Job Description

Appointment of Full Time

10 sessions – 37.5 hours per week

CONSULTANT IN OPHTHALMOLOGY
WITH A SPECIAL INTEREST PREFERABLY IN MEDICAL
RETINA
Base: Withybush General Hospital
College approval Number & Date of Approval 06/08/2019

Job Reference: 100-MED-WGH-039

Anticipated Start Date: Immediate

Links to Additional Information

Hywel Dda University Health Board Homepage http://www.hywelddahb.wales.nhs.uk/

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Medical Recruitment, Hafan Derwen, St David’s Park, Jobswell Road, Carmarthen SA31 3BB

Tel  01267 239737 / Fax  01267 239860 / Email 

[email protected]
 Introduction

Office accommodation, secretarial support and full IT facilities

including access to intranet and internet will be provided.

Hywel Dda Health Board is one of seven acute Health Boards in

Wales, and covers a quarter of the land mass of Wales.

This post comes during a period of Health Board-wide service

reviews, including a comprehensive reconfiguration of services for
Mental Health in West Wales. The potential for Health Board-wide
developments and a closer liaison with primary care and social
services is substantial and exciting. A major expansion in
undergraduate medical student teaching is planned.

Hywel Dda University Health Board provides services to the 3 counties of Ceredigion,
Pembrokeshire and Carmarthenshire which together cover a quarter of Wales. It is
predominantly rural in nature with areas of outstanding beauty attracting National Park
status. Llanelli on the south coast is the only major industrial town in the area.
Aberystwyth, Lampeter and Carmarthen are University towns. Cardiff, the capital of
Wales is approximately 125 miles away while Swansea is about 65 mile away from
Aberystwyth.

Any applicant who is unable, for personal reasons, to work full-time will be considered for
the post. If such a person is appointed, modification of the job content will be discussed
on a personal basis in consultation with Consultant colleagues.

NHS Wales Core Principles

The NHS is about people, working with people, to care for people. NHS Wales values all
its staff – from Wales, the UK, EU and non-EU foreign nationals. As part of NHS Wales’
ongoing commitment to strengthen the values and behaviours of Health Boards and
Trusts, the following Core Principles have been developed which further help staff
respond better to the demands for its services:-

 We put our patients and users of our services first

 We seek to improve our care
 We focus on wellbeing and prevention
 We reflect on our experiences and learn
 We work in partnership and as a team
 We value all who work for the NHS

These Core Principles describe how everyone within NHS Wales is expected to behave
and help us all to achieve the highest quality in everything we do.

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This is a new post and you will join colleagues in a very dynamic and forward looking
Ophthalmology Service.

To support the service in the development of a medical retina services, including

management of patients with macular degeneration and diabetic retinopathy.
Demonstrate effective leadership to multidisciplinary staff members of the unit
Develop teaching, training, audit and research within the Organisation
Participate in local and national audits

The potential for Health Board-wide developments and a closer liaison with primary
care and social services is substantial and exciting. A major expansion in
undergraduate medical student teaching is planned.

The Ophthalmology Service is almost exclusively, outpatient and day care based.
There are 3 inpatient beds on the adjacent ENT ward. In the south of Hywel Dda
University Health Board services are all centralised at Glangwili General Hospital,
Carmarthen with each of the Consultants undertaking outpatient and day case
sessions at one or more of the designated local hospitals or outlying clinics.

Any applicant who is unable, for personal reasons, to work full-time will be considered
for the post. If such a person is appointed, modification of the job content will be
discussed on a personal basis in consultation with Consultant colleagues.

Details for Visiting

Those wishing to discuss the post informally in the first instance, or visit the
department are encouraged to contact:

Mr. Sam Evans Mr. Mark Henwood

Clinical Lead for Ophthalmology Clinical Director
Glangwili General Hospital Scheduled Care
Tel: 01267 235151 Tel: 02167 235151

Miss Eirini Skiadaresi

Consultant Ophthalmologist – Medical Retina Lead
Prince Philip Hospital
Tel: 01554 783346

Shortlisted candidates will be encouraged to visit and contact the Local

Panel Members – details of these will be available to shortlisted candidates when panel is
confirmed

Please note that pre-interview visits to other Outside AAC panel members are neither required
nor expected.

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 JOB DESCRIPTION

The Job Itself

Title: Consultant in Ophthalmology specialising in

Medical Retina

Professionally responsible to: The Medical Director

Managerially accountable to: Clinical Director & Acute General Manager/Clinical

Team Lead within the Speciality with ultimate
accountability to the Chief Executive

Responsibility for Staff as Part of this Post: All junior medical staff

This appointment is Health Board wide, with your principal place of employment being
Withybush General Hospital, although other working locations including off site
working may be necessary and will form part of your agreed job plan. This will be
subject to change as the Health Board’s clinical requirements are amended to meet
the needs of the service/patients.

This appointment is part of the service requirement to deliver Ophthalmology services

to the population of Hywel Dda University Health Board. The successful candidate will
work as one of a 6 Consultant team providing a full range of elective and emergency
ophthalmology service for the residents in Carmarthen, Llanelli, Ammanford and
Haverfordwest and part of the wider Hywel Dda University Ophthalmology network
with 9 consultants in total.

You will contribute to a 2 tier on call rota remunerated at 1 session. This is 1:6 during
the week and 1:9 weekends when cover expands to encompass the whole of the
Health Board catchment area.

The job plan involves working across several sites as is inevitable in such a large
geographic area. Other working locations including off site working may be necessary
and will form part of your agreed job plan. This will be subject to change as the
Health Board’s clinical requirements are amended to meet the needs of the
service/patients.

The service is almost exclusively, outpatient and day care based. There are 3
inpatient beds on the adjacent ENT Ward. Services for the South of Hywel Dda
University Health Board are all centralised at Glangwili General Hospital, Carmarthen
with each of the consultants undertaking outpatient and day case sessions at one of
more of the adjacent designated local hospitals or outlying clinics. All inpatient and
day case work for Pembrokeshire residents are carried out in Carmarthenshire.

Other hospitals at which duties are performed: Outpatient clinics are already in
place in Pembrokeshire, in Withybush General Hospital, as well as in Pembroke Dock
and Tenby Hospitals. In Carmarthenshire, outpatient clinics are held in Glangwili
General Hospital, Prince Philip Hospital and Amman Valley hospital where there are
facilities for cataract and minor ophthalmic operative work.

The department at Glangwili General Hospital contains a dedicated ophthalmic theatre

and eye unit for day cases and all areas have recently been re-equipped with state of
the art equipment.

Amman Valley Hospital provides a Wet Macular Degeneration Service for the whole of
the catchment area.
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The Clinical Strategy of the Health Board is under constant development and the post
holder may be required to undertake different duties agreed at the time of
appointment.

Purpose of the Post and General Responsibilities

To provide, with consultant colleagues (as appropriate) a service in Ophthalmology

and
supporting the development of sub-speciality interest to the hospitals and community
so
designated with responsibility for the prevention, diagnosis and treatment of illness.

All clinical staff are accountable and responsible for their own clinical competence and
should limit their actions to those for which they are deemed competent. Clinical staff
are also required to comply with the requirements of their professional organisation
regarding supervision.

As a senior employee of the Health Board the post holder will work in close co-
operation
with, and support other clinical, medical professional and managerial colleagues in
providing high quality healthcare to the Health Board’s patients.

Integral to the responsibilities of the post are the following requirements:-

To ensure the provision and delivery of a first class 7 day clinical service
To provide effective leadership to all staff engaged in the specialty
To sustain and develop teaching and research wherever appropriate
To undertake all work in accordance with the Health Board’s procedures and
operating policies
To conduct clinical practice in accordance with contractual requirements and within
the parameters of the Health Board’s service plans
To maintain the confidence of business plans and development strategies
formulated for the specialty or the Health Board
Core clinical expertise in Ophthalmology
Experience and knowledge of running a sub specialty service
Leadership and team building skills as well as working as part of a
multidisciplinary team
Supporting and training multidisciplinary teams
Delivering care in the community alongside primary health care and social care
teams
Providing persuasive strategic advice to LHB’s and Social Services Departments
Addressing the Intermediate Care Agenda
Participating in CPD including Audit
You are expected to maintain your professional development for Revalidation
A Teaching and Training Role for medical undergraduates and postgraduates
Educational Supervisor role to Junior and Middle Grade Medical Staff
To undertake regular multidisciplinary clinical audit and provide evidence based
medicine

Specific Responsibilities of the Post

Clinical

To share the responsibility for the acute care of Ophthalmology patients

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 To support the development and delivery of a sub specialty service in hospital and
in the community
To conduct clinical practice in accordance with contractual requirements within the
parameters of the Division’s and Health Board’s agreed objectives.
To develop and deliver a comprehensive seven day service for Ophthalmology
service

Teaching/Training (as agreed with Clinical Director/MD)

To provide conditions for improved training opportunities in line with national and
local recommendations arising out of MMC and related requirements
To participate in the undergraduate teaching programme
To assist and participate with the development of postgraduate training for F1s,
F2s, CTs, STs, SpRs, Speciality Doctors and other staff as appropriate
Where agreed, to act as Educational Supervisor to junior and middle grade
medical staff

Audit (as agreed with Clinical Director/MD)

To promote evidence-based clinical practice

To undertake regular audit

Research Opportunities in Hywel Dda

The Health Board has University status with strong links to the Swansea & Cardiff
Universities to promote research & development and multi-professional teaching. We
recently appointed our first Chair in Respiratory Medicine into the Health Board, with
further appointments for the future, and we are the first Health Board in Wales to
appoint Bevan Commission Fellows. This initiative programme aims to engage and
capture the enthusiasm and commitment of our up and coming clinicians in Wales in
addressing Prudent Health Care.

HDUHB is committed to enhance local research and development and the successful
applicant would be strongly encouraged to develop a local research portfolio as part of
their core NHS responsibilities (Handbook to the NHS Constitution, January 2009)as it
improves patient outcomes
(http://www.crncc.nihr.ac.uk/ppi/why_is_research_important) and is a Welsh
Government priority
(https://www.wales.nhs.uk/sites3/page.cfm?orgid=580&pid=59041).

The annual operating R&D Budget has increased by over 750% since 2008 and
research operates across all 4 hospital sites with increasing opportunities in Primary
Care.
- Basic sciences: we have memoranda of understanding with Swansea and
Aberystwyth Universities, jointly funding post-doctoral researchers and co-
supervising MSc, MPhil and PhD students in e.g. sport science, rehabilitation,
medical engineering, psychology & qualitative research, management change,
biomarker discovery and most recently metabolomics

- Commercial Trials: with experienced research nurses dealing solely with

commercial companies working on your behalf and pharmacists dedicated only
for clinical trials, our clinicians are working increasingly with major companies.
This is not only in our established areas of strength such as diabetes and
respiratory medicine, but new studies have just opened with Consultants as
Principal Investigators in cardiology, lipid medicine, urology, rheumatology and
dermatology

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 - Portfolio trials: there are specialist researchers from the Health & Care
Research Wales and NIHR workforce recruiting patients into National and
International trials across all 4 hospital sites and increasingly in Primary Care.
New funding and a specialist R&D Manager will help any clinician act as a local
Principle Investigator or develop their own pathway to portfolio work.

We have an 8-room Clinical Research Facility in PPH, with state of the art facilities
that was opened in 2012 and new initiatives involve BioBanking, EU Lead for
telemonitoring at scale and new Clinical Research Fellowships. For more details,
please contact the Director of R&D.

Revalidation & Appraisal

□ The post holder will be expected to participate in annual appraisal and to maintain
a portfolio of supporting information to bring to appraisal as a basis for discussion.
The All Wales format for appraisal is the online Medical Appraisal and Revalidation
System (MARS),
□ You will be expected to maintain GMC Revalidation as and then required, and will
be supported through this process by the appointed Revalidation Manager. The
Responsible Officer for Hywel Dda Health Board is Medical Director.

Quality and Standards

To be familiar with and actively promote adherence to the regulatory framework
including NICE and National Service Framework Guidance and to actively promote
professional standards “The Duties of a Doctor”
To undertake all work in accordance with the Health Board’s procedures and
operating policies

Learning Organisation
To be involved in and actively manage complaints and any medico legal claims in
their area of practice, management of serious incidents and responsibility for
sharing any organisational learning from these

Patient Experience
To monitor and respond to measures of patient experience

Patient Safety
To work actively to reduce unintended harm to patients
To contribute actively to the content areas of the 1000 Lives Campaign and any
other subsequent patient safety campaign
To adhere to the Health Board’s Clinical Incident Policy

Personal Development
To attend accredited conferences and meetings to update personal level of clinical
practice, teaching and management skills in line with CME requirements
To participate in an annual Job Planning Review process
To participate in the Health Board’s Annual Appraisal process

Equal Opportunities
It is the aim of the Hywel Dda HB to ensure that no job applicant or employee
receives less favourable treatment on grounds of gender, religion, race, colour,
sexual orientation, nationality, ethnic or national origins or is placed at a
disadvantage by conditions or requirements which cannot be shown to be
justifiable. To this end, the HB has an Equal Opportunities Policy and it is for each
employee to contribute to its success.

Flexible Working & work-life balance

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 Flexibility in employment is a key factor in demonstrating our commitment to fair
and equal treatment inside the workplace and in attracting the highest calibre of
applicants to work for the organisation. It is the aim of the Health Board that
employees in all areas and levels of the organisation will be considered for flexible
working in accordance with the Equality Act 2010 and regardless of their level of
seniority, their current working pattern, or whether they are employed on a
permanent or fixed term basis.

Management (as agreed with Clinical Team Lead/Hospital Director/AMD/

MD)
To provide medical information for the development of systems appropriate for
Health Board needs
To participate in departmental consultant and senior staff meetings
To attend other departmental, Divisional and Health Board meetings as necessary
To attend regional and national meetings as necessary
To undertake all work in accordance with Health Board procedures and operating
policies
To work within the financial and other restraints decided upon by the Health
Board. Additional expenses of any kind will not be committed without the approval
of the appropriate manager/budget holder.
To co-operate with local management in the efficient running of services and an
expectation to share with consultant colleagues in the medical contribution to
management. In addition, it should be noted that a system of Clinical Directorship
is in operation and close liaison with appropriate colleagues will be required
To ensure that arrangements are in place for adequate medical staff to be
available in relation to the treatment and care of patients

The post holder has a general duty of care for their own health, safety and wellbeing
and that of work colleagues, visitors and patients within the hospital. This statutory
duty is in addition to any specific risk management or clinical governance
accountabilities associated with the post.

Finally, the post holder is expected to:

Observe the rules, policies, procedures and standards of Hywel Dda University
Health Board together with all relevant statutory and professional obligations
Observe and maintain strict confidentiality of personal information relating to
patients and staff

Specialty/Department Information

The post holder will be expected to help develop and deliver all aspects of the sub
specialty service. Currently we have one consultant who delivers our Wet Macula
Degeneration Service and you will be expected to contribute to this arm of the service
in line with your interest in Medical Retina. The AMD clinics are for initial assessment,
treatment with intravitreals and follow up. Medical retina cases will also be seen in
these clinics. Laser clinics are available in each of the three DGH’s these are run by
our junior doctors with the opportunity for consultants to treat select cases.

This will expand the existing service within the Health Board and in the community
whilst working closely with other colleagues.

OPHTHALMOLOGY

Currently there are 6 substantive Ophthalmologists (including this post) employed by

the Hywel Dda University Health Board, providing services for Carmarthenshire and
Pembrokeshire residents.
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Names of Senior and Consultant Members of the Department
Mr S Evans, General Ophthalmologist / Clinical Lead (sub specialty Ocular Plastics &
Glaucoma)
Mr H Jenkins, General Ophthalmologist (sub specialty VR)
Miss E Skiadaresi, General Ophthalmologist (sub specialty in Medical Retina & Uveitis)
Mr R Wintle, General Ophthalmologist (sub specialty in Medical and Surgical Retina)
Mr D Rathod, General Ophthalmologist (sub specialty in Paediatrics)
Mr D Papageorgius, Locum General Ophthalmologist
Mr W Tantawy, Locum General Ophthalmologist
This post, General Ophthalmologist (sub specialty in Medical and Surgical Retina)

Clinical Tutor for the Speciality

Mr Rathod is the clinical tutor for Ophthalmology.

Departmental Integration
The service requirement is for a General Ophthalmologist able to deal with the wide
range of ophthalmic diagnoses including a high volume of cataract surgery as well as
having a special interest in medical retinal conditions.

The short and medium term objectives for Ophthalmology service include:

Providing a comprehensive service for all aspects of Ophthalmology

Access to subspecialty expertise across the Health Board
Development, support and training for nurse consultant and nurse practitioner
colleagues

An innovative Rapid access clinic has been set up at Glangwili to run throughout the
day. This is manned predominantly by Speciality doctors in order to cope with the
demand of emergency care. Some emergencies are accommodated, where possible,
in the other DGH ophthalmology clinics as and when. This service has enabled a much
more efficient use of clinics, which previously struggled to cope with acute cases in
addition to the appointment based workload.
Diagnostic facilities are available in all three DGH as well as the medical retina unit at
Amman Valley Hospital. There are OCTs on every site, but fluorescein angiography is
only available at the 3 DGH where suitable emergency back-up is available.
Expansion of the nurse led services now include cataract follow up, new and follow up
glaucoma clinics and there is scope to expand this further.
The department has been at the forefront of developing collaborative schemes with
primary care. This includes a Glaucoma refinement service through designated
optometrists, as well as a cycloplegic refraction scheme. More collaboration is being
encouraged through the development of the Wales Eye Care Service.

Consultant Development and Mentoring Programme

We run a successful Consultant Development and Mentoring Programme within the

Health Board, this programme is specifically designed to meet the needs of newly
appointed consultants, and offers a current and future focus by:
 developing you as a senior leader, to enable you to effectively contribute to
Hywel Dda and its future direction.
 Enhancing your capability as a senior leader and to support you to deliver
organisational priorities
 build capacity for the future, by aligning current priorities with planning for
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 delivering future service.
 delivering development aimed at consultants, enabling you to translate the
NHS Medical Leadership Competency Framework (MCLF) behaviours into
practice

The programme has been designed to support new Consultants to achieve the
competencies required from the Medical Leadership Competency Framework (MCLF).
This framework has been included within the NHS Leadership Framework (LF), and as
such is consistent in its language and approach.

In addition, the programme offers:

 membership of an action learning set for the duration of the programme
 have access to diagnostic tests to support identification of individual learning
and development needs, including the LF 360◦self-assessment
 the opportunity for Academic accreditation (tbc)
 access to an executive coach
 opportunity to meet with the Chief Executive and Chair of Hywel Dda
 access to the Hywel Dda quarterly leadership forum
 invite to join the senior leadership programme’s master classes
A mentorship Scheme is also in place within the Health Board, with over 15
fully trained mentors to which all newly appointed Consultants will be
allocated

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Provisional Job Plan
Actual DCC/SPA split will be discussed and agreed with the successful applicant in
the light of their individual agreed SPA needs.
Also the successful candidate will be allocated 0.5 SPAs per week in their first 12
months to participate on our Consultant Leadership Programme
(As required under paragraph 30a of the Terms and Conditions of Service)
Day Time Location Work Category No. of
Sessions

Monday Am Withybush Hospital OPD DCC 1.00

Pm Withybush Hospital OPD DCC 1.00

Tuesday Am Withybush Hospital AMD Clinic DCC 0.5

(alt. weeks)

Pm Withybush Hospital SPA SPA 1.00

Wednesday Am Withybush Hospital AMD Clinic DCC 1.00

Pm Withybush Hospital AMD Clinic DCC 1.00

Thursday Am Withybush Hospital SPA DCC 0.5

Pm Off-site SPA SPA 1.00

Friday Am Crymych AMD Clinic DCC 1.00

Pm Crymych AMD Clinic DCC 1.00

TOTAL Sessions 10.00

Direct Clinical Care (including patient administration and travel time) 7.5

On Call – If Applicable 1

Supporting Professional Activities – 1 SPA may be taken at home for 2.5

Professional Continued Development.

10.00
TOTAL SESSIONS

On-Call Availability Supplement

Agreed on-call rota – Prospective cover for Annual/Study leave (30 days 1:6
in 3 years)
Agreed Category in line with colleagues on the same rota – currently High
paid at:
(Subject to change in line with annual job plan review)

This Job Plan is provisional and will be discussed and agreed with the successful candidate upon
appointment and annual job plan review.

In line with the terms and conditions, the final job plan is subject to the agreement of the Health Board
through the Clinical Team Lead/CLINICAL DIRECTOR and the appointee.

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Person Specification for CONSULTANT OPHTHALMOLOGIST WITH A
SPECIAL INTEREST IN MEDICAL RETINOPATHY

Requirements Essential Desirable Measurable by

- Full GMC Registration and Licence to Practice - Appropriate Higher
- FRCOphth or equivalent Degree e.g. MD, PhD or
- On Specialist Register/SpR due to obtain MSc or equivalent
relevant CCT/CESR(CP) within 6 months of
interview
- A statement of eligibility for registration
issued by PMETB
Qualifications - A primary medical qualification and recognized Application
specialist qualification and recognized
specialist qualification from a European
Member State which will allow direct entry to
the GMC Specialist Register
- Experience Commensurate with that of
Consultant Status
- Further relevant degree/diploma
- Broad based experience in Ophthalmology - Experience of NHS
- Expertise and proven experience in the - Wider experience,
management of Medical Retina conditions and research and training in
General Ophthalmology providing sub specialty
- Knowledge of UK hospital systems (or equivalent) service
- Knowledge and participation in CPD - Evidence of above
- Competence in Ophthalmology average performance
Clinical Application/
- Expertise medical retina - Additional clinical
Experience Interview
- Able to apply knowledge qualification(s)
- Safe and effective written and verbal
communication skills
- Knowledge and experience of communicating bad
news
- Meet the requirement of the GMC’s “Good
Medical Practice”
- Evidence of participation in clinical audit and - Knowledge of risk
understanding role of audit in improving medical management
Clinical Application/
practice - Knowledge of annual job
Governance Interview
- Comprehension of core philosophy and building planning/appraisal
blocks of Clinical Governance review process
- Experience and knowledge of critical appraisal of - Evidence of initiating,
evidence so as to improve clinical outcomes progressing and
Application/
Research concluding research
Interview
projects with publication
- Research degree
- Evidence of organising programmes and teaching - Organisation of further
medical students and junior doctors teaching programmes in
Application/
Teaching - Willingness to teach all grades of professional medical education
Interview
multidisciplinary staff - “Training the Trainers”
experience
- Knowledge of the management and structure of - Evidence of
Application/
Management the NHS management training
Interview
- Willingness to participate in clinical management
- Ability to cope with stressful situations and - Evidence of leadership
undertake responsibility attributes
- Excellent interpersonal skills and team-working - Motivational skills
skills
- Ability to work as part of a multidisciplinary and
multi-agency team and alone
- Ability to work flexibly in response to the
changing needs of Geriatric Service
Personal - Ability to embrace the following personal values and
behaviours on a daily basis: Interview
Qualities
· Dignity, Respect and Fairness;
· Integrity, Openness and Honesty;
· Caring, Kindness and Compassion.

- Ability to demonstrate a commitment to our

organisational values:
· Working together to be the best we can be;
· Striving to develop and deliver excellent
services;
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 - · Putting people at the heart of everything we do
- All applicants to have demonstrable skills in
written and spoken English adequate to enable
effective communication about medical topics
with patients and colleagues
- Satisfactory Immigration Status
Other Application/
- Satisfactory Health Clearance
Requirements Interview
- Satisfactory Declaration, Enhanced CRB
Disclosure Check
- Ability to fulfil all duties of post, including on-call
commitments and travel to meet requirements of
the post

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