Glyn Smith McLachlan Mrs Cheryl Mrs Felicity Jay Mrs Patrici Mrs Sonia Christoffersen Mr Ian Blackburn Cory Stainer Mrs Gaynor Parry Mrs Susan Gaylard Mrs Barbara Norvill Aneurin Bevan CHC Annual Plan 2021-2022 33
Co-opted Co-opted Co-opted Co-opted Co-opted Members Members Members Members Members Mrs Sue Campbell Mr Peter Hindley Ms Rizwana Mr Rob Mr Brian Nadeem Heaton-Jones Kember Ms Liz Power Mrs Lynne Lewis Mrs Christine tucker Cllr Mrs Carol Mr Phillip Westwood Mrs Pauline Walters Hillman Mrs Susanne Ms Vicky Williams Cllr Des Williams Hillman Aneurin Bevan CHC Annual Plan 2021-2022 34
Appendix 2 – CHC staff Appendix 2 – CHC support staff Team Whole time posts (Whole Time Equivalent) Chief Officer 1.0 Appendix 2 – CHC staff Deputy Chief Officer 1.0 Complaints Advocates 2.4 Business Manager 1.0 Advocacy Support Officers 1.0 Appendix 2 – CHC support staff Administrative team 3.3 Patient and Public Engagement Officer 1.0 Total 10.7 Appendix 2 – CHC staff Aneurin Bevan CHC Annual Plan 2021-2022 35
Appendix 3 – Finance Appendix 3 – Finance Budget heading Budget 2020/21 Fixed 452,820.00 Variable 37,431.00 Appendix 3 – Finance Overall allocation 487,773.00 Appendix 3 – Finance Aneurin Bevan CHC Annual Plan 2021-2022 36
Appendix 4 – Equality Impact Assessment Negative Positive None Impact Comments Appendix 1 – Full Council Membership Protected Characteristics Age x Disability x Sex x Race x Religion/Beliefs x Sexual Orientation x Appendix 1 – Full Council Membership Aneurin Bevan CHC Annual Plan 2021-2022 37
Gender reassignment x Marriage and civil partnership x Pregnancy and maternity x Other characteristics to consider Welsh Language x Publication available in Welsh Other Languages x Publication available in other languages on request Human Rights x Poverty level x Persons with dependents x Rural residence x Gypsy and traveller communities x Digitally vulnerable x Awareness of operational plan will be shared electronically in the first instance due to COVID-19 restrictions of face-to-face engagement. Aneurin Bevan CHC Annual Plan 2021-2022 38
Risk Assessment Are there any risks arising from the implementation of this policy? Awareness of this publication will be distributed via website, social media and email network contacts in the first instance. This plan would also usually be shared with the public at public events and meeting groups on a face-to-face basis for those who may also be digitally vulnerable. During the pandemic, we are unable to hold face-to-face engagements but will encourage our networks to share the document electronically and in paper form where needed. CHCs will also seek to undertake face-to-face engagement with the public as soon as it is safe to do so and in line with Government guidance. What measures are in place to manage or remove these risks? As stated above. Aneurin Bevan CHC Annual Plan 2021-2022 39
Welsh Language This document/policy has been assessed in line with our Welsh language requirements for policy making standards 69, 70 and 71. In coming to our impact determination, we reviewed the evidence of suggestions put forward by stakeholders and members of the public during our operational planning public consultation period. Engagement opportunities during this period were available in both Welsh and English via a standardised survey. No specific comments were raised regarding the Welsh language, and no responses were received through the medium of Welsh. As part of our planning process, we considered our Welsh Language Standards and our obligations when preparing this plan. Outcome Positive impact – This operational plan is available in Welsh and English, and the activities within the plan will be subject to their own Welsh Language needs assessment against the standards and an individualised Equality Impact Assessment when the activity itself is being operationalised as a standalone project. Aneurin Bevan CHC Annual Plan 2021-2022 40
This plan is a working document. Our statutory functions require us to respond during the year to issues and change proposals as they arise. This may require us to revise our priorities or amend our planned activities. Aneurin Bevan CHC Annual Plan 2021-2022 41
www.aneurinbevanchc.wales www.aneurinbevanchc.wales www.aneurinbevanchc.wales Aneurin Bevan CHC Annual Plan 2021-2022 42 www.aneurinbevanchc.wales
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