Final Report Reference:
good practice & innovation
THE RESPONSE PROJECT 3RD June 2010
Author(s):
Lynda Austin
Fitz Adams
Main Contact:
Lynda Austin
Department:
Heart of Birmingham tPCT Teaching Directorate
Revision History
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Final Report Reference:
Version 5
Project Title:
The Response Project
good practice & innovation
Contents CONTENTS ......................................................................................................................................2 ACKNOWLEDGEMENTS ...................................................................................................................3 EXECUTIVE SUMMARY ....................................................................................................................3 BACKGROUND ................................................................................................................................4 AIMS & OBJECTIVES ........................................................................................................................5 METHODOLOGY..............................................................................................................................5 IMPLEMENTATION..........................................................................................................................7 OUTPUTS ........................................................................................................................................9 SUSTAINABILITY ....................................................................................................................................10 OUTCOMES...................................................................................................................................10 LESSONS LEARNED ........................................................................................................................ 11 CONCLUSIONS .............................................................................................................................. 12 IMPLICATIONS .............................................................................................................................. 12 RECOMMENDATIONS ................................................................................................................... 12 REFERENCES................................................................................ ERROR! BOOKMARK NOT DEFINED. APPENDIXES .................................................................................................................................12 DISSEMINATION SUMMARY ....................................................................................................................14
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Acknowledgements The Response trial project was funded by JISC under the ‘Facilitating Collaboration’1 stream of the BCE programme2 as part of the ‘Trialling Collaborative Online Tools for BCE’ project3. JISC infoNet4 led the delivery of outputs with support from other JISC Advance Services5. The trial project team would like to thank the following for their hard work and contribution to this trial project as well as the wider BCE agenda: Caroline McIntyre Workforce Planning and Training Manager, Heart of Birmingham tPCT Dr Sandy Bradbrook and the MHA Steering Group Marilyn Thomson, Associate Dean, Birmingham City University for suggesting this would be a good project for the MHA. The MHA Project Team for continuing to support the project regardless of technical problems!
Executive Summary Introduction This report provides an evaluation of the MHA Response project as it reaches the end of its pilot phrase. The Response project is led by Birmingham Metropolitan College and consists of a partnership of academic organisations (HE and FE) and Heart of Birmingham teaching Primary Care Trust. The overall aim of the project was to use online collaborative tools to share knowledge and documents to ensure that the voice of the employer, the NHS, is heard when developing course materials. Because of changes in the NHS, academic institutions need to be able to respond to a different environment. It is critical that training programmes are available and linked to existing and emerging models of care. The Response project has been innovative in that is has provided a platform for the NHS together with HEIs and FECs to discuss workforce planning and development without time consuming meetings and travel costs. Wider stakeholders were also involved in receiving updates and making suggestions on different ways we could deliver the project. Aims and Objectives The first stage of the project focused on choosing and implementing the chosen technology / software. All partners had a project laptop provided so that they could ‘attend’ virtual meetings wherever they happened to be. This was an important consideration for academic staff who are part of the project team and who are responsible for recruiting from India, China etc and spend a lot of time travelling. The software chosen was Elluminate for video conferencing and a Moodle site for sharing files; forums and discussions. The project has achieved its overall aim of improving knowledge transfer and exchange between NHS employers and education organisations and it has facilitated the sharing of information. One area in which the project has really helped to address is a lack of knowledge in the education sector about workforce planning in the NHS. However, there have been a number of technical issues regarding access and broadband speed in some partner organisations. http://www.jisc.ac.uk/whatwedo/programmes/bce/stream2.aspx http://www.jisc.ac.uk/whatwedo/programmes/bce.aspx 3 http://collaborativetools4bce.jiscinvolve.org/ 4 http://www.jiscinfonet.ac.uk 5 http://www.jiscadvance.ac.uk 1 2
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Goals and Objectives: 1) Training and Development for Project Staff All project staff received a number of training sessions on a) the laptops b) Moodle and c) Elluminate. These sessions were delivered by the Birmingham Metropolitan College and were well attended and successful in achieving their outcomes. One of the training sessions was recorded. 2) System of shared files Moodle was chosen to house all project files. This has been successful and information from the Strategic Health Authority, the NHS and other sources is available on this site. However, because of the change of government some documents have now been removed because they are no longer relevant to the direction of travel for health. 3) To improve knowledge transfer and exchange This has been successful. Information has been shared on research papers, NHS workforce development and planning initiatives and online presentations have been given using Elluminate. Overall the goals of the project have been achieved but a number of technical issues particularly concerning the NHS have been problematic. The webcams in the project laptops was a problem for the majority of the partners, although academic networks allowed the laptops to access the chosen sites there was intermittent access to the webcam and for others no access. There was also a problem with attendance at online meetings. Finding a date that was suitable for 8 people for the online sessions was difficult. Because of restructuring and inspections within a few organisations some project participants were also told to attend other meetings, because they were a priority, by their line managers and so cancelled online sessions. An unintended outcome has been a much closer ‘partnership’ between HEIs and FECs that has led to a consortium being formed to apply for Lifelong Learning funding.
Background The Midlands Health Academy (MHA) is a unique partnership that includes HEIs, FECs and NHS organisations in the Birmingham and Black Country areas. The MHA consists of 9 partners who are working together to establish a closer relationship with local communities that will manifest itself in more people entering NHS employment. The second and equally important facet of the MHA is to raise awareness of education, training and employment opportunities that are available for existing NHS staff. The MHA Partnership The organisations who took part in this trail project are:
The University of Wolverhampton
Aston University
Birmingham City University
Walsall College
South Birmingham College
Birmingham Metropolitan College
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Heart of Birmingham tPCT
Although 2 other Trusts are also part of the MHA Steering Group it was decided that Heart of Birmingham tPCT would be the only NHS partner because of the difficulties with liaising with a number of IT departments across Trusts. The MHA Partnership has been meeting since 2007 and has already been involved in a number of joint projects. However, one of the main focuses of the MHA is workforce planning and development and it was felt that this JISC project would provide an ideal vehicle to facilitate work in this area.
Aims & Objectives The Project agreed to deliver the following aims and objectives: Aim 1: To manage version control for complex documents Objectives: Train all staff to use and understand the online system Aim 2: Set up system of shared files/folders Objectives: Create shared files linked to specific areas including progression pathways. Aim 3: To improve knowledge transfer and exchange between HEI’s; FECs and NHS employers and facilitate sharing of knowledge Objectives: Share research and other relevant papers Share employer workforce needs Share good practice between partners These objectives were closely aligned to government policy at the time the project was planned. The NHS Plan was focused on improving patient care and care closer to home was central to that agenda. This meant transferring some services that were being delivered in acute trusts into the community. Staff in primary care would need to learn new skills and competencies to deal with this change which would mean significant changes in terms of workforce development and planning. In addition the project was also a response to the Business and Community Strategies of the MHA partnership, these tended to focus on providing academic expertise to respond to the needs of business development and growth and improve the rate at which academic organisations respond to the needs of business.
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Generally these aims and objectives were achieved. The development of progression pathways was only partially successful. There are already progression agreements amongst partners covering some clinical careers. However because of changes in the local health economy and the possible merger of the 3 Birmingham PCTs, Heart of Birmingham tPCT was not a position to commit to progression agreements at this time.
Methodology Choosing the Right Tools The choice of technologies/tools we trailed during the project was driven by the need to meet the project requirements of: 1) sharing documents 2) discussion/collaboration – using chat / discussion forums and real time conferencing with webcams 3) mapping shared curriculum / progression routes 4) identifying gaps in provision re: workforce development needs within the NHS Project partners considered a number of different options with reference to the online tools that would deliver the best outcome for the project. Early discussions confirmed that the repository and chat/discussion forum would be Moodle. This was considered a reliable platform that some of the project team were already familiar with but a major factor was that there was a Moodle developer in the team. The choice for online conferencing tool was more difficult. This led to a number of options being identified and discarded because they would not deliver the outcomes required. The options considered were Skype, Dimdim and Webex. However, through a JISC Advance workshop the project team discovered Elluminate which had the added advantage of support with setting up conferences and training on how to use it. Additionally we could use the JiSC Advance Elluminate licence which represented a large saving for the project. Therefore, it was decided that the project would trial Elluminate. One of the major barriers that had to be addressed by the project team was access to the NHS network. Moodle was allowed through the Firewall and online chat sessions did not present a problem. Although one Elluminate session was undertaken at Heart of Birmingham tPCT access to a webcam was not allowed although there was full access to audio and materials presented. A request was sent to Information and Governance Committee to allow a webcam to be fitted to a PC on Trust premises however, after 6 months permission has still not been granted. Various phone calls between Birmingham Metropolitan College and Heart of Birmingham were held to discuss issues but the reason we were given by the NHS for not allowing access to some hardware / software was patient confidentiality. We did test broadband pens using Skype but this tool is not suitable for 6 + people although for one to one sessions it was useful. One of the major issues the project team experienced when using Elluminate was the amount of broadband width required which led to very slow running times and interruptions etc. Evaluation Methodology Formative evaluation was undertaken in January 2010 and summative evaluation was conducted from April – June 2010.
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The criteria for the evaluation were: •
The successes in terms of achieving against project aims and objectives
•
How engaged partners were in using the technology to meet and discuss workforce planning and development
•
Identify unexpected outcomes
•
The challenges
•
Lessons learned
The approach to the Trial Project evaluation was developed in consultation with partners. The methods selected were: •
Questionnaires for all partners (using Moodle)
A questionnaire was placed on Moodle and all partners were asked to fill in and submit. •
Interviews (using Moodle Chat)
Moodle chat was used to pose some questions regarding evaluation of the software used and any problems that it posed for individual organisations. •
One to one telephone interviews regarding the partnership
Informal, semi structured interviews were held through telephone calls to some project partners to tease out some of the unintended outcomes of the project such as strengthening partnerships and multi-‐tasting (linking to efficiency savings!) The questionnaire can be found in the Appendix Section.
Implementation The Project Team took a staged approach to implementing the project with a lot of emphasis on training and development for the staff involved in the delivery of the project. Although some of the project team were fairly confident with using different technologies, others had never used Moodle or online conferencing. Stage One Confirming Project Partners (February 2009) Although each organisation had agreed to take part in the project a specification detailing the knowledge and skills that would be required of project participants was presented at a MHA Steering Group. Project participants were required to have knowledge of both clinical and non clinical courses being run in their organisation; they were required to understand some of the policy drivers and constraints within the NHS and it was anticipated that they would have some undertaking of workforce planning and development in the NHS. Each organisation responded to this request and many of the project participants were ‘new’ to MHA activities and had not previously worked with colleagues from other institutions. Agreeing the specification for the laptops (February 2009) It was decided that project laptops would be provided that had built in webcams and enough memory and processing speed to run popular online conferencing tools. All the academic institutions allowed access to their networks for the laptops; however, Heart of Birmingham tPCT denied access unless the PCT IT department set them up. This would have resulted in access to many sites being
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blocked. It was anticipated that the laptops would be purchased in March / April 2009 however, because funding was not received until after this time the laptops were delivered in June 2009. Agreeing which online tools would be used (March/ April 2009) After looking at the specifications of different applications the project team decided to trial Moodle and Elluminate to conduct online meetings and store the shared folders. Project Staff Training (June – October 2009) Staff from seven organisations took part in a series of workshops. There was differing technical skill sets amongst these 7 participants, with some staff very confident in using Moodle and eager to access a variety of online tools, whilst others had little IT experience or knowledge. The first 2 training workshops focused on using the laptop and accessing Moodle (which had been set up on the laptop). The majority of staff were using Windows XP and older versions of MS Office and were unfamiliar with Windows Vista. The training session was an ideal opportunity for staff to meet for the first time and the feedback from participants was that meeting face to face before meeting online did help strengthen the partnership. The second phrase of training focused on Moodle and a comprehensive training manual was produced for this. The three training sessions started with how to login and went through ‘what is Moodle?’, the chat and forum facilities, uploading documents, and uploading videos. Training on Elluminate was done online by a facilitator, after a session was held on how to access and login to Elluminate. Stage Two (October – June) This stage focused on accessing the online tools. The chat rooms / forums on Moodle were used to discuss the training / development needs of the NHS and to look at progression routes into clinical careers. Hob’s workforce planning returns to the Strategic Health Authority, which detail the number and type of jobs that will be available in 1 / 3 and 5 years were shared. Partners shared details of new /existing courses that would feed into staff progression, particularly those relevant to NHS staff in Bands 2/3/4 some of whom may have no qualifications. This was also an opportunity for academic staff to learn more about the range of courses other HEIs and FECs in the area were running and to evaluate how some of the Level 2 /3 courses could be feeder routes into their higher level clinical courses. Elluminate was used to delivery presentations (including two key presentations re: the challenges facing the NHS and the new white paper Commissioning for Quality Education). Both these sessions were recorded. Stage Three (January – June 2010) Summative and Formative Evaluation During January a chat room session was held in Moodle to discuss the project and to discuss participant’s experiences for using both Moodle and Elluminate. Several technical problems were highlighted during this session including ‘drop out’ or ‘freezing’ when accessing Elluminate (one participant reported losing access to Elluminate 7 times during one session), and loss of sound. One participant also found that the online training on using Elluminate was undertaken by someone who was technical and perhaps didn’t understand that some people need to learn at a slower pace. Only one participant experienced no problems with Elluminate. They were based in Walsall College which has just been connected to fibre optic cables which may account for the excellent streaming. Because the technical difficulties encountered could not be solved (except by installing fibre optic 8 of 14
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cabling!) the project team examined and trialed another tool. Skype was trialed using USB modems to overcome the prohibitions put on Skype in some organisations and it proved to be successful with no ‘freezing’ etc. However, although excellent for one to one communication it is not suitable for 8 users. The Formative Evaluation highlighted that the two major benefits of the project were: 1) Less time (and money) spent on travelling 2) More productive use of time (can multitask – answer phone calls etc.) A cost analysis of the savings achieved by the partners using online tools was undertaken. On average each participant saved their organisation £27 per session. This cost analysis took into account salary costs whilst travelling, mileage allowance and parking charges. Two further sessions with Elluminate also resulted in participants streaming ‘freezing’ and being 1) unable to log in or 2) losing the network connection completely.There was also a problem with accessing webcams.
Outputs Moodle Site The project created a new Moodle site designed to meet the needs of the project. The site contains a chat room, partnership resources, video resources and up-‐to-‐date news on health topics. It can be found at http://moodle.sutcol.ac.uk/moodleacademy/login/index.php. There was positive feedback from all project participants about the Moodle site. There were no access issues and if people forgot passwords or logins then Fitz Adams from Birmingham Met responded very quickly to reset passwords. Once the new structure of PCTs in Birmingham is finalised it is envisaged that the site will be transferred to a NHS network so that is can still be used as a valuable resource. There are a number of resources available on the site and it has provided a platform for synchronous and non-‐synchronous communication and debate over a range of NHS workforce topics. There are some Progression Agreements between partners but due to the restructuring that has been taking place in academic institutions and the NHS in Birmingham further progression pathways have not been developed. Evaluation Results Project participants were asked to rate the online tools that we used based on the following criteria: 1) Ease of Use 2) Technological problems encountered 3) Using this technology rather than face to face meetings Participants were asked to rate on a scale of 1) rubbish to 5) Fantastic Ease of use: scored range was from 2 to 5 with many people finding Moodle very easy to use but having problems with Elluminate. Technical Problems: again a range from 2 to 5. A couple of participants had none or very few problems with the technology however the majority of people had major problems with either logins or ‘freezing’. Face 2 Face: The majority of participants scored 2 against this section, indicating that they had enjoyed using online methods of communication. However, during interviews participants also emphasised that meeting face 2 face during training sessions facilitated the online communication. 9 of 14
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Less successful elements of the Project: “Not all members of the team have logged into Moodle at the same time so we have not been able to have a 7 way conversation” “Number of participants using the Elluminate sessions and the lack of activity in the forums’ “Not being able to access the webcam” Most successful elements of the Project: These results were obtained through the Evaluation Questionnaire and Interviews. “Using Elluminate to have a feedback back session on a meeting that the MHA Project Manager had attended and to have the PowerPoint presentations from that meeting made available to us online” “The ability to network without being face 2 face” “Difficult to say as involvement was hampered by inability to use webcam and login to some sessions” “Overall the project demonstrated that this medium can work to share, disseminate and post courses and resources that may be helpful to promote widening participation. It (the project) facilitated a spirit of co-‐operation and collaboration and sharing of resources” “I think that the online presentations done by the project manager were the most successful aspect. As an NHS employee she has access to resources and people that we in colleges and universities do not get. I learned a lot about NHS workforce planning and how we need to work together more closely to develop the future workforce” All the project participants were keen to continue using online tools. Overall the project achieved its outputs with the exception of developing further progression pathways.
Sustainability Birmingham Central Health Innovation Education Cluster (HIEC) is a new group funded by the Department of Health. The HIEC is a partnership of NHS PCTs, Acute Trusts including mental health, five universities, and industrial, commercial and third sector organisations covering Birmingham, The Black Country, Worcestershire and Herefordshire. One of the aims of the HIEC is to integrate learning pathways from further to higher to lifelong education and it is this stream that the JISC MHA project will continue to facilitate within the HIEC. The MHA will continue as a partnership, albeit with closer and more varied partnership arrangements as a result of this project. Once the situation regarding the health sector in Birmingham is clear then work will commerce on curriculum mapping against NHS jobs and the further development of progression routes. The group will continue to use online tools to communicate and share documents.
Outcomes The most important aim of the project was “To improve knowledge transfer and exchange between HEI’s; FECs and NHS employers and facilitate sharing of knowledge”. Overall the project team feel they are more aware of issues in the NHS and its needs in terms of staff development and planning than they were before participating in the project. The MHA Project Manager has, as a result of the project, been invited to participate in a new course planning meeting within a HEI. This means that employers have a mechanism to directly influence course content and when undertaking validation HEI’s can assure the panel that the course is meeting the needs of
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employers. The project has facilitated partnership working by introducing different groups of people from a variety of institutions in training sessions and online. Because of the networking opportunities available whilst working on the project, some of the organisations are now looking at joint working and applying for Lifelong Learning funding as a consortia. Finally, there we several benefits associated with having shared access to online materials. Although many NHS documents are available online it is very difficult to find them as they can be on one of several sites. The internal Hob documents that were made available are not available to the public for several months yet the content, workforce plans, is of great importance to academic organisations.
Lessons Learned Because of the disparate stakeholders involved in the Response project and the fact that some of them were involved in work that took them overseas, it was essential that laptops were purchased. This allowed staff to access online sessions even if they were off site. The built-‐in webcam was necessary, but tended to work intermittently on some networks. The project team would advocate the use of USB broadband for future projects. More time needed to be spent testing the laptops / networks in each organisation. There were several ‘bugs’ that needed to be addressed that initial testing did not highlight such as login problems. This meant that some people missed online sessions. The project team trailed USB Broadband pens and Skype which worked well. External environment such as reduced funding for both academia and the NHS and the restructuring of local colleges and PCTs have greatly impacted on the project. Although Response did not have staff that left the project, it did have project staff that because of external factors had their work reprioritised and ended up missing meetings. The training given when first accessing Elluminate needs to be more appropriate for those less technology minded. One partner reported “I found the elluminate session hard going mainly due to the intermittent reception that I had. Also, I was a bit put off by the constant stream of instructions to do tasks and the lack of learning on one task before running on to the next. It got a bit much and I tuned out I'm afraid. In reality I expected the pace to be a little slower and the tasks/information flow to be more meaningful. Sorry to be negative -‐ I think it will be a good tool in the end!” Top Four tips 1) If working across several organisations become best friends with all the Network Managers. 2) Test, test and test again all laptops, software, programmes and network access in the partner organisations. Spend at least 1 month visiting all partners to ensure the equipment and access to the chosen tools work institu. 3) Arrange face 2 face sessions before using online tools – this facilitates the development of the partnership. 4) Thoroughly test Elluminate on your own network before deciding to use it as a tool for your project.
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Conclusions The project achieved its aims and objectives against a very difficult external background of possible redundancies and budget cuts. Although all partners remained committed to the project, some of them were asked to concentrate on other areas because of external factors facing their organisations. This resulted in some sessions on Moodle and Elluminate attended by only 3 or 4 people rather than the 7 that were expected. There were a number of technical difficulties due to freezing and being cut off in mid session when on Elluminate. Some partners found this fairly stressful and felt they were wasting time trying to access the tool. Overall partners found their expectations of the project were met; particularly in terms of more productive use of their time (less travelling) and being better for the environment. All the partners agreed that the training delivered by Fitz Adams from Birmingham Met was excellent and helped to facilitate the partnership that further developed through the online sessions. Given the efficiency savings required in the NHS over the next two years, the use of online collaborative tools would be one way of helping to achieve this. The latest White Paper detailing the radical changes in the healthcare sector has now been published. Primary Care Trusts are going to be phrased out and GP Consortia will be responsible for commissioning patient services and for identifying staff training and development for their own staff. The tools the project has trialled could play an important role in strengthening links between academia and these new bodies.
Implications For a geographically disparate group who have a common theme and wish to work in partnership then using online collaborative tools is the way to do it. Due to the changes taking place in the way healthcare will be commissioned both Moodle and online conference tools could be of major benefit to the GP Consortia that are in the process of being introduced. However, to facilitate online collaborative tools both academia and the NHS need to relax rules about accessing certain ‘safe’ sites and work to ensure that webcams work smoothly on the available bandwidth.
Recommendations 1) The training given when first accessing Elluminate needs to be appropriate for those less technologically minded. 2) Further funding should be made available to build on the work undertaken. The new White Paper lays out the way GP Consortia will now take on the Commissioning role from PCTs. The Consortia will consist of a number of GPs who are geographically dispersed. Online collaborative tools would be invaluable for meetings between academic staff, Consortia and Foundation Trusts who will take on the PCT Provider functions. 3) The support given by the JISC Advance team was exceptional. The workshops were superb and really helped to contribute to the success of the project so this type of support should be continued.
Appendixes The following questionnaire was administered in June, online using the Moodle site. JISC Evaluation Questionnaire 12 of 14
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1. Have you used online tools such as Moodle or Elluminate before participating in this project? yes no 1.
What expectations did you have of the benefits for you and your organisation in participating in this pilot project? a. Less time (and money) spent travelling? b. More productive use of your time (can also multitask – phone calls etc)? c. More focused meetings? d. Other
2.
Has the pilot project met your expectations? yes no
Please comment ………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………… 3.
If you experienced problems with Elluminate please indicate below 1) Network connection slow 2) Lost network connection 3) Problems logging in 4) Could not access webcam through network 5) Any other problems please detail below:
……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………… 4.
If you experienced problems with Moodle please detail below:
……………………………………………………………………………………………………………………………………………………… ……………………… 5.
What do you think has been the least successful aspect of the project so far? ……………………………………………………………………………………………………………………………………………… ……………………………………………………………………………………………………….
6.
What has been the most successful aspect of the project so far? ……………………………………………………………………………………………………………………………………………… ……………………
7.
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Would you be willing to continue using Moodle / Elluminate for future meetings? Yes No
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Dissemination Summary The MHA Project Manager is a member of a Regional Health Employers group and has given a presentation at one of their Board meetings. In addition The MHA has been invited to give a presentation at an event being held in Birmingham East and North PCT by their Entrepreneur in Residence as an example of good practice in online collaboration. Partners have disseminated information internally in their respective organisations. After the event in September in York , organised by the JISC team, Heart of Birmingham tPCT are going to publish a feature in their in-‐house magazine ‘In Focus’.
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