Operational Plan 2020-2021 - Hywel Dda Community Health Council Aneurin Bevan CHC Operational Plan 2020-2021 - Health in Wales
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Hywel Dda Community Health Council
Aneurin Bevan CHC Operational Plan 2020-2021
Operational Plan
2020-2021
April 2020
www.communityhealthcouncils.org.uk
1
Aneurin Bevan CHC Operational Plan 2020-2021
Community Health Councils (CHCs) are the
independent voice of people in Wales who use
www.communityhealthcouncil.org.uk
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.
An electronic copy of this document can be found on our website:
www.communityhealthcouncils.org.uk/hyweldda
If you would like this publication in an alternative format and/or
language, please contact us:
Suite 5
1st Floor
Ty Myrddin
Carmarthen
SA31 1BT
Tel: 01646 697610
Email: hyweldda@waleschc.org.uk
Twitter: @hywelddaCHC
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Facebook: Hywel Dda Community Health Council
Hywel Dda CHC Operational Plan 2020-2021
Contents
Chair’s introduction 4
Carmarthenshire locality 7
Ceredigion locality 8
Pembrokeshire locality 9
About your CHC 11
Making a difference through our activities 12
Our governance 13
Our vision 14
Our strategic framework 15
Our equality objectives 16
Deciding what we do and how we do it 17
Key themes and priorities across Hywel Dda 18
All Wales key priorities 22
Responding to matters as they arise 23
How can you get your voice heard and get 24
involved
How to contact us 25
Appendices 26
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Hywel Dda CHC Operational Plan 2020-2021
Chair’s introduction
We already know that People value their NHS and
2020-2021 will be a period recognise that they are under
of change for people in the pressure and sometimes
Hywel Dda University struggling. People are worried
Health Board (the Health about changes in where, when
Board) area. and how they get the care they
need, especially at times when
NHS services in they have to rely on others.
Carmarthenshire, Ceredigion We recognise that not all
and Pembrokeshire are changes automatically result in
evolving as part of the Health improvements but that all
Board’s long term plan to improvements require change.
manage health care in a way The huge array of changes that
that will aim to tackle some of have happened as part of the
the difficulties that people corona virus pandemic now
currently face when accessing means that our health services
health care. In addition to this, are very different to the way
the corona virus pandemic has that things were just a few
meant that things are now months ago.
changing at a very rapid pace.
We hear in our discussions
The Community Health Council
with people, the challenge they
has an important role in this.
face in getting a GP
As the statutory patient voice appointment. People
we are involved in making sure remember times when they
that the voice of health care could often just go and wait to
users is pivotal in the be seen in the GP surgery the
realisation of the HB strategy. same day, without booking
We are also crucial in ensuring ahead. This kind of service is
that when health services rarely available nowadays.
change as part of a global People tell us that getting to
response to the corona virus, see a doctor is far harder than
local changes are scrutinised. it used to be and they find this
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Hywel Dda CHC Operational Plan 2020-2021
unsettling, especially if now well.
they have to use very different
ways of getting an Most people are aware that the
appointment. NHS is only part of the picture
in trying to ensure that people
People also tell us that hospital live well and age well. Social
care can be an issue. Until a care support is also important
few months ago the main to allow people to be as active
issues were waiting times for and involved as they possibly
appointments, treatment or can within their own
admissions, parking issues communities, despite their
when people get there. It can health problems. We know
also be issues about getting that at present, health and
home from hospital and having social care providers do not
the support they need when always work as well as they
recovering from treatment and
could do. This is a further area
living with ill-health. Corona
of change that is being
virus has now meant that
addressed.
people are more worried about
delays in all kinds of hospital
During 2020-2021, we will
care as well as huge
continue to work with the
differences in the way that this
Health Board and other
care will now safely happen.
organisations to involve people
in decisions, so that together
Alongside this, we understand
we can move forward with
that in general, not all kinds of
positive changes. We will do
health care can be provided in
this, even though the
all locations, close to where
pandemic situation has already
people live. This means that
resulted in big differences for
sometimes there will be
all of us in our everyday lives.
regional centres, working
across a number of health
Importantly, we will continue
boards. Whilst it is reassuring
to respond to things that
to have centres of expertise,
matter to individuals and
people worry about being far
groups within our
from home when they are not
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Hywel Dda CHC Operational Plan 2020-2021
communities. Our CHC listen to people’s experiences
members and staff have of NHS services, what was
traditionally gone out and good, what was not so good
about, within local and from this we can identify
communities to make sure that what is needed to make things
people’s views on their health better for us all. We want to
services are heard. We have be able to reflect back these
to represent and reflect the different views and opinions to
views of 384,000 people and decision makers within the
this means that there will health care arena.
inevitably be different opinions
about what people want and Finally, CHCs across Wales are
what people need. We now also likely to facing changes as
need to adapt our ways of the Welsh Government takes
working to make sure that we steps towards forming a new
continue to do this even when “Citizens’ Voice”. We want to
there may be restrictions about continue to hear from you as
where we can go. individuals, groups and
communities and tell you what
To achieve our plan for this we do. We want to strengthen
year will mean that our the voice of people in our
volunteer members, communities in
community partners and local Carmarthenshire, Ceredigion
people have to continue and Pembrokeshire.
working together. We want to
Mansell Bennett MSc
Chair of Hywel Dda Community Health Council
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Hywel Dda CHC Operational Plan 2020-2021
Carmarthenshire Locality
Carmarthenshire, with a population of 184,900, is the largest
county within Hywel Dda. The key towns are Llanelli, Carmarthen
and Ammanford.
Within Carmarthenshire there are two District and General
Hospitals - Glangwili hospital in Carmarthen and Prince Philip
Hospital in Llanelli.
There are also two community hospitals one in Ammanford and
the other in Llandovery. Within Carmarthenshire there are 32
GP surgeries including branch surgeries.
Carmarthenshire Locality Priorities
Carmarthenshire Locality aims to monitor services within its district.
This includes primary, acute, mental health, learning disabilities,
community care and dentistry.
Whilst at the start of the year, our plans were to look at services
such as:
Endoscopy Unit in PPH,
Referral to treatment times
Children’s services
Midwifery services
Llanelli Wellness Village
Crosshands integrated care facility
The new GP Access Policy
Car-parking in hospitals
Transport
Llandovery Community hospital
Amman Valley community hospital
We will now have to shift our focus to looking at how the Health
Board is changing its approach in light of the corona virus pandemic
and how services are being re-established to meet the needs of
patients.
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Hywel Dda CHC Operational Plan 2020-2021
Government guidance means that we cannot currently speak to
people in their communities and in hospitals as we would usually
do. This means that we now need to find new ways of hearing
what people want to share with us about their local NHS.
We will review our position in terms of visiting patients and
attending public events and once it is appropriate we will restart
this work.
Ceredigion Locality
Ceredigion is the most rural county in Hywel Dda with a
population of approximately 75,000 people. The main hospital
of Bronglais is situated in Aberystwyth towards the north. There
is a community hospital in Tregaron and there are also two
integrated care centres within the county as well as 11 GP
surgeries.
Beyond our role in the Coronavirus response, which now has to
take priority, Ceredigion Locality Committee will continue to
monitor services including, primary care, hospital care, mental
health and learning disabilities along with care provided in
community settings.
We have seen over the past year that in Ceredigion, there have
been changes in providing more care out of hospital settings
within the community, led by recently opened integrated care
centres in Cardigan and Aberaeron and in line with the Health
Board’s wider aims. At the start of the year, our plans were to
monitor and look at services such as:
The new integrated care centres
Tregaron community hospital
GP services across the county,
Adult Mental Health Services
Older Adult Mental Health Services
Midwifery services
The new GP Access Policy
Transport
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Hywel Dda CHC Operational Plan 2020-2021
Whilst we planned to focus on areas of service change that we
knew were in the pipeline, particularly in mental health services,
we now have to adapt our workplans. We also know that the
Health Board has had to make a range of rapid changes to
services as part of their pandemic response. We now need to
monitor these changes as the NHS across Wales tries to re-
establish routine care for people at the same time as dealing with
the uncertainties arising from the corona virus pandemic.
We will recommence visits and events where we speak directly to
the public, once it is safe and appropriate for us to do so in light
of social distancing restrictions.
Pembrokeshire Locality
Pembrokeshire is a county in the southwest of Wales, bordered by
Carmarthenshire to the east and Ceredigion to the northeast. It has a
population of 125,025. Its main town is Haverfordwest, where
Withybush Hospital is located. There are two Community hospitals in
the county, one in Tenby and the other in Pembroke Dock. There are
16 GP practices, this includes branch surgeries.
Pembrokeshire Locality Priorities
As with the other CHC locality committees, our volunteer
members in Pembrokeshire aimed to monitor services within its
district over the forthcoming year. This was going to include
primary care, acute care, mental health and learning disabilities
along with community care and dentistry. Our plan was to
specifically look at:
Discharges
Surgical assessment unit
Women’s and childrens services
Wards 9 & 10
Referral to treatment times
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Hywel Dda CHC Operational Plan 2020-2021
Outpatients appointments
GP access policy
Again, the committee’s plans have now had to be modified in
light of the corona virus pandemic which has resulted in
significant changes in health care services across all three
counties in Hywel Dda. Our primary focus for this year will now
need to change to consider the impact these changes have had,
what people tell us about the NHS as it now stands and how a
new kind of normal is now going to materialise, taking into
account what the people of Pembrokeshire feel is important to
them.
Pembrokeshire CHC members will therefore adapt their workplan
to meet the requirements that the global pandemic has placed
upon us, to monitor and scrutinise health services in a very
different way. To enable us to do this, we are also going to have
to change our ways of working and this creates a very dynamic
picture for us in the months ahead.
Across the three counties, we will monitor patient experience and
scrutinise Welsh Ambulance Service Trust through our committee
work, ensuring that the WAST hear any patient feedback that the
CHC receives. This activity will also be influenced by any changes
arising from the corona virus pandemic situation.
Finally, bearing in mind that people living within the Hywel Dda
area also use health services in other areas, we will not overlook
these. We know that for various reasons, people sometimes need
to travel some distances for specialist care because there may
not be any appropriate local options. We will continue to work
with other CHCs on a regional and national level, where indicated
to ensure that such services are scrutinised, monitored and
consider the views of people using them.
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About your Community Health Council
Hywel Dda CHC is the independent voice of people in
Carmarthenshire, Ceredigion and Pembrokeshire who use
NHS services. We are made up of local people who act as
the eyes and ears of patients and the public. We encourage
and support people to have a voice in the design and
delivery of NHS services.
We provide an important link Our members are appointed in
between those who plan and accordance with our statutory
deliver NHS services, those regulations. We also have the
who inspect and regulate it ability to co-opt members from
and those who use it. our communities to support our
work; we currently have a
Our CHC is made up of 36
number of co-opted members.
volunteer members, local
people who volunteer their Our CHC also has a small team of
time to lead our work and paid staff. A full list of our
undertake activity on your members and staff is provided in
behalf. Appendices 1 and 2.
5Hywel Dda CHC Operational Plan 2020-2021
Making a difference through our
activities
CHCs have four main functions these can be described as:
systematically visiting and scrutinising
local health services
enabling users of the NHS to raise concerns
about the services they receive through an
Independent Complaints Advocacy Service
representing the interests of patients and the
public in the planning and agreement of NHS
service changes
continuously engaging with the communities
we represent and the health service providers
serving those communities
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Our governance
The way we organise ourselves to carry out our activities
is set out in regulations passed by the Welsh Parliament.
The activities we carry out The Board of Community Health
on your behalf are co- Councils sets national standards
ordinated and overseen by for all CHC activities and
our 3 local committees in monitors and manages our
the counties of performance against these
Carmarthenshire, standards.
Ceredigion and
The standards set out what
Pembrokeshire.
level of service you can
Together these make up expect from our CHC as we
our Full Council. carry out our activities on
your behalf.
You can find out more about
how we organise ourselves
on our website, including
details of our meetings.
Day to day and operational
management is the
responsibility of our Chief
Officer.
We are one of 7 CHCs in
Wales. All CHCs are
overseen by the Board of
Community Health Councils
in Wales.
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Our vision
People in Carmarthenshire, Ceredigion and
Pembrokeshire 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 understand and value the role played by Hywel Dda
Community Health Council in supporting them to be heard and
in representing the collective interests of patients and the
public.’
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Our strategic framework
To help make our vision a reality the CHC movement in
Wales has agreed a strategic framework incorporating 5
key priorities. These priorities underpin our plans and
activities.
Making every voice count
Improving our influence and reputation
Building and developing an effective
learning and values based culture
Valuing our members and staff
Strengthening our national voice
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Our equality objectives
To help us deliver our key priorities, we have also identified
these equality objectives:
▪ 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.
We will adapt our approaches to reach those whose care is
delivered out of hospital and develop our resources and
advocacy services to ensure that they are widely accessible,
available and relevant.
▪ 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.
▪ We will build on our existing partnerships and forge new ones
where working together increases our chances of making a
difference.
Our membership must reflect the diversity of the communities
they represent and support. We will monitor our membership
and develop targeted and more inclusive ways of recruiting new
members so that we become more representative.
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Deciding what we do and
how we do it
In deciding our activities for 2020-2021 we asked
people to tell us what mattered most to them about
NHS services in Carmarthenshire, Ceredigion and
Pembrokeshire. We did this by speaking to people
directly at a range of local events; via social media
and through our website and newsletter. Alongside
this, we also considered evidence from a range of
sources:
Survey returns and comments from our visits
Information from our Complaints Advocacy Service
Enquiries from members of the public throughout the
year
Letters from individuals and community groups
Reports published by the Health Board
Reports published by other NHS organisations
Reports published by other bodies
Our local committee discussions
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11Hywel Dda CHC Operational Plan 2020-2021
Key themes and priorities across
Hywel Dda
We looked at information from a range of sources to help us
decide what we could focus on in terms of our key priorities in
2020-2021. In making these decisions, we had to consider the
fact that we simply cannot cover every aspect of health care.
In addition, the corona virus pandemic cannot be overlooked and
will significantly influence our work for the forthcoming year. As
quickly as corona virus has affected everyone’s daily lives, we
now have to reformulate our plans.
This does not mean that we will disregard the plan that we had
before the corona virus pandemic but instead, we will have to re-
prioritise throughout the year, taking an agile and a responsive
approach to the things that matter to the people within our three
counties.
When making decisions about our priorities, we originally had to
think about:
The things that we must do as part of our statutory
obligations
Planned changes being considered within local health services
that may affect people in our area, where we can have an
influence
What we have been told by the people we represent and work
with
What NHS bodies tell us about their plans during the year
What we have seen or heard during our meetings, committee
attendances and visits
People we do not hear from very often and who we may need
to reach out to
Potential changes within CHCs themselves across Wales
which will impact on our capacity
18Hywel Dda CHC Operational Plan 2020-2021
Work which we have started in previous years, where we
need to find out more and take further action.
Working towards our equality objectives by involving as
many people as possible by adapting our ways of working
to allow this to happen
Work we need to undertake alongside other CHCs and other
bodies as part of a collaborative approach
Before the corona virus situation, we continued to hear about
difficulties in getting GP appointments. We will continue to
monitor the situation in what is called “Primary Care” across the
three counties to see if this situation is changing, particularly now
that getting an appointment is even more challenging and
sometimes people are more worried about going to the GP.
Alongside this, we knew that when people are not able to get GP
appointments, sometimes they resort to using A&E departments
instead. These continue to be a focus of our scrutiny because we
know that often people face long waits in A&E departments.
Again, people still need to access A&E departments even when
corona virus makes the situation more complex and we want to
keep abreast of this.
Where there are challenges in getting GP appointments, we
know that sometimes people have to use the Out of Hours
service when they become unwell and their GP Surgery is closed.
We will continue to scrutinise this because we are know that
across Wales, Health Boards have had difficulties in staffing the
Out of Hours Service.
Linked with all of this, before the corona virus pandemic, we
regularly heard that hospital beds were full and there were
difficulties getting patients home from hospital.
Lack of community care options or support packages resulted in
people staying in hospital longer than they needed to.
19Hywel Dda CHC Operational Plan 2020-2021
If people can get out of hospital more efficiently, this frees up
beds for others. This issue will remain under our scrutiny as we
know that the Health Board had to free up beds to deal with the
anticipated number of people with corona virus.
Mental health services have been prominent in the press and
social media during the past year. We know that the Health
Board is transforming its mental health provision to provide
better, more responsive care. Nevertheless, we still hear that
community mental health care is not working to meet people’s
needs. We will continue to monitor this and in particular the way
that local health services are addressing the needs of people in
crisis. With social distancing now part of our everyday language,
we need to understand what this feels like for people who need
support.
Unfortunately, maternity services across the UK have been the
focus of significant media coverage during the past year. We
supported an inspectorate body in monitoring this during
2019/2020. As well as this, we have visited all maternity units
across all three of our hospitals. We will keep this on our watch
list, looking at ways that we can help us understand what having
a baby is like when maternity services have had to change to
deal with corona virus.
We continue working on our current project to map the
experience of people with cancer who have care and treatment
across more than one health board. We understand that when
care is delivered across health care boundaries, this may impact
on patient experience and we want to understand this better. We
also know that when people’s care has had to be changed
quickly, to keep them safe, this has been unsettling and
worrying. We want to know how this is being managed, going
forward.
20Hywel Dda CHC Operational Plan 2020-2021
We will continue with our project work with the Welsh Ambulance
Services NHS Trust to see what people’s views are about some of
the new ways of working that are being used to manage ever
growing demands and very challenging working environments.
In 2019-2020, we reached out to young people with our
orthodontic survey. We wanted to find out more about young
people’s experience of health care and we intend to continue
building links with youth groups and schools to make sure that
young NHS users also have a voice. Not only are they future
users of health care but they are also the people who will staff it
and run it for others. We are mindful that they too face
uncertainty with their health care and we also want to hear their
views as things change rapidly.
Finally, having reviewed our complaints information we are aware
that many people’s lives are affected by dementia. For those
experiencing dementia themselves as well as their families trying
to support them, we want to specifically identify the problems
people face as well as the solutions that are sometimes available
and which need to expand. Whilst the health care world has
changed quickly over the past few months, the needs of people
with progressive illnesses still need to be considered as part of
this evolving picture.
21Hywel Dda CHC Operational Plan 2020-2021
All Wales key priorities (undertaken
by all CHCs in Wales)
CHCs work together to drive improvement and influence
policy on a national basis. We do so wherever our planning
processes identify shared priorities and issues that affect
people across Wales, and where working together will
maximise our impact.
During the year, people across Wales have told CHCs the things
they are worried most about.
Within the current context of events and in response to concerns
we have heard from people, during 2020- 2021 we will now work
together and with others to look at how the NHS in Wales deals
with the corona virus pandemic and its changing position.
Bearing in mind the 4 harms that have been discussed by the
Chief Medical Officer for Wales, CHCs will consider how NHS
services respond to this unprecedented situation. We need to
identify what this means for people before, during and after the
pandemic and how it has impacted on their health care
experiences.
22Hywel Dda CHC Operational Plan 2020-2021
Responding to matters as they
arise
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 to see if a concern raised with us is shared by others.
23Hywel Dda CHC Operational Plan 2020-2021
How can you 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 updates.
If you are part of a group or organisations and if you are
organisation and would like interested in receiving copies of this
to work with us on any of our on a regular basis, please contact
activities we would love to us so we can get this to you.
hear from you. We are also
happy to come and hear from You may also want to keep up to
any groups who have a story date with our Twitter and Facebook
to share about any aspect of accounts on social media so that
NHS services. We publish a you can give us your views,
calendar of meetings on our participate in surveys or come and
website so that you can see meet us when we are out and
when and where we will be about. We publish an annual
discussing key issues report which gives a full account
affecting NHS services. of the work we have done and
how it made a difference.
Our committee meetings are And…we are always looking
held in public so you are for new members!
welcome to attend. Please let The vast majority of our work is
us know if you would like to undertaken by local volunteers
receive a set of committee who have an interest in helping
papers in advance. their communities to have a say
in how their NHS is designed
We have a monthly newsletter and delivered. If you could
that we distribute spare some time over 3-5 days a
electronically to a range of month please get in touch.
24Hywel Dda CHC Operational Plan 2020-2021
How to contact us
ABERYSTWYTH OFFICE
Welsh Government Building, Rhodfa Padarn, Llanbadarn Fawr,
Aberystwyth, Ceredigion SY23 3UR
CARMARTHEN OFFICE
Suite 5, Ty Myrddin, Old Station Road, Carmarthen SA31 1BT
MILFORD HAVEN OFFICE
Suite 18 Cedar Court, Havens Head Business Park, Milford
Haven, Pembrokeshire, SA72 3LS
01646 697610
hyweldda@waleschc.org.uk
HDDComplaints.advocacy@waleschc.org.uk
www.communityhealthcouncils.org.uk/HYWELDDA
@HYWELDDACHC
25Hywel Dda CHC Operational Plan 2020-2021
Appendix 1
Full Council Membership
Members of Hywel Dda Community Health Council
as at 31 March 2020
Carmarthenshire Ceredigion Pembrokeshire
Local Authority
Cllr Ann Davies Cllr Elizabeth Evans Cllr David Bryan
Cllr Ieuan Wyn
Davies Cllr Lyndon Lloyd Cllr Ken Rowlands
Cllr Ken Lloyd Cllr Alun Williams Cllr Steve Yelland
Third Sector
Ken Jones Pat Bates Dr Barbara Wilson
Maureen Webley Marjorie Fogg Vacancy
Barry Williams Vacancy Vacancy
Welsh Government appointments
Mansell Bennett Carol Bainbridge John Harvey
Dr Pauline Griffiths Jarrod Thomas Margaret Povey
Patricia Neil Diane Richards Lindsay Moran
Edward Halling Gwenda Williams Pamela Parsons
Paul Mason Hugh Hughes Dr Sam Lewis
Christine Clarke Phillip Jones Ian Phillips
Co-Opted Members
Dr Gabrielle Ellinor Morgan
John Geary Heathcote
Vacancy Vacancy David Williams
Vacancy Vacancy
26Hywel Dda CHC Operational Plan 2020-2021
Appendix 2
CHC support staff
Team Whole time posts
(**WTE – Whole Time
Equivalent)
Chief Officer 1 WTE
Deputy Chief Officer 1.6 WTE
Complaints Advocates 2 WTE
Business Manager 1 WTE
Advocacy Support Officers 1 WTE
Administrative team 1.69 WTE
Patient and Public Engagement Officers 1.6 WTE
Total 9.89 WTE
27Hywel Dda CHC Operational Plan 2020-2021
Appendix 3
Finance
Budget heading Budget
425,649
Fixed
35,326
Variable
460,975
Overall allocation
28Hywel Dda Community Health Council
Suite 5
1st Floor
Ty Myrddin
Carmarthen
SA31 1BT
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