Community Engagement Project Portfolio
Portfolio Checklist
Part One – Essential Scrapbook Evidence
No | Content (1500 words) | |
1. | Patient/service user profile | |
2. | Community profile including qualitative and quantitative data | |
3. | Identified public health challenge | |
4. | Record of person-centred narrative | |
5. | Reference list of data sources (electronic and published data) | |
Part Two – Systematic Summary Report
Written Assignment (1500 words) |
To include:
· Introduction · Statement of learner’s intent · Key issues identified through portfolio · Conclusion and recommendations · Reference list |
Appendices
No | Content | |
1. | Log of activities demonstrating understanding of the topic | |
2. | Log of seminars/discussions with the module lead | |
3. | Log of meetings/discussions with inter-professional colleagues | |
4. | Supplementary material (additional/optional) |
Part One – Essential Scrapbook Evidence
- Patient/Service User Profile
Mr. X, 58 years and a father of four, has been a regular visitor at our facility for several years. Born and bred in Southend, Mr. X was diagnosed with diabetes ten years ago following a routine check-up of his physical well-being and mental functionality. Based on assessing his behavioural and social characteristics, Mr. X admitted that he has smoked tobacco since he was a teenager. As a common and significant public health issue facing Southend, Essex, and England, smoking has become a prevalent occurrence associated with adverse eventualities and chronic illnesses among the people. The additional determinants of health that impacted Mr. X’s experience include genetics as his parents were smokers and his father had diabetes. Similarly, the environment in which he grew up predisposed him to start smoking tobacco at a young age. At the same time, his behavioural and social traits have been characterised by continued smoking, drinking beer regularly, and lack of physical activity (Kemppainen, Tossavainen, & Turunen, 2012). As a result of these factors, Mr. X and his wife have been obese for more than a decade, which has further intensified their risk for developing diabetes and other chronic illnesses.
- Community Profile
According to Public Health England (PHE) (2019), the life expectancy at birth for males living in Southend was valued at 79.1 years between 2017 and 2019, while females were averaged at 82.5 years during the same period. These rates were relatively lower than those in England, 79.1 years among and 83.4 years among women, and 80.5 and 83.5 years for men and women respectively across the region. However, they were averagely better than the worst scenarios estimated throughout England at 74.4 years for men and 79.5 years for women. The best life expectancy at birth rates reported in England was 84.9 years for men and 87.2 years for women. Similarly, the under 75 mortality rates from all cases recorded in Southend between 2017 and 2019 were 353, while those in England and across the region were 326 and 298, respectively (PHE, 2020). The best and worst cases reported recorded in England and throughout the region were 224 and 548, respectively. The mortality rates for people below 75 years from all cardiovascular diseases within Southend between 2017 and 2019 were 75.5 per 100,000, while those in England and across the region were 70.4 and 62.9 per 100,000. The best and worst cases within England and across the regions were valued at 43.6 per 100,000 and 121.6 per 100,000 (PHE, 2020).
Additionally, the under 75 mortality rates from cancer reported in Southend between 2017 and 2019 was 141.6 per 100,000, while those in England and the region were 129.2 and 122.6 per 100,000, respectively. The best and worst cases reported within England and throughout the region were valued at 87.4 and 182.4 per 100,000. During this period, the suicide rates reported in Southend were 13.2 per 100,000 individuals, while those in England and throughout the region were 10.1 and 10.5 per 100,000 individuals. The best and worst suicide rates reported ranged between 4.9 and 19.0 per 100,000 individuals (SBC, 2019).
Besides, Southend is ranked 56th out of 149 local authorities in the region regarding child obesity incidents reported between 2018 and 2019. During this period, the best and worst cases of childhood obesity were recorded in Richmond upon Thames, ranked the first position, and Wolverhampton ranked 149th, thereby making Southend an above-average local authority (SBC, 2019). Similarly, in regards to the NHS’s health checks, Southend was ranked 24th out of the 149 local authorities between 2018 and 2019. The top position was scooped by Hammersmith and Fulham, while the last position went to East Riding of Yorkshire. These rankings were followed closely by Southend scooping position 80 out of 140 local authorities in terms of tobacco control between 2018 and 2019. The first positions went to Richmond upon Thames, while Kingston upon Hull was ranked last (SBC, 2021). This ranking positioned Southend in a worse than average place among the region’s local authorities.
In terms of alcohol treatment, the City of London was ranked position one, Southend scooped position 72, and Devon came last out of the 131 local authorities. Similar ratings were recorded regarding drug treatment among the 141 local authorities as the City of London scooped the first position, Southend came in at position 19. In contrast, Kingston upon Hull came in last (SBC, 2021). As a result, Southend was ranked position 18 out of the best local authorities to start in life, while Waltham Forest scooped position one and Kirklees scooped the last position. In terms of sexual and reproductive health, Hackney was position one out of 147 local authorities, Southend came at position 147, while Stockton-on-Tees scooped the last position. In a survey on the air quality and management areas (AQMAs), Halton had 0%, as per 2017, while Southend had a rating of 0.2%, scooping position 14, and Westminster 100th out of 131 local authorities (PHE, 2019).
- Identified Public Health Challenge
PHE (2019) pointed out that the overall life expectancy for Southend’s population has since the 1990s risen dramatically by over five years for men and over three years for men. However, mortality rates among infants have declined more than halved. The most significant contributor to the life expectancy increase has been associated with a significant reduction in the premature mortality rates from cardiovascular disease (CVD). Additionally, the substantial decline in mortality rates related to CVD has occurred due to a decrease in smoking rates, dietary changes, improved access to preventive medication and treatment regimens (NICE, 2008). Although Southend-on-Sea has and continues to develop new strategies to boost reduction in smoking rates, substance and alcohol abuse, and gambling, the issues remain prevalent within the population (NHS, 2021).
Smoking, as the health issue discussed in this report, has brought catastrophic eventualities to the people of Southend, as portrayed below:
- 962 adult deaths reported between 2015 and 2017 due to smoking, a rate of 295 per 100,000, which was worse than the average in England (263 per 100,000) (PHE, 2018)
- 2,011 hospital admissions in 2016 and 2017 due to smoking
- £ 3.1 million costs incurred by the NHS (NHS, 2021)
- Smoking prevalence among adolescents (15-year-olds) was rated at 10%, similar to that of England between 2014 and 2015
- Prevalence among adults was rated 18% in 2017, worse than that of England (15%) (PHE, 2019)
- Smoking prevalence among pregnant women between 2017 and 2018 was rated at 11%, similar to that of England (PHE, 2019)
- Among adults with serious mental illnesses (SMIs), the prevalence rate was 45%, worse than that of England at 41% between 2014 and 2015
- Smoking prevalence in adults in manual and routine occupations was 26.8%, worse than that of England and throughout the region, at 25.4% and 25.7%, respectively (PHE, 2020)
In the recent past, Southend and England, in general, have experienced significant increases in access to and the quality of healthcare, coupled with substantial growth in health resources. Indeed, the environment people live has a significant influencer on their physical and mental welfare and can further hinder healthy decision-making (SBC, 2019). As a result, Public Health England, alongside other entities, has identified seven priorities to focus their efforts on promoting health among the people of Southend and throughout England. These priorities include securing improvements in reducing smoking and preventing children from engaging in this habit. These activities have been followed by tackling the obesity menace in Southend and throughout England, especially in children. It has further been coupled with the reduction of harmful consumption of alcohol and related hospital admissions (SBC, 2021). Additionally, PHE and the relevant stakeholders in England have set out to ensure that each child develop in the right way, reduces the risks of dementia, and its prevalence among older adults, and addresses issues related to growth in antimicrobial resistance. They have further set out to achieve an annual decline in tuberculosis incidence (PHE, 2021).
The PHE recognizes that attaining these goals is a challenging task that necessitates collaboration and partnership with the local and central authorities, clinical commissioning groups, and the wider NHS, alongside other entities and groups, to boost commitment and support for promoting health (NHS, 2021). Most fundamentally, nurses and other healthcare providers have been at the forefront in promoting health within Southend and throughout England. Their operations concerning reducing smoking, especially among 15-year-olds and other age sets, have entailed initiating 500,000 quit attempts through campaigns aimed at smoking cessation, including the Stoptober initiative, and developing tools to support effective commissioning. These measures have been coupled with regular and routine check-ups with health facilities in Southend and throughout England (PHE, 2020).
- Record of Person-centred Narrative
Smoking remains England’s biggest health challenge that causes approximately 80,000 premature mortality annually and brings along a myriad of illnesses. Today, almost eight million people smoke in England, with a big proportion having developed the habit in their teenage years. Another set of people engaged in this behaviour entails pregnant women. Smoking during pregnancy has led to 2,200 premature births, 5,000 miscarriages, and more than 300 perinatal deaths annually throughout the UK (PHE, 2021). Mr. X started smoking as a teenager, and during the birth of their firstborn son, his wife was smoking as well. Today, their son is 23 years old, and he and his fiancé are smokers. Within the community, Mr. X stated that he has come across numerous teenagers who smoke and engage in other undesirable behaviours that include substance abuse.
Reference list for Part One
References
Age UK. (2019). Improving health and well-being in Mid and South Essex. July-2019-Health-and-wellbeing-resources-pack-for-mid-and-south-Essex-compressed.pdf, 1-50. https://www.ageuk.org.uk/globalassets/age-uk/documents/programmes/health-and-wellbeing-alliance/july-2019-health-and-wellbeing-resources-pack-for-mid-and-south-essex-compressed.pdf
JSNA. (2016). A Local Guide to Health Needs Assessments- 2016. Joint Strategic Needs Assessment (JSNA), 1-2. https://www.southdevonandtorbay.info
JSNA. (2019). Essex Countywide report. Joint Strategic Needs Assessment (JSNA) 2019. https://cmis.essex.gov.uk/essexcmis5/Document.ashx?czJKcaeAi5tUFL1DTL2UE4zNRBcoShgo=0j2Cl10xBy8FeoppSl8d6Q4T5vm1Km0AJWzeXTmK%2BjuopxlGt4NY2Q%3D%3D&rUzwRPf%2BZ3zd4E7Ikn8Lyw%3D%3D=pwRE6AGJFLDNlh225F5QMaQWCtPHwdhUfCZ%2FLUQzgA2uL5jNRG4jdQ%3D%3D&mCTIbCubSFfXsDGW9IXnlg%3D%3D=hFflUdN3100%3D&kCx1AnS9%2FpWZQ40DXFvdEw%3D%3D=hFflUdN3100%3D&uJovDxwdjMPoYv%2BAJvYtyA%3D%3D=ctNJFf55vVA%3D&FgPlIEJYlotS%2BYGoBi5olA%3D%3D=NHdURQburHA%3D&d9Qjj0ag1Pd993jsyOJqFvmyB7X0CSQK=ctNJFf55vVA%3D&WGewmoAfeNR9xqBux0r1Q8Za60lavYmz=ctNJFf55vVA%3D&WGewmoAfeNQ16B2MHuCpMRKZMwaG1PaO=ctNJFf55vVA%3D
NHS. (2021). Southend, Essex, and Thurrock Mental Health and well-being Strategy. Appendix 1 MH Strategy – Master Document MER V3a – SET 003.pdf. https://southend.moderngov.co.uk/documents/s8131/Appendix%201%20MH%20Strategy%20-%20Master%20Document%20MER%20V3a%20-%20SET%20003.pdf
PHE. (2013). Nursing and Midwifery Contribution to Public Health Improving health and well-being. Public Health England (PHE), 1-14. https://www.gov.uk/government/organisations/public-health-england
PHE. (2014). From evidence into action: opportunities to protect and improve the nation’s health. Public Health England, 1-28. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/366852/PHE_Priorities.pdf
PHE. (2018, July 3). Southend-on-Sea Unitary authority. Public Health England: The – Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/file/3828/southend-on-sea_health_profile_2015
PHE. (2019). Protecting and Improving the Nation’s Health PHE Strategy 2020-2025. (Public Health England). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/831562/PHE_Strategy_2020-25.pdf
Public Health England (PHE). (2019). Local authority health profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/health-profiles/data#page/1/gid/1938132696/pat/6/par/E12000006/ati/202/are/E06000033/cid/4
Public Health England (PHE). (2020). Public health profiles – Area details. Public Health Profiles – PHE. https://fingertips.phe.org.uk/topic/public-health-dashboard/area-details#are/E06000033/ati/202/gid/1938133162/par/E92000001
Public Health England (PHE). (2021). Local tobacco control profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/tobacco-control/data#page/1/gid/1938132885/pat/6/par/E12000006/ati/102/are/E06000033/cid/4
SBC. (2019). Director of Public Health Annual Report 2018-19. The – Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/file/6600/annual-public-health-report-2018
SBC. (2021). Health and well-being – Southend-on-Sea Borough council. Southend-on-Sea Borough Council (SBC). https://www.southend.gov.uk/southend-insights/health-wellbeing-2
Southend-on-Sea Borough Council (SBC). (2021). Southend-on-Sea ward health profiles – Southend-on-Sea Borough council. Southend-on-Sea Borough Council. https://www.southend.gov.uk/downloads/download/824/southend-on-sea_ward_health_profiles
Watkins, S. (2017). Southend-on-Sea Localities Needs Profile: East. NHS- Southend Clinical Commissioning Group.
https://southendccg.nhs.uk/about-us/key-documents/strategic-plan-related-documents/3284-01-local-needs-profile-southend-east/file
Part Two – Systematic Summary Report
In nursing practice, community profiling facilitates a determining population’s health needs. It fosters an understanding of the extent to which public health issues affect people’s well-being and the identification of the appropriate ways to address them. As a high-priority practice, community profiling focuses on health across the entire population. It considers working with the community and other groups and organizations to plan and implement interventions depending on the needs of the local community (Stonehouse, 2017). Based on the public health issues identified, nurses, alongside other health professionals and the agencies within the community, are strategically placed to adopt the role of recognising the needs of their community (Poulton, 2009). These individuals, groups, and organizations further come together in planning effective treatment regimens and focus on guaranteeing the access and availability of appropriate services. The attainment of these objectives occurs through an in-depth assessment of the community’s health needs, a thorough review of health issues facing the population, and the identification of new health priorities (Watkins, 2017).
Statement of the Learner’s Intent
Since various communities are faced with distinct health needs, community profiling based on assessing the factors affecting the population’s well-being significantly contributes to the identification of other underlying components that should be addressed (WHO, 2009). The community profiling and assessment measures focus on primary needs that include comparative, expressed, felt, and normative components. The normative needs include those defined by health professionals as impediments to an individual norm. For instance, nurses consider the primary need in a diabetes patient to be lifestyle changes aimed at reducing his/her body weight (Motamed, 2019). The felt needs include the individuals’ perceptions of what he/she wants. In the case of the diabetic patient above, he/she may perceive the need to make some changes in his/her lifestyle to reduce his body mass index. Expressed and comparative needs include those highlighted by the patient and those identified upon comparing the community with another (JSNA, 2016). In this case, the primary intent entailed community profiling by focusing on Southend-on-Sea as a community within England. It further involves an emphasis on the public health issue, smoking, and analysing the extent to which it has affected the population. These components have been identified by comparing the effects of smoking in England and throughout the region. It has further involved analysing the measures put in place to address the public health issue by incorporating the community members and other relevant stakeholders (Davies, 2019).
Key Issues identified through the Portfolio
Based on the application of the health needs assessment process, this community profiling portfolio focused on smoking as the public health issue facing the people of Southend and England, in general, Age UK, 2019. This assessment processed involved a series of activities such as identifying the population by focusing on an individual’s point of view, Mr. X. It further focused on identifying the parties involved and incorporating their experiences with the public health issue (Jack & Holt, 2008). These elements were followed closely by identifying the health priorities within the population, the perceptions of needs, and the assessment of the health conditions and determinant factors. Among the significant issues identified in the Southend community includes significant improvements in the access to and availability of healthcare services and changes in the incidence and prevalence of health conditions (Binns & Low, 2015).
Life Expectancy and Mortality Rates
Specifically, an assessment of the behavioural risk factors revealed that the current population of smokers (18+ years) in Southend was 58.4%, worse than the rate in England in the period between 2011 and 2017, 17.2 to 21.8%. Besides, Southend’s assessment indicated that, in 2017, the estimated prevalence of smoking in Southend was 19.1%, worse than in England. Additionally, the life expectancy at birth for males living in Southend was valued at 79.1 years between 2017 and 2019, while females were averaged at 82.5 years during the same period (PHE, 2021). These rates were relatively lower than those in England, 79.1 years for men and 83.4 years for women, and 80.5 Years for men and 83.5 years across the region. However, they were averagely better than the worst scenarios estimated throughout England at 74.4 years for men and 79.5 years for women. The best life expectancy at birth rates reported in England was 84.9 years for men and 87.2 years for women.
Similarly, the under 75 mortality rates from all cases recorded in Southend between 2017 and 2019 were 353, while those in England and across the region were 326 and 298, respectively (Poulton, 2009). The best and worst cases reported recorded in England and throughout the region were 224 and 548, respectively (PHE, 2020). The mortality rates of people below 75 years from all cardiovascular diseases within Southend between 2017 and 2019 were 75.5 per 100,000, while those in England and across the region were 70.4 and 62.9 per 100,000. The best and worst cases within England and across the regions were valued at 43.6 per 100,000 and 121.6 per 100,000 (PHE, 2019).
Additionally, the mortality rates associated with cancer among people below 75 years reported in Southend between 2017 and 2019 was 141.6 per 100,000, while those in England and the region were 129.2 and 122.6 per 100,000, respectively. The best and worst cases reported within England and throughout the region were valued at 87.4 and 182.4 per 100,000 individuals (PHE, 2019). During this period, the suicide rates reported in Southend were 13.2 per 100,000 individuals, while those in England and throughout the region were 10.1 and 10.5 per 100,000 individuals. The best and worst suicide rates reported ranged between 4.9 and 19.0 per 100,000 individuals.
Illness and Hospital Admissions
Besides, Southend is ranked 56th out of 149 local authorities in the region regarding child obesity incidents reported between 2018 and 2019. During this period, the best and worst cases of childhood obesity were recorded in Richmond upon Thames, ranked the first position, and Wolverhampton ranked 149th, thereby making Southend an above-average local authority (PHE, 2019). Similarly, in regards to the NHS’s health checks, Southend was ranked 24th out of the 149 local authorities between 2018 and 2019 (NHS, 2021). The top position was scooped by Hammersmith and Fulham, while the last position went to East Riding of Yorkshire. These rankings were followed closely by Southend scooping position 80 out of 140 local authorities in terms of tobacco control between 2018 and 2019. The first positions went to Richmond upon Thames, while Kingston upon Hull was ranked last. This ranking positioned Southend in a worse than average place among the region’s local authorities (JSNA, 2016).
In terms of alcohol treatment, the City of London was ranked position one, Southend scooped position 72, and Devon came last out of the 131 local authorities. Similar ratings were recorded regarding drug treatment among the 141 local authorities as the City of London scooped the first position, Southend came in at position 19. In contrast, Kingston upon Hull came in last (NHS, 2021). As a result, Southend was ranked position 18 out of the best local authorities to start in life, while Waltham Forest scooped position one and Kirklees scooped the last position. In terms of sexual and reproductive health, Hackney was position one out of 147 local authorities, Southend came at position 147, while Stockton-on-Tees scooped the last position (PHE, 2018). As mentioned in section 1, a survey on the air quality and management areas (AQMAs), Halton had 0%, as per 2017, while Southend had a rating of 0.2%, scooping position 14, and Westminster and ranked a 100th out of 131 local authorities (PHE, 2018).
Conclusion and Recommendations
Following the basic concepts in public health practices, this community profiling portfolio set out to deal with the health of the population in Southend instead of the adoption of clinical objectives that epitomize restoration, maintenance, and improvement of an individual’s well-being. Although identifying the various public health issues facing the people of Southend involved assessment based on an individual’s perspective, it sought to improve the well-being of the community, in general. The attainment of this objective involved emphasis on protecting the people, preventing the occurrence and prevalence of diseases, and promoting the population’s well-being. To better understand the extent of the public health issue, smoking, in Southend, it is imperative to assess epidemiology principles that provide tools for comprehending its exacerbation patterns, risk factors, and the outcomes of prevention and treatment activities.
Among the significant issues identified include the prevalence of smoking among the public starting at a young age, pregnant women, and individuals across all ages. Its prevalence predisposes smokers to numerous adverse eventualities, including premature mortality, various cancers, cardiovascular disease, diabetes, and other severe health conditions. In assessing Mr. X’s case, it becomes apparent that smoking is a generational public health challenge that has affected the population. To address these issues, the local authorities must consider imposing laws regulating access to cigarettes and tobacco in general. For instance, the local authorities, working hand-in-hand with healthcare professionals and other entities in Southend should increase the legal age limit of smoking to 21 years and further ban smoking in public as ways to regulate its access.
Reference list for Part Two
References
Binns, C., & Low, W. (2015). What is public health? Asia Pacific Journal of Public Health, 27(1), 5-6. https://doi.org/10.1177/1010539514565740
Davies, J. (2019, July 31). Public Health England issue urgent advice after six suspected drug-related deaths in South Essex. https://www.essexlive.news/news/essex-news/public-health-england-issue-urgent-3158536
Jack, K., & Holt, M. (2008). Community profiling as part of a health needs assessment. Nursing Standard, 22(18), 51-56. https://doi.org/10.7748/ns2008.01.22.18.51.c6311
JSNA. (2016). A Local Guide to Health Needs Assessments- 2016. Joint Strategic Needs Assessment (JSNA), 1-2. https://www.southdevonandtorbay.info
Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses’ roles in health promotion practice: An integrative review. Health Promotion International, 28(4), 490-501. https://doi.org/10.1093/heapro/das034
Motamed, S. (2019). Health promotion, community-campus-local authorities’ partnership, and new health professional profile. European Journal of Public Health, 29(Supplement_4). https://doi.org/10.1093/eurpub/ckz186.428
NICE. (2008, February). NICE public health guidance 9: Community engagement to improve health. National Institute for Health and Clinical Excellence (NICE). www.nice.org.uk/PH009
PHE. (2013). Nursing and Midwifery Contribution to Public Health Improving health and well-being. Public Health England (PHE), 1-14. https://www.gov.uk/government/organisations/public-health-england
PHE. (2014). From evidence into action: opportunities to protect and improve the nation’s health. Public Health England, 1-28. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/366852/PHE_Priorities.pdf
Poulton, B. (2009). Barriers and facilitators to the achievement of community-focused public health nursing practice: A UK perspective. Journal of Nursing Management, 17(1), 74-83. https://doi.org/10.1111/j.1365-2834.2008.00949.x
Public Health England (PHE). (2019). Local authority health profiles – PHE. Public Health Profiles – PHE. https://fingertips.phe.org.uk/profile/health-profiles/data#page/1/gid/1938132696/pat/6/par/E12000006/ati/202/are/E06000033/cid/4
SBC. (2019). Director of Public Health Annual Report 2018-19. The – Southend- on- Sea Borough Council. https://www.southend.gov.uk/downloads/file/6600/annual-public-health-report-2018
SBC. (2021). Health and well-being – Southend-on-Sea Borough council. Southend-on-Sea Borough Council (SBC). https://www.southend.gov.uk/southend-insights/health-wellbeing-2
Stonehouse, D. (2017). Understanding the Nursing Process. British Journal of Healthcare Assistants (BJHA), 11(08), 388-391. https://www.magonlinelibrary.com/doi/abs/10.12968/bjha.2017.11.8.388?af=R
Tannahill, A. (2009). Health promotion: The Tannahill model revisited. Public Health, 123(12), 396-399. https://doi.org/10.1016/j.puhe.2009.05.009
Watkins, S. (2017). Southend-on-Sea Localities Needs Profile: East. NHS- Southend Clinical Commissioning Group.
https://southendccg.nhs.uk/about-us/key-documents/strategic-plan-related-documents/3284-01-local-needs-profile-southend-east/file
WHO. (2009). Milestones in Health Promotion: Statements from Global Conferences. World Health Organization (WHO). https://www.who.int/healthpromotion
Appendices
- Log of activities
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- Log of seminars/discussions with Module Lead / Personal Tutor
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- Log of meetings/discussions with inter-professional colleagues
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