ITEM 11 Assistive Technology
North Lanarkshire Council · 22 November 2023
Back to Health and Social Care Integration Joint Board — 22 November 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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REPORT Item No: 11 SUBJECT: Assistive Technology TO: Integration Joint Board Lead Officer for Report: Ross McGuffie, Chief Officer North HSCP Author(s) of Report Margaret Flavell, Senior Manager Adult Social Work Claire Farren, Service Manager DATE: 22nd November 2023 1. PURPOSE OF REPORT This paper is coming to the IJB for: For approval ☐ For endorsement ☒ To note ☐ This report provides an update on the new assistive technology team within North Lanarkshire Health and Social Care Partnership and its impact since inception and aims going forward. 2. ROUTE TO THE BOARD This paper has been: Prepared By: ☒ Reviewed By: ☒ Endorsed By: ☒ This paper has been: Prepared by the Assistive Technology Team and reviewed and endorsed by senior management. 1
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3. RECOMMENDATIONS 3.1. The PFA committee is asked to: a) Note the progress of the new assistive technology team to date. b) Note the progress on promotion of digital services by the team. c) Note the uptake in technology and increase in engagement. 4. VARIATIONS TO DIRECTIONS? Yes ☐ No ☒ N/A ☐ 5. BACKGROUND/SUMMARY OF KEY ISSUES Background to Assistive Technology Team and its links to meeting digital plan for North Lanarkshire 5.1 Following The guidance of the Scottish Government and COSLA (Convention of Scottish Local Authorities) North Lanarkshire Council have been working to meet the expectations of the new digital strategy for Scotland “A changing nation: how Scotland will thrive in a digital world.” This has resulted in the partnership’s dedication to getting the right support to the right people in the right way. There is a focus on wellbeing and an acceptance that exclusion from the digital world can increase isolation and limit our life chances. In 2022 it was recognised that a team was required to support the necessary steps to enhance and safeguard wellbeing through digital technology as well as making sure the most vulnerable people that we support have the skills, connectivity, and devices to participate in a digital nation. 5.2 Changing demographics, pressures on existing services and budget restraints have motivated us to consider how we can continue to provide service to individuals who need it at the right time. Prior to 2019, there was a team of two people in a central assistive technology team who coordinated the standards, processes, training, and innovation for assistive technology provision across North Lanarkshire Social Work Services. When the staff left the organisation this level of work was maintained, but there was limited capacity to actively develop the service despite the rapidly changing enhancements to this sector. 5.3 North Lanarkshire Health and Social Care Partnership agreed an innovative approach and wanted to accelerate their approach of using assistive technology solutions to support people differently. The Assistive Technology Team (ATT) was created in January 2023. The new ATT consists of a Senior Officer, 4 Resource Workers and 8 Technology Support Assistants. The ethos of the team is to ‘Think Tech First’ and the ambition is to promote the use of assistive technology to improve quality, delivery and safety in care planning across the partnership. Assistive Technology is at the forefront of The Strategic Commissioning Plan 2023-2026 and is 2
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integral to achieving better outcomes for people to maximise their independence and safety. The Team is based in the Dalziel Building, Motherwell with regular presence in localities. Aims and Progress 5.4 In accordance with ‘Care in the Digital Age’ the team aims to deliver new digital solutions to support the national priorities around proactive and preventative care. The team are embedded within social work localities and work alongside community alarm, access social work, community care teams, reablement and intensive home support, Home Assessment Team (HAT), Integrated Day Services, Locality Support Services, Community Mental Health Team, Integrated Rehabilitation teams and third sector agencies. It is an ambition that the development of assistive technology across these services will have a positive impact on our ability to deliver support and services at the right time whilst reducing pressures on the afore mentioned teams. Since the inception of the new assistive technology team, work has been ongoing to increase awareness, knowledge and uptake of digital solutions. 5.5 Digital solutions are becoming more accessible and increasing in variety and as a result can be utilised as options for service delivery and service use. The Assistive Technology Team (ATT) work to the ambition that health and social care services are safe, person centred, secure and ethical. In doing so the aim is to ensure staff, people, carers, and family feel confident in the use of digital solutions to improve and enhance the delivery of care and support. Since its inception 558 referrals have been received by the service. 5.6 A Komp test of change, funded by National Services Scotland began in March 2023 and there are now ten KOMPS supporting people in our communities; five of these to facilitate medication prompting. The Komp itself is a large self-standing screen with one button that turns it on and off. It is self-answering following a ten second count down. The Komp is accompanied with a separate app that allows service users families and friends to connect to the device. It is very user friendly. The simplicity of the device makes it a more inclusive option for those requiring supports, in line with Scotland’s digital strategy “getting the right support to the right people in the right way” with a focus on “wellbeing and that exclusion from the digital world can increase isolation and limit our life chances.” The focus being on supporting people in controlling the home environment, medication prompting, reducing isolation, mitigating risks, and reducing carer stress. The initial findings have found a 100% reduction in home support where the device has been utilised. As a result of the trial none of the individuals required homecare support with the KOMP meeting their current needs. This has eliminated the need for a combined total of 84 medication prompts a week for homecare. 5.7 It is essential that we include the people in our communities and their families/carers in decisions regarding future planning around the use of assistive 3
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technology. While North Lanarkshire has a long history of good relationships with our communities it is essential that any future developments in the use of technology to support service users/carers are coproduced. To date the ATT have participated in 38 events with community-based groups. This work is aligned to Getting It Right For Everyone (GIRFE) and the Human Learning System approach. 5.8 We have an assistive technology flat used to showcase technology solutions and facilitate training to staff groups across the partnership and council. Visits to the flat have increased by 300% since the ATT have been in place. The tech flat offers the opportunity to see technology in use and the ways in which it can promote independence and enhance quality of life. Engagement with the technology flat continues to increase as it is recognised as an integral part of new worker induction across health and social work. The outcome being that staff are educated on and able to recommend technology solutions to those they support. The technology flat is also a platform to compliment and promote North Lanarkshire Council’s self-management platform, Making Life Easier (MLE) which allows individuals to access information, professional advice and direct access to services and support. 5.9 NHS Lanarkshire, North and South Lanarkshire Health Social Care Partnership (HSCP) recognise that people in receipt of social care have some of the highest risk of falls and related poor outcomes. Unfortunately, this high-risk group struggle to access and fully benefit from proactive approaches (timely and appropriate intervention before fall or injury occurs). Funded by the Tech for Better Care programme (https://htn.co.uk/), we are carrying out a short piece of work in partnership with Scotland’s Digital Health & Care Innovation Centre to develop a technology-enabled approach to relational and proactive falls prevention. It is called ‘No need to Fall’. In doing this we can help to ensure people spend better quality time in the home and in turn improve outcomes for families, carers and the workforce. Key Issues and future developments 5.10 Co-production work with communities to identify what their needs are in relation to assistive technologies. 5.11 Making Life Easier development for self-assessment of technology. 5.12 Devise systems to ensure effective ongoing monitoring of impact of use of assistive Technology across Health and Social Work Services 5.13 Assessment and planning- embedding technology into practice o PDD work to supplement home support provision with use of assistive technology. o Assessment and planning/SDS o Use of technology embedded into MySWIS and the future MOSAIC. 4
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o Use of technology "experts" throughout all aspects of assessment and planning and review processes o Use of technology at first point of assessment - Access Social Work, Home Assessment Team 5.14 A process of co-production to support the implementation of the use of assistive technology across services presents significant development opportunities for staff as well as the potential for increased job satisfaction as demonstrated through local experience and national research. 5.15 Continue to develop a training suite in the use of technology and how this can be used to support people living in North Lanarkshire. 5.16 ‘No Need to Fall’ Project with SLC, NHS Lanarkshire and DHI 5.17 Ongoing pressures on the system and our ability to provide Care at Home services have pushed us to think more creatively about how we can offer support. People who would have historically received care at home services now need to be reviewed with urgency and we need to embed a culture where we consider the use of technology in all assessment and planning. Doing this will have its challenges as we require to ensure that staff have the confidence and skills and that our communities are supportive of such innovation while making sure all solutions are person centred and the person is safeguarded. 6. CONCLUSIONS 6.1 In 10 months the Assistive Technology Team has made a considerable impact on assessment and planning and to the outcomes of people supported by the partnership. 6.2 The team have been well received by all services and they are now embedded across teams. 6.3 The team continue to evolve and develop whilst responding to the challenges faced by the partnership as well as the fast-paced developments in the technology sector. 5
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7. IMPLICATIONS 7.1 NATIONAL OUTCOMES Link(s) to National Health and Wellbeing Outcomes People are able to look after and improve their own health and wellbeing and live in good health for longer ☒ People, including those with disabilities or long-term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community ☒ People who use Health and Social Care Services have positive experiences of those services, and have dignity respected ☒ Health and Social Care Services are centred on helping to maintain or improve the quality of life of people who use those services ☒ Health and Social Care Services contribute to reducing health inequalities ☒ People who use Health and Social Care Services are safe from harm ☒ People who work in Health and Social Care Services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide ☒ Resources are used effectively and efficiently in the provision of Health and Social Care Services ☒ 7.1.1 The communities of North Lanarkshire will continue to be informed of changes in digital technology and consideration of this will be part of any health and social care assessment. People will be given support to ensure they understand and engage with recommended technology. 7.2 ASSOCIATED MEASURE(S) 7.3 FINANCIAL This paper has been reviewed by Finance: Yes ☐ No ☒ N/A ☐ 7.3.1 Finance have not reviewed this current paper; however, finance have been consulted throughout the life of the project and are currently members of the analogue to digital board. 6
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7.4 RISK ASSESSMENT/RISK MANAGEMENT Relevant Risk Register Details Current Risk Level Risk Owner Assistive Technology Low Margaret Flavell 7.5 ENGAGEMENT & PARTICPATION Please tick the engagement and participation objectives that link(s) with this piece of work and provide further details regarding the engagement and participation that was undertaken. Objectives Further Details ☒ Involve stakeholders in the development work aimed at achieving the national outcomes As outlined above and ongoing ☒ Provide stakeholders with information on how to get involved As above ☒ Ensure a diverse range of engagement and participation and opportunities are in place to suit different needs As above ☒ Measure how well we involve community stakeholders in the planning, design and delivery of our services As above ☒ Provide regular feedback on how stakeholder engagement and participation is shaping and influencing service development and delivery As above ☒ Provide support to enable stakeholder representatives to participate meaningfully and confidently at meetings As above ☒ Develop participation guidelines to ensure a common understanding and set of expectations for both stakeholders and partnership staff As above ☒ Support engagement planning and participation in localities, taking account of other engagement activity and local plans across the Community Planning Partnership As above 7.5.1. The communities of North Lanarkshire will continue to be informed of changes in digital technology and consideration of this will be part of any health and social care assessment. People will be given support to ensure they understand and engage with recommended technology. 7
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7.6 INEQUALITIES & FAIRER SCOTLAND DUTY EQIA Completed & Fairer Scotland Impact Assessment Form Completed and attached to report: Yes ☒ No ☐ N/A ☐ EQIA added to website: Yes / Date added ☐ No ☒ N/A ☐ 8. BACKGROUND PAPERS Care in the Digital Age: Delivery Plan 2023-24 - Care in the Digital Age: Delivery Plan 2023-24 - gov.scot (www.gov.scot) Scotland Digital Health and Care Strategy - Digital health and care strategy - gov.scot (www.gov.scot) The Health Foundation launches Tech for Better Care funding scheme - htn 9. APPENDICES Appendix 1 Analogue to Digital Equality Impact Assessment CHIEF ACCOUNTABLE OFFICER (or Depute) Members seeking further information about any aspect of this report, please contact the following; Claire Farren – farrencl@northlan.gov.uk 8
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Direction from North Lanarkshire Integration Joint Board (IJB) 1 Reference Number 202310-10 2 Report Title Assistive Technology 3 Date direction issued by IJB 4 Date from which direction takes effect 5 Direction to: 6 Does this direction supersede, revise or revoke a previous direction – if yes, include reference number(s) 7 Functions covered by direction 8 Full text of direction 9 Budget allocated by Integration Joint Board to carry out direction 10 Performance Management / Governance arrangements 11 Date direction will be reviewed 9
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Document Text Appendix 1 EqIA version number EqIA status Complete X Incomplete If Incomplete please say why - for instance pending further consultation / research Governance Committee Date approved insert date Review date Insert date McClungR@northlan.gov.uk FraserDi@northlan.gov.uk Contact details Robert McClung Diane Fraser Author Owner Analogue to Digital Transition Project Name of Policy / Budget Saving
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Section 1. About the Policy 1.1 Name of the policy / strategy / function / procedure: Is this a: - A new policy /strategy / function / procedure / service Budget saving Review of policy /strategy / function / procedure Review of Service Other (please specify) Community Asset Transfer Is this is a key strategic decision subject to the Fairer Scotland Duty Yes No 1.2 Person Responsible for the policy etc. Name: Robert McClung Job Title and Service / Team: Senior Officer Analogue to Digital project Lead (Adult Services) 1.3 What is the scope of the assessment? Detail where appropriate Whole of the organisation Service specific Discipline specific Other 1.4 What is the policy/ strategy/ function/ saving trying to achieve / do? Analogue to Digital Telephone lines in the UK are being upgraded to digital technology. The process of migrating to digital telephone lines has already started, and the rollout is scheduled to be completed by 2025. As of 2021 services can no longer sell analogue services such as BT and Virgin, and by and escalated process by 2023 no analogue tech nology can be sold also by any company. Analogue to Digital in Community Alarm Current telecare solutions in use in Scotland use analogue technology. This means that they send signals between the alarm device and Alarm Receiving Centre (ARC) by making a dialup phone call and sending a series of audible tones. Analogue signalling does not work reliably when sent over the digital phone lines that are being installed in user’s homes, grouped schemes, and ARCs Telecare is digital when signalling traffic is carried end-to-end (from a user’s alarm device to the ARC) in a digital format. This device is not connected to the user’s telephone line, instead it contains a SIM card that allows it to connect to the mobile telephone networks.
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This means that the Alarm Receving Centre, alarm devices and peripherals will now need to be digitally enabled to meet the future needs of the service users within our community. This project fits directly into the council’s ambition priority to - Improve the health and wellbeing of our communities. North Lanarkshire Health and Social Care partnership and North Lanarkshire Council is looking to develop a strategic business plan for the analogue to digital transition through the review and analysis of current service provision and their users. This project will look to have an in-depth look at understanding of current technology in place, current HSCNL digital workstreams and their impact on this project and collaboration, engagement of community alarm users, engagement of HSCNL staff in respect of technology and community alarm service and appraisal of alternative technology for future use within the partnership This project will look to provide our communities with the ability for self-management, proactive responses from services and for a holistic person-centered basis for a person’s wellbeing using technology. This project will have produced a strategic business plan for the analogue to digital transition along with all relevant risk assessments. Following the strategic business plan, this project will then focus on implementing the organizations transition from analogue to digital. This will come in the form of procuring a new alarm receiving center through a cloud hosted based system or hardware-based system, to replace our current analogue alarm receiving center. This will then allow for us to look at digitally enabled devices to replace our current analogue community alarms. 1.5 If this is a budget saving, how will the saving be achieved? This project will not focus on budget savings. Section 2. What do I know now? 2.1 Who are the stakeholders and beneficiaries? The stakeholders will be our residents within North Lanarkshire Council areas who are provided with a community alarm service or a telecare service. Other stakeholders will be employees who work for the community alarm service and Health and Social care who assess and prescribe telecare equipment. 2.2 What data, consultation, research and other evidence or information is available relevant to this assessment? (This is a desktop exercise) Digital Telecare National Briefing Document (2020) gives an overview of the work done by telephony providers around the transition of their analogue copper lines to new fibre digital lines. This was done without consultation of the public or any organisation.
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This document also outlines An estimated timeline with an in-depth breakdown of the timescales to complete key operational components of the transition. Estimated resources and costings for the transition. Information on the impact that the transition will have on service users. Potential benefits and opportunities of a digital telecare service. Risks to be considered. Recommendations that telecare service providers should follow to minimise disruption to their service users. Information on resources available from the Digital Telecare Programme which will support the transition journey. North Lanarkshire have also enlisted a third part organisation to carry out reviews of the community alarm service which details peoples experience of using this alarm system. 2.3 Considering the information in Section 1 and 2.1 and 2.2 2.3.1 If this policy is subject to the FSD what does it suggest about the impact or potential impact on socio-economic disadvantage? (please refer to FSD Interim Guidance) Low income People in receipt of a community alarm are now in the process of being charged for this. Due to the digital upgrade and the enhance cost of equipment and alarm receiving centre this will further affect cost of this service. Low wealth Material deprivation Area deprivation 2.3.2 Are any of the people communities listed below likely to be more affected by this policy than others? People who share one or more of the protected characteristics of the Equality Act 2010 Yes Details No Details Don’t Know Age (a particular age or range of ages) X 78.1% of community alarm users are aged 70 years and over. Disabled people and people with long term health conditions X Most users of the community alarm service fall within this characteristic. We are unable to pull statistics for this. Women and men, girls and boys X
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People defined by their race, colour and nationality, ethnic or national origins. X Married people and civil partners X Pregnant women and new mothers (including breastfeeding women) X Lesbian, gay and bisexual people X People transitioning from one gender to another X People of different religions or beliefs or non-beliefs X Other groups Children and families X Homeless people X Looked after and accommodated people X Care leavers X Carers – paid / unpaid, family members X Carers will be affected due their possible requirement to use the community alarm systems to summon support fore the person they are providing the care Asylum seekers X Employees – full and part time. Including SES, MAs etc. X Staff who work within the service will be affected by changes to their operating systems and procedures. Others 2.4 Do you have evidence or reason to believe that this policy will, or may potentially affect the Council’s duty to: (Please tick all that apply). Yes No Don’t Know
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1. Eliminate unlawful discrimination, harassment and victimisation and any other conduct prohibited by the Equality Act 2010? X 2.Advance equality of opportunity between people who share a relevant protected characteristic and those who do not X 3. Foster good relations between people who share a protected characteristic and those who do not? X 4. Protect and promote human rights? X 5. Reduce socio-economic disadvantage X Please provide details. Section 3. What else do I need to know /find out? 3.1 Further consultation – Please use the table directly below to say who you will consult with (tick Yes or No). Consider those groups from section 2.3 where you ticked yes or don’t know. Once consultation has taken place provide the details below. People and communities Yes No Describe what you did, with whom and when. Please provide a brief summary of the responses gained and links to relevant documents, as well as any actions Age (a particular age or range of ages) X Information relating to the digital transition will be passed to all relevant users of the community alarm service. This will be done in conjunction with our communications team to ensure that the most up to date information is sent and is accessible for all. Disabled people and people with long term health conditions X Information relating to the digital transition will be passed to all relevant users of the community alarm service. This will be done in conjunction with our communications team to ensure that the most up to date information is sent and is accessible for all. Women and men, girls and boys X People defined by their race, colour and nationality, ethnic or national origins. X Married people and civil partners X Pregnant women and new mothers and breastfeeding women. X Lesbian, gay and bisexual people X People transitioning from one gender to another X
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People of different religions or beliefs or non-beliefs X Other groups X Children and families X Homeless people X Looked after and accommodated people X Care leavers X Carers – paid / unpaid, family members X Information relating to the digital transition will be passed to all relevant users of the community alarm service. This will be done in conjunction with our communications team to ensure that the most up to date information is sent and is accessible for all. Asylum Seekers X Trade Unions X Employee Equality Forum X Others X 3.2 What additional research or data is required? At this time all research and data has been provided by the Digital Office for Scotland as this is a nationwide activity being completed by external telephony providers which will affect all areas. 3.3 What does the additional research and data tell you about potential or known effects? N/A Section 4. Assessing the impact and strengthening the policy Considering all the evidence you now have from section 1-3, how will the policy affect different people and communities in relation to equality, socio-economic disadvantage and human rights?
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4.1 How does/will the policy and resulting activity affect those with the characteristics listed below (including employees)? Please use the table below to provide details. Detail any Positive impact Detail any adverse impact If adverse how can we mitigate this? Where no mitigating action is planned please say why not Age (a particular age or range of ages) The introduction of digital telecare will allow for better call function (clarity/speed/reliability/quality. This will also allow for further technology which could enhance care and independence to be introduced. Due to the digital upgrade and the enhance cost of equipment and alarm receiving centre this will further affect cost of this service. Ensure that benefits have been maximised. Disabled people and people with long term health conditions The introduction of digital telecare will allow for better call function (clarity/speed/reliability/quality. This will also allow for further technology which could enhance care and independence to be introduced. Due to the digital upgrade and the enhance cost of equipment and alarm receiving centre this will further affect cost of this service. Ensure that benefits have been maximised. Women and men, girls and boys People defined by their race, colour and nationality, ethnic or national origins. Married people and civil partners Pregnant women and new mothers (including breastfeeding women) Lesbian, gay and bisexual people People transitioning from
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one gender to another People of different religions or beliefs or non- beliefs Other groups Children and families Homeless people Looked after and accommodated people Care leavers Carers – paid / unpaid, family members The introduction of digital telecare will allow for better call function (clarity/speed/reliability/quality. This will also allow for further technology which could enhance care and independence to be introduced. Due to the digital upgrade and the enhance cost of equipment and alarm receiving centre this will further affect cost of this service. Support is provide to ensure the person they care with has their benefits maximised to allow them to keep this service. Asylum Seekers Employees – full and part time. Including SES, MAs etc. The introduction to the digital telecare should provide a better working platform for staff with better call reliability and handling. This should reflect in their ability to take and field calls more efficiently A new way of working may need to be introduced which will require further training and support for staff to follow Support will be provided throughout the project. Others 4.2 What measures could be taken to strengthen the policy / strategy to help advance equality of opportunity, foster good relations, promote human rights and reduce socio-economic disadvantage. North Lanarkshire could look to build on its use of community alarm service reviews to carry out a more holistic in-depth review of a person’s needs. This would allow the service to maintain and enhance its relationship with the users of the alarm service. 4.3 Considering questions 4.1 and 4.2 what actions / measures will be put in place before introducing this policy please provide details.
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Action Timescales Responsible Officer Review details (include timescales) Section 5. Monitoring, evaluating and reviewing Section 6. Making a decision and sign-off Recommendation Tick Comment (where applicable, please give more information e.g. where to pilot, what modifications, etc.) Timescales Introduce the policy New policy and procedures will be put in place once digital transformation of the service is complete 12 Months Adjust the policy then introduce Introduce the policy with justification regarding potential adverse impact Stop and withdraw the policy Name of Policy Head of Service /Senior Manager sign-off: Name Job title and division/ team Date Signature 5.1. How will you monitor the impact and effectiveness of the new policy? This will be reviewed at the beginning of the transition and throughout the implementation of the digital equipment. The full project will be subject to a review as in line with North Lanarkshire’s project management policy.
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For further information please contact: Name: Hugh Holt Job title: Senior Officer Service: Adult Services Contact details: Holth@northlan.gov.uk