Royal Free London NHS Foundation Trust Staff, members and governors’ magazine // July / August 2025 Collaboration and community care Meet the rehabilitation champions
Follow our X account @RoyalFreeNHS to see what our patients and staff are saying about us 3 We have now passed the six-month mark from when our North Mid colleagues joined the RFL group. I’m very proud and genuinely pleased with the progress we’ve made since, not only landing safely but driving opportunities, leveraging our collective working, seeing group-wide improvements and the relationships and positivity that have been built between teams. Now is therefore the right time to collectively define who we are as a group and form a new set of trustwide values that represent how we want to be. This is a brilliant opportunity to ensure we reflect our rich culture and diversity across the trust. There will be extensive engagement opportunities coming up, so please get involved. Read more on page 10. The government recently announced the 10-year health plan for the NHS, focusing on community care, digitisation and the prevention of illness and conditions. If you’ve read the RFL’s clinical strategy, you’ll see how closely it aligns with the principles of the government’s plan. The neurological rehabilitation centre at Edgware Community Hospital is one example of how our teams support patients to receive care in the community or at home. Read this feature on page 6. You can also read about the impressive feat of our sleep and ventilation team at the RFH, who managed to get over 100 patients starting treatment within a day, on page 9. I hope you have all been able to enjoy some sunshine in recent weeks. All of you work incredibly hard to make sure our patients have the best care possible, so thank you again for everything you do. Hello and welcome Peter Landstrom Group chief executive Key to abbreviations: Barnet Hospital: BH Chase Farm Hospital: CFH North Middlesex University Hospital: North Mid Royal Free Hospital: RFH Royal Free London: RFL 2 Most of us take getting out of bed for granted, but for some of our most vulnerable patients the simple act of sitting in a chair is a vital stepping stone to recovery. Juniper, an elderly care ward at BH, has led the way with its ‘Shift Left’ quality innovation and improvement project. The goal is to help patients stay strong and active so they don’t lose their ability to do everyday activities, which can cause other health problems while in the hospital. The project has been successfully embedded thanks to the buy-in of the whole team. Naty Diamante, ward manager, says that every single member of staff on the ward being trained has been crucial to its success. Now everyone understands why getting patients out of bed, if they are judged fit enough, is so important to their recovery, because of its proven positive impact on building strength and stamina. She said: “On admission we do a risk assessment and part of that is finding out what the patient’s baseline was prior to being unwell. It includes everything from food to mobility and function, and it’s our job to work out how they can regain that.” Patients are encouraged to sit out of bed during the day unless there is a medical reason, such as a fracture, for why that’s not possible. In addition, social dining has been introduced for patients who want to eat together. Naty said: “Patients have the choice to eat together or apart, but we will aim to get them out of bed. I always want to know how many patients were deemed fit to sit Keep me active out, and compare that with how many did get out in the end.” From the doctors, therapists, nursing staff and healthcare assistants, this work is accepted as everyone’s responsibility and there is a range of activities for patients, from playing board games and puzzles, to watching TV together or listening to music. Discussing which patients can get moving is a priority in the team’s morning huddle. It won’t be appropriate for every patient, but most will be able to manage at least a couple of hours and then they can go back to bed if they tire. Staff on Juniper ward who have introduced Shift Left The project is now entering its second year and has been rolled out in elderly care wards across the trust. Naty added: “Other wards have been keen to take this up because they can see the benefits and our patient feedback is incredibly positive. Now we need to keep up the good work and continue to play our role in enabling patients to leave hospital faster.” Liz Dotingco, deputy ward manager, who led the project on Juniper, said: “Doing anything like this needs consistency, strong leadership and it has to become part of business as usual every single day. We’re proud to be showing the way.” Our patient feedback is incredibly positive “ “
5 4 Two radiographers have proudly stepped into their new professional roles after successfully completing their apprenticeships, marking a significant milestone in their careers. Kerri Barker and Holly Mount graduated this July from the three-year apprenticeship programme, fully funded by the trust’s apprenticeship scheme. Both began their journeys with different backgrounds but shared the same drive to advance in radiography. Kerri Barker, based at CFH, has been with the trust for 23 years. Starting in a clerical role at BH, she gradually transitioned into patient-facing assistant roles. “Moving into those roles meant much more patient interaction, which I really enjoyed,” Kerri reflected. After qualifying as an assistant practitioner in 2011, she worked in that capacity until she embarked on the apprenticeship course in 2022. The apprenticeship involved attending the University of Exeter campus three times a year for one week at a time, with the rest of the learning integrated into her work at CFH. “I’m definitely a face-to-face learner, so this setup suited me perfectly. The support from my team and mentors was incredible,” she said. Now qualified, Kerri embraces a more challenging workload with enthusiasm. “I’m fully responsible for patient care during appointments. I like to think I’m a caring person so it really suits me, and I find it truly rewarding,” she added. Mental health has always been important to me personally “ “ Apprenticeships open doors to dedicated staff Carl Leith van Heyningen, paediatric ED consultant A RFL mental health champion has introduced new training for staff working in the children’s emergency department (ED) at North Mid, to help them better manage young patients experiencing a mental health crisis. Carl Leith van Heyningen works as a paediatric ED consultant at North Mid and recently took on a mental health champion role at the trust. Carl was keen to help staff develop their skills by creating an engaging way for them to train for mental health emergencies. He developed simulation training sessions where staff can roleplay scenarios in the ED, recreating cases of children with mental health struggles attending in crisis. The team then debrief and discuss best practices. Role playing can include acting out phone calls to family members, security and the police. Mental health champion brings new ED training to life Kerri Barker now embraces the challenges of her new role Staff from the children’s ED team at North Mid Holly, who was in the same class as Kerri, viewed the apprenticeship as an opportunity to complete a long-held goal. She initially pursued an undergraduate radiography degree but paused her studies over 13 years ago when she became pregnant with her first child. Despite this, she maintained a strong connection to the NHS, working in various roles since she was 16, often taking bank shifts. “At the time, the academic side of the degree was tough,” she said. “I failed by just one mark when I became pregnant at the end of the second year, so I decided to leave and focus on my family.” She left with a qualification in imaging and healthcare science but always intended to return to radiography. She later became an assistant practitioner in radiography at BH, and her manager suggested she consider the apprenticeship programme. “I had never really thought about apprenticeships in healthcare before – usually, you hear about them in construction,” Holly said. Holly now aspires to specialise in interventional radiology and encourages others to pursue apprenticeships for career growth. “Nothing is too difficult,” she said. “As a single parent balancing work, study, and family, graduating has been challenging. My children are proud and tell everyone about it – and having them at my graduation was amazing.” Paul Marijetic, head of apprenticeships at the RFL, praised their achievements: “We are incredibly proud of Kerri and Holly. Their dedication and hard work have been outstanding, and their expertise now contributes directly to delivering highquality patient care at the RFL. “Apprenticeships are a vital route to developing skilled healthcare professionals and they can also address staff shortages. I encourage all managers to consider them as a way of growing their own teams.” Search ‘apprenticeships’ on Freenet to learn more about the various options available to staff. “We need to give mental health the same respect as physical health. They are intertwined and our young people are suffering significantly. Mental health has always been important to me personally, particularly after seeing someone I’m close to struggle with her mental health at an incredibly young age,” Carl said. “This training is all about improving the experience of care that these children receive. Safety is also paramount for them and our staff. While ED colleagues might not be experts in mental health, they need to have confidence in their skills to help these patients and keep them as safe as possible.” North Mid has seen the number of children with mental health difficulties in ED double in recent years, similar to hospitals across the UK, showing just how vital this training is. Over 120 members of staff involved in children’s care have taken part so far, and 90% reported feeling confident in coping with a young person having a mental health crisis after receiving the training. One scenario used in the training sessions involves a ‘young teenager’ brought into the ED after having selfharmed. They then run outside the hospital having not yet been assessed by a member of the team. In this case, the team would practise carrying out a local search around the hospital, negotiating with the young person to come back, and act out a phone call alerting the family. These kinds of situations aren’t uncommon in ED – staff can often assess young patients who have overdosed or are at risk of self-harm. Carl said: “Whenever a young person becomes a risk to themselves, we need to be able to talk with them, assess their physical safety, consider the safety of others, and potentially involve security.” Erica Da Silva, senior staff nurse, completed the training. She said: “One of my simulation scenarios involved a 15-year-old who seemed irritated at first, but this escalated to the point where it wasn’t safe to get close to her. Carl brought in an actor to act this out and it felt so real. Seeing patients since, I’m more aware of how things like tone and proximity can affect us and the patient.” Carl added: “This training is just a small part of the work that needs to happen. As healthcare professionals, it is all of our responsibility to upskill.” Holly Mount hopes to specialise in interventional radiology
6 7 Meet the rehabilitation stars helping patients reach their goals A lot of us won’t give much thought to everyday tasks like making ourselves a sandwich or popping out to post a letter. But at the Neurological Rehabilitation Centre (NRC) in Edgware, patients are working hard to regain their ability to do these day-to-day activities or adapt to a new way of living. And it’s the team of over 60 rehabilitation champions based at the NRC who help patients with neurological conditions achieve their goals, either as inpatients or in the community. Caring for complex patients Nadia Jeffries has been clinical and operational lead at the NRC for eight years now. She said: “One in six people in the UK are living with a neurological condition. Most patients who come to the inpatient unit have a sudden onset condition, such as a brain injury post neurosurgery, spinal cord injury from a traffic accident, or a complex stroke. “Many are supported to go home but some patients may not regain full independence when they leave the unit, so we continue to help them manage their disability and minimise any complications.” The NRC hosts a 14-bed inpatient unit for patients requiring complex care, complete with a physio gym and mock kitchen for patients to practice different skills in. Speech and language therapist Nicki Subel works with patients who have difficulties swallowing or communicating. She said: “These patients are often here for a while and we see them every day. It’s quite intensive rehab but the best thing is getting to know the patient. We’re not just helping with function or skill, but with their quality of life.” Dipi Bhudia is a rehabilitation assistant and often works with inpatients in the gym. She shared a bit about her role: “I work with staff from all the disciplines and run sessions with patients – this could be swallowing exercises, washing and dressing, or visiting their home before they’re discharged. It’s interesting and you get to learn on the job.” Making a difference in the community There are 25 staff members who work in the community seeing some of the 800 patients on the long-term conditions register, including those with progressive disorders like multiple sclerosis (MS) and motor neurone disease. Jenelyn Dimatatac, therapy assistant, said: “This is my first community role and I love helping patients in their own home. It’s not the perfect environment, but it makes you think creatively about how you can offer the right care there.” Melissa Geron, community occupational therapist, added: “You see the patient functioning in their own home, and for me that’s the best way to see them. They might have a favourite sofa that means a lot to them, but which they can’t get up from. We can see that and put support bars on the sofa so they can use it safely.” Bhawani Mainali is the only MS community nurse in north central London and visits patients in their home or the community. Speaking about a key part of her role, she said: “When I first started, I noticed that there were so many MS patients in the community who didn’t have anywhere to share their experiences. I now run an MS coffee morning twice a month. Over 100 patients come to meet people in similar situations, and it encourages them to self-manage and seek peer support.” Modelling multi-disciplinary team working Occupational therapists, dietitians, rehabilitation assistants, physiotherapists, nurses and neurologists are just a few of the many roles at the NRC. Specialist dietitian Trena Houdek works in the community team, supporting patients with their eating, drinking and nutrition at home. She said: “The multidisciplinary team working in the NRC is outstanding. We’re all based in the same place and share advice in our clinical meetings. You never feel like you’re on your own.” Involving patients in their own recovery plan is also a key part of the process. “What our patients need is repetition and practice doing real life activities,” said Marketa Ramsay, clinical specialist physiotherapist and inpatient therapy clinical lead. “They’re actively involved in their goal setting, and we make an effort to find out who they are as a person and how we can help them get their sense of self back.” Occupational therapist Sarah Evans supports patients with any work-related goals. She said: “Occupational therapy is aligned with participating in meaningful activity and work is such a big part of that for patients – it provides a sense of purpose, value and identity. “Some people want to rush back to work as they can think that everything else will fall into place afterwards, and we need to reassure them that recovery is a priority. We listen to them and help them establish what their challenges at work might be and any reasonable adjustments they need.” L-R: Jenelyn Dimatatac, therapy assistant, Bhawani Mainali, MS nurse, and specialist dietitian Trena Houdek Members of the NRC community team Staff based in the centre’s inpatient unit We’re not just helping with function or skill, but with their quality of life “ “ You never feel like you are on your own “ “ The highs and the lows of rehabilitation Nicki said: “Sometimes it can be challenging as we focus on safe discharge, but that might not be what the patient is focussed on. They may want their speech 100% back to normal, and that might not be realistic. Our clinical psychologist, Holly, helps them understand and plan their goals.” “I’ve been working with a patient with progressive supranuclear palsy, a progressive disorder causing brain cell damage, who used to be a musician,” Melissa shared. “He can’t play an instrument anymore but for him and all our patients we will always look at exploring ways we can promote quality of life, even during hard times. And despite everything many patients still have smiles on their faces and express gratitude for the care they have been given.” Bhawani added: “Patients with complex needs have good days and bad days. You need to have a kind heart and a sense of humour.” “It’s quite emotional work,” Dipi said. “We’ve had patients who have walked out of the centre unaided after being told they’ll never walk again – that’s the best feeling ever.” Nadia Jeffries, clinical and operational lead at the NRC
8 Every day, healthcare support workers (HCSWs) are the quiet backbone of our hospitals, offering compassion, skill, and dedication to patients and colleagues alike. We spent some time with our HCSWs to learn more about those who go above and beyond in making a real difference in the lives of those they care for. Vandna Dicheva is a HCSW at BH, having joined the team there in 2023. Today she has been assigned to the ambulance handover area in ED, and as usual is working at pace making sure everyone coming through the door is getting the tests they need. Her grandparents died before she was born and she thinks this is why she might have been drawn to care for people, especially the elderly. “I like to know I’m helping people.” In May, Vandna found out she was joint winner of the HCSW of the year award at the RFL’s annual nursing, midwifery and HCSW awards. She was on holiday with her parents in India at the time. “Sadly I couldn’t make the event but it was lovely to be with my parents and see their shock and pride in my achievement,” she said. Vandna is keen to progress her career. She said: “The first few weeks in the job I found quite overwhelming but now I want to continue my training within the trust and will be looking for opportunities going forward.” Valentin Sario Jr has been a BH member of staff since 2008. Healthcare is a family affair for him, as his wife works on Quince ward, while he works on Walnut ward. “My passion has always been looking after people, and older people in particular,” he said. “I was a caregiver back home in the Philippines. When I moved here I was able to begin a vocational qualification where I learned so much about caring for the whole person, not just looking after their illness.” Valentin was the other joint winner of HCSW of the year, and says he was ‘speechless’ when he was announced as the winner. His advice to others – pursue an area of healthcare that interests you: “That way we are bringing our best selves to work and really helping our patients.” Lordia Gyamfi began her NHS career as a bank worker during the pandemic, and now works as a HCSW in the outpatient department at CFH. Part of her role involves supporting patients attending cancer clinics, often providing comfort during stressful times. “My favourite part is being a voice of reassurance,” she said. “You never know when someone will get good news, and sharing in their relief is the best feeling.” Lordia won the unsung contribution award, something she didn’t expect. “When they mentioned someone who marks colleagues’ birthdays and other celebrations, I thought it might be me – and it was amazing to hear my name.” With ambitions to become a nurse, Lordia credits the RFL for supporting her goals: “The trust really helps us with our ambitions and career plans.” The healthcare support workers at the heart of the RFL 9 Vandna Dicheva is often assigned to the ambulance handover area Lordia Gyamfi likes to reassure patients during stressful times The sleep and ventilation service team have dramatically improved access to treatment for patients Dream team helps patients gain faster access to life prolonging care A radical new approach to treating people with a sleep condition is dramatically improving waiting times for patients at the RFH. Obstructive sleep apnoea (OSA) is a debilitating condition which causes airway blockages during sleep, disrupting breathing and preventing someone from entering deep sleep. Without treatment, people with OSA feel very tired during the day, even though some may think they’ve slept well. It leads to poor concentration and can cause serious mistakes at work. It also puts individuals at higher risk of developing other conditions, including heart disease, diabetes or a stroke. Once diagnosed with OSA, the treatment involves sleeping with a continuous positive airway pressure (CPAP) mask, which delivers pressurised air to keep the airways open, allowing a good night’s sleep. As referrals surged from 600 in 2016 to nearly 4,500 last year, the RFH team recognised the need for a more efficient care model to reduce waiting times and improve patient outcomes. To address this, the team, led by Swapna Mandal, lead consultant for sleep and ventilation at the trust, decided a radical new approach was needed to help patients get the treatment they required. She said: “The demand for this service keeps going up – we are seeing at least 10% increases per year – so we had to do something a bit radical. “This is a condition which has been underdiagnosed and it’s so important for people with OSA to receive treatment to improve their quality of life. Correct treatment can also extend their lives by up to 20 years.” Patients referred to the service are triaged and those who are suitable undertake a sleep study at home. This involves a device which monitors their sleep and sends data to the clinical team, indicating whether the patient has OSA. We had to do something a bit radical “ “ Following diagnosis, patients are taught how to use the CPAP machine. These are no longer carried out via a one-to-one session. Instead, they benefit from large group teaching sessions held in a lecture theatre. These sessions have expanded dramatically – from 20 to as many as 140 participants – allowing the team to train and support many patients simultaneously. After the initial teaching session, members of the clinical team go around the room helping patients with their devices and answering questions. Early evidence shows that patients educated in this group setting are more likely to adhere to CPAP therapy, which is critical to improving their health and quality of life. “There are a very small number of patients who need one-to-one support and we identify those during the triage process,” Swapna said. “We’ve found that these sessions are effective for the vast majority of patients and the proportion of those who stick to their treatment is higher where they’ve attended as a group – so it’s been a real success.” Valentin Sario Jr works on Walnut Ward
Governors’ update Get in touch: Our governors are elected to represent and listen to the views of staff, patients, and the public. If you would like to get in touch, please email rf-tr.membership@nhs.net Patients have welcomed vibrant new artwork to North Mid’s collection thanks to the Royal Free Charity. Since becoming a part of the RFL group, the hospital now has access to the charity’s specially curated artwork. Harriet Armstrong, medical photography manager at North Mid, has worked with charity art curator Joss Blake to select art from the charity’s collection for the hospital. She said the recent additions have already made a tangible difference to patient and staff wellbeing: “When you install artwork into a healthcare environment, the staff feel like you value the space, and the patients feel cherished. They’re no longer looking at a blank, clinical wall.” Research shows artwork in healthcare settings can reduce stress, anxiety and pain, improving overall wellbeing and potentially shortening hospital stays. Harriet said: “We’ve had feedback from patients saying it brightens their day, and they love seeing a portal into another world. It creates escapism. Bringing art in shows another level of care. What a lovely way to show patients they matter to us.” Harriet previously launched an arts programme for stroke patients, funded by the Royal Free Charity. 10 11 Vote for your RFL governors Growing our RFL community Shaping our RFL values Painting a better patient experience The programme showed measurable therapeutic benefits which were presented at the European Stroke Congress. Recent Royal Free Charity initiatives include volunteer-led art tours to aid rehabilitation, and a virtual tour narrated by broadcaster Andrew Marr for those unable to leave their hospital beds. These efforts show how art can offer comfort and distraction in clinical settings. We are hugely grateful to everyone who has put themselves forward as a candidate for this year’s governor elections. We are recruiting for 10 vacancies on our Council of Governors – four in the patient constituency and three in both the staff and public constituencies. Voting is now open and all eligible trust members will be contacted directly via email or post with details on how to vote in the elections. In total, 70 people have put themselves forward – you can read their election statements on the voting website. Voting will close at 5pm on Thursday 14 August and successful candidates will start their terms on Wednesday 1 October. Governors add huge value to our trust. They are elected to represent your interests, to hold the nonexecutive directors to account, and to support the board of directors who are ultimately responsible for how we deliver patient care. If you have any questions about the election, please contact Mi-Voice, our independent election provider, via email: support@mi-voice.com Encourage your friends, family and colleagues to become a member of the RFL and get more involved with their local hospital. From sharing feedback about our services to being able to stand for election as a governor, they will have a chance to make a real difference. Members are kept up to date with the latest RFL news and developments, and invited to events to increase their understanding of local health services. We would be grateful for your support in spreading the word and helping us grow our RFL community. For more information, contact our membership team: rf-tr.membership@nhs.net. With the addition of North Mid to the RFL group, we have a fantastic opportunity to redefine who we are, what we stand for, and how we work together. It’s time for us to come together to shape a new set of trust values that reflect our combined culture, guide us in our day-to-day interactions, and inspire us to achieve the best possible outcomes for our patients and staff. Thomas Pounds, chief people officer, said: “This is a really exciting opportunity for us to reset and redefine our values as a wider group. Values and behaviours are more impactful than they might sound – they help develop and define our culture and this is about using them as levers to drive cultural change.” By aligning ourselves around a set of shared values, we can build a stronger, more unified organisation grounded in trust and excellence. Everyone’s voice matters, and to make sure the values truly reflect who we are and who we aspire to be, the trust is seeking input from as many colleagues as possible. A change coalition group has been set up with representatives from across the different health units and corporate areas. In addition there are number of resources available on Freenet for staff to share their feedback. Introducing our new appointed governors Zena has been an elected Haringey councillor for Harringay ward for over 10 years and joined our Council of Governors in June 2025. She is the cabinet member for children, schools and families. Zena has spent 20 years working in Haringey, where she developed their play and early years services. She has also worked in eastern and central Europe supporting children from minority groups to access mainstream education. John has been a Hertfordshire County councillor since May 2017 and joined our Council of Governors in June 2025. He is a member of the council’s public health and community safety cabinet panel. John gained a BSc in mathematics and biology from King’s College London. A chartered accountant by profession, John worked for many years in the insurance and outsourcing industries before becoming a councillor. Councillor Zena Brabazon – appointed governor for Haringey Council Councillor John Hale – appointed governor for Hertfordshire County Council Thomas Pounds, chief people officer Medical photographer Harriet Armstrong with artwork at North Mid
12 60 seconds with… Naresh Balasingham Colorectal cancer multi-disciplinary team (MDT) coordinator Tell me a bit about your role Ultimately our role as MDT coordinators is to help ensure that no patient who gets referred to us on an urgent suspected cancer pathway falls through the net. The MDT team has over 40 members, including MDT co-ordinators, trackers and cancer performance managers all responsible for different tumour sites, across BH, CFH and the RFH. We’re tracking investigations and chasing up scans, ensuring things are done for patients and their family members in a safe and timely manner. I also organise weekly MDT meetings with our consultants to discuss next steps for patients and plan treatments. For me it’s not just about organising meetings or meeting targets, it’s about remembering that there’s a patient and a family member behind every single scan that we expedite and every single investigation we chase. And that’s what really drives me, I think it’s such a rewarding profession. MDT co-ordinators are the backbone of any cancer MDT. What would you say to someone who is thinking of a career in this area? Don’t ever wait. There’s no perfect time to get into a role that you’re interested in. I would say just go for it, if you’re interested in systems, if you’re interested in improving things. It’s a whole team when it comes to cancer care. You become that person that the clinical team goes to. You’re helping in your own way. Patients, and their family members, are often going through the hardest time in their life. You learn interpersonal skills, that’s such a major thing in this role – it really is about relationship building. I’ve been in the NHS 10 years and in this role three years. I would say this role is by far my most fulfilling and I learn every day. What are some of your highlights? I would say two major things. One, I got the chance, along with one of the excellent clinical nurse specialist team, to present at a national NHS England conference for other MDT coordinators, which was quite uplifting. We spoke about how we improved our colorectal cancer staging. And second, I would say is our improvement collaborative project, which is still ongoing, to help our most vulnerable patients, for example we’ve co-produced easy-read documentation with local learning disability groups. What are the main challenges in your role? It’s time, I suppose, as with any anybody in the NHS. Everyone’s under pressure, everyone is stretched. But I ultimately think having a positive mindset goes a really long way. There is a lot of power in a positive attitude and I would say supporting and enabling colleagues both at a junior level and senior level drives me. How do you like to unwind outside work? I like to work out and recently I’ve been getting into walking as a time to unwind. Other than that, I like to paint miniatures. It’s quite therapeutic and can get quite intricate. Taking care of your wellbeing Every day, our staff go above and beyond to care for our patients. Please take the time to also look after your own wellbeing: • 24/7 helpline (out of hours) contact Care First on 0800 174319 (24/7) service) for emotional and psychological support or access online via carefirst-lifestyle.co.uk; login details can be found on Freenet • Contact the Samaritans (on 116 123), NHS Helpline (111) or your GP • Cost of living worries can have a huge impact on our mental health – visit our financial wellbeing page on Freenet • Visit Freenet for a range of resources, information and other wellbeing tips
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