Document Title Communications Strategy. Lead Author(s) Head of Marketing and Communications and Engagement

Transcription

1 Document Title Communications Strategy Document Description Document Type Strategy Service Application Trust Wide Version 2.0 Name Jayne Ilic Anne Baines Lead Author(s) Job Title Head of Marketing and Communications and Engagement Director of Strategy Change History Version Date Comments 2.0 March 2014 Updated strategy Links with External Standards Information Governance Toolkit Key Dates DATE Ratification Date Trust Management Board 19 th March 2014 Minute Number 36/14 Review Date March

2 Document Title: Please Tick () as appropriate Executive Summary Sheet Communications Strategy This is a new document within the Trust This is a revised Document within the Trust What is the purpose of this document? Walsall Healthcare NHS Trust has a vision to provide first class, integrated health services for the people we serve in the right place at the right time. The need to communicate and engage well with our colleagues, the public, patients and our stakeholders is pivotal to the success of the Trust, particularly against a challenging backdrop of a tight fiscal setting and rising patient expectations What key Issues does this document explore? The main focus of the communications strategy is to support the delivery of the six key strategic aims as set out in the Trusts corporate strategy: First Class Patient Experience Integrated Care An Effective NHS Foundation Trust An Engaged and Empowered Workforce Good Use of Resources Safe, High Quality Services Who is this document aimed at? All staff What other policies, guidance and directives should this document be read in conjunction with? Corporate Strategy How and when will this document be reviewed? The strategy will be reviewed every three years by the Head of Marketing and Communications and Engagement 2

3 CONTRIBUTION LIST Key individuals involved in developing the document Name Jayne Ilich Designation Head of Marketing and Communications and Engagement Circulated to the following for consultation Name/Committee/Group/ Relevant Stakeholders Designation Version Control Summary Significant or Substantive Changes from Previous Version A new version number will be allocated for every review even if the review brought about no changes. This will ensure that the process of reviewing the document has been tracked. The comments on changes should summarise the main areas/reasons for change. When a document is reviewed the changes should using the tracking tool in order to clearly show areas of change for the consultation process. Version Date Comments on Changes Author 3

4 Document Index 1 Executive Summary 5 2 Drivers for change 6 3 Purpose, Aims and Objectives 7 4 Why good communication is important 9 5 Communication Principles 9 6 Reputation, brand reinforcement and marketing 10 7 Understanding the audiences 10 8 Media Relations 11 9 External communications and marketing Internal communications A new world of communications Measurement and review Conclusion 19 Pg No Appendix 1 Appendices Stakeholder Map 20 Pg No 4

5 1. Executive Summary Walsall Healthcare NHS Trust Communications Strategy Walsall Healthcare NHS Trust has a vision to provide first class, integrated health services for the people we serve in the right place at the right time. The need to communicate and engage well with our colleagues, the public, patients and our stakeholders is pivotal to the success of the Trust, particularly against a challenging backdrop of a tight fiscal setting and rising patient expectations. The increasing role of colleague engagement in the identification of issues and development of improvements, significant change in the NHS arising from a number of national reports driving greater candour and openness at their root all promote the need for the effective communications as does the ever rising expectations of the quality of care that we provide and heightened media interest in the NHS. Throughout 2013 a number of events have significantly altered the environment in which we operate. There have been recommendations from a number of key reports including the Mid Staffordshire Hospitals, Winterbourne Homes and the NHS Trust Development Agency (NTDA) Planning Guidance for NHS Trust Boards particularly in relation to communicating with our local communities and how we look at measuring success. The Trust has already started to lay the foundations for good communication and engagement and this strategy sets out a number of actions required to deliver our aspiration for first-class communication with all of our stakeholders. With this in mind the main focus of the communications strategy is to support the delivery of the six key strategic aims as set out in the Trusts corporate strategy. 5

6 It is also important that the communications strategy reflects the values of the Trust and that these are embedded in the way in which we communicate to our stakeholders. 2. Drivers for Change Changing face of the NHS There have been a number of changes to the way in which the NHS is organised, particularly in relations to commissioning. This has meant growing relationships with newly formed public bodies such as Clinical Commissioning Groups, the Local Authority (as commissioners), Healthwatch and the National Trust Development Authority for example. The increasing range of local commissioners from General Practice and the local authority as well as new more distant commissioners including the Local Area Team and Specialised Commissioning requires a range of approaches to remain a feature on an increasingly complicated horizon. Alongside these changes Walsall Healthcare NHS Trust is also working towards a Foundation Trust status in late 2014/15 and we will need to further develop our established relationships with members and yet to be established Council of Governors. Rising expectations for openness, transparency and involvement With the advent of the Francis Report, Winterbourne, Keogh, Berwick and subsequent reports on quality we will need to continue to work differently in the future; with greater patient involvement and transparency. Patients and their carers are getting more involved in shaping and making choices about their healthcare. In order to help them to make informed choices we will have to provide more information about our services and their outcomes. 6

7 New ways of communicating The Trust must constantly review and refresh existing communication techniques and embrace modern technologies to ensure that we are continuing to reach all audiences. The growing popularity and mainstreaming of "e" communication, through social networking, podcasts, blogs etc. presents new ways for our patients, colleague and partners to access information, form opinion and for us to gauge and influence them. The mixed economy of provision Within the NHS we have a mixed economy of working in competition with some providers e.g. tenders, Any Qualified Provider ( AQP) and working in collaboration with other providers including those from statutory, third sector and private sectors. We need to tailor our communications to ensure that we address whether the purpose is to promote our services to win business or support healthy dialogue with partners. The structure of the organisation The structure of the nature of an integrated organisation which has colleagues providing services across hospital and community services results in a variety of disparate locations and teams. Therefore, communication has to be inclusive across the whole Trust and mechanisms in place to ensure two-way feedback. 3. Purpose, Aims and Objectives Purpose of the Communications Strategy To embed a strategic, proactive and creative approach to communications and engagement that supports Walsall Healthcare NHS Trust to achieve its strategic vision, objectives and goals. Objectives OBJECTIVE 1: Ensure patients and the public are well informed about the quality, safety and availability of services available at the Trust so that we become a provider of choice for the local population (and beyond). Ensure that there are processes in place to share information with patients and stakeholders that demonstrates how Walsall Healthcare NHS Trust brand is shaping and developing their services. Work collaboratively with partners and other key stakeholders to ensure a coordinated approach, for example Walsall Clinical Commissioning Group (CCG) and Walsall Partnership Group. Ensure that our patient information is accessible and accurate and written in plain English. 7

8 OBJECTIVE 2: Further develop the Walsall Healthcare NHS Trust brand and reputation through proactive and reactive media management, marketing, high quality patient information Deliver strong media relations and deliver external communications in a planned, proactive and consistent way Maintain specific plans for media management out-of hours and in the event of a major incident or emergency Continue to develop high quality, clear marketing materials and regularly audit to ensure that they consistently meet the brand guidelines OBJECTIVE 3: Create a dynamic culture of colleague engagement supported by twoway effective communications across the organisation to ensure that we become an employer of choice and so that so that our colleagues will recommend their Friends & Family to us. Evaluate and strengthen existing internal communication channels within the Trust particularly between the hospital and community Ensure that colleagues update on projects and other Trust news such as award wins so that it becomes routine to feedback into communications Develop a structured approach to further embed colleague feedback from engagement sessions within the communication methods OBJECTIVE 4: Be seen as thought leaders in the NHS and locally on Trust issues. Ensure a strong on-line presence to allow the sharing of achievements and important information Establish an efficient system for horizon scanning and forward planning to ensure that we can lead on or respond to NHS and health issues Be seen as leaders in service leaders in service development, quality service delivery and patient experience OBJECTIVE 5: Support our journey to Foundation Trust status and beyond through innovative and creative communications. Develop the communication contribution role of members and patients to become ambassadors of the organisation and the services it provides Nurturing relationships that include and strengthen the voices of hard to- reach groups including the Asian community and younger audiences Ensure that processes are in place to share information with stakeholders that demonstrates how they can be involved in the journey to and beyond Foundation Trust status To deliver our objectives, communication needs to be proactive, show clear leadership and focus. We need to ensure that we are talking about the issues that really matter to our colleagues, commissioners and patients /stakeholders and the local community. 8

9 4. Why good communication is important? Good communication is very important if organisations are to effectively engage with their colleagues. Within the Trust the percentage of colleagues reporting communication has been improved via the Pulse Survey is nearly 40%. Good communication and engagement can be achieved through a variety of channels which are aligned to the needs of the various audiences. There are a number of techniques available such as media relations, advertising marketing, social media, public relations, events, campaigns and internal communications. 5. Communication Principles The Trust's Communication Strategy will adhere to the following set of principles: Overarching Delivered by principle Effective Ensure vision and objectives central to communications Good media relations are fostered Responsive Being flexible and responsive to change Being quick to react and anticipating action needed to achieve the appropriate impact Listening to all stakeholders, understanding their issues and addressing their information needs Innovative and modern Presenting the Trust as a modern and forward thinking organisation Promoting innovation in communication and engagement Respectful Communication will be two-way with effective mechanisms to enable people to give us their views Responding to feedback in a timely way and demonstrating how suggestions have been considered Tailor messages to meet the specific needs of the audiences whom we are speaking to Planned and timely Reflecting the strategic intent of the organisation to achieve its goals Prioritising communication activity based on need. Honest and accountable Being honest about how and why decisions have been made and the reasons for them Telling the truth and being honest about the reasons for non-disclosure where information can t be shared. Ensure information is timely, accurate, consistent and clear Clear Ensuring information is straightforward and unambiguous Writing everything in plain English The tone in which we communicate will reflect the Trusts values and promises. Using language in a way that appeals to the intended audience and is accessible to ensure the maximum impact 9

10 6. Reputation, brand reinforcement and marketing A distinct part of communications activities over the next three years will be to proactively increase marketing of the Trust s activities, services and reputation. For all of our stakeholders, Walsall Healthcare NHS Trust should be automatically associated with good, high quality services and level of care. Our brand and what it stands for should be regarded as one of our most protected assets. A positive reputation and brand will help to establish the Trust as a provider and employer of choice, and to foster loyalty and trust in the brand. Over the past two years we have engaged in developing the brand further by creating new materials to support both hospital and community services, this has included new signage, corporate branding materials and campaigns which have supported specific projects such as the Lorenzo launch. This co-ordinated, improved external image will lead to loyalty, familiarity, public confidence and increased awareness of the Trust's activities. The Trust's Communications and Marketing Department acts as brand guardian and has, and will continue to provide advice to colleague on branding and corporate identity. It is important that the branding is used at every opportunity to support its development both internally and externally. 7. Understanding the audiences The Trust has a wide range of target audiences and stakeholders that can be divided broadly into two groups, internal and external. For the purposes of communication planning this can be further categorised into o colleagues o members o GPs o patients, representatives and carers o community groups o influencers, overseers and scrutineers Throughout our communications work we will make sure that each of these target audiences is appropriately communicated with and we use a variety of channels including those outlined in sections 9 and 10. The tone and content and style of mechanic used depend on the audience and the immediacy of the communication. The Trust has also developed a detailed stakeholder map which can be found in Appendix 1. Over the next few years the shape of the audiences may change and grow so we need to regularly review the map and ensure our communications techniques are aligned. 10

11 8. Media Relations Walsall Healthcare NHS Trust has a high profile in local media and a growing presence in the local media which is important in order to sustain our reputation for being a leading healthcare provider in the West Midlands and Black Country. As an NHS organisation we are accountable to the public and need to work with the media to explain our role to stakeholders. We also need media support as it is valuable way of reaching audiences, communicating key messages and mitigating risk where needs be. Good media relations forms one of core principles this strategy. We have established a very good network of media contacts locally and the ambition would be to engage with more trade and national media over the next three years whilst continuing to strengthen relationships with local media. The Communications Team is committed to building strong links with the media and will require the support of all colleagues, particularly senior managers, in providing journalists with information. During 14/15 the Trust aims to increase the number of positive stories within the local press in order to gain increased public understanding of the services that we provide. All requests and responses to the media will be conducted through the Communications Team. Out of hours, the Director-on-call will liaise with the media if an issue does arise. Key messages Key messages will help us to focus thoughts on the story we want to convey; can be developed with colleague members so that they feel engaged and part of the Trust and disseminating them widely also helps our audiences understand our vision and strategy. Key messages can also help to evaluate and measure the success. Key Topics We need to ensure that our that our communication efforts are focused and targeted and that we work closely with our stakeholders. There are a number of topics where we need to focus our efforts in order to support the delivery of our strategic aims. Patient Experience Quality and safety delivery including infection control Service performance Service information about our hospital and community services Workforce and colleague issues Changes and forward plans including the delivery of efficiency targets progress to Foundation Trust status 11

12 Media objectives There are a number of objectives we will adhere to ensure we have effective media relations: Working proactively: In order to increase proactive exposure through the media we need to ensure that we can articulate clearly future developments/services for the Trust, introducing, for example a team of clinical colleagues who can be put forward as experts in their subject area. We will be proactive in sourcing news stories from across the Trust and will also engage a number of internal Communications Champions to provide two way feedback of news and features from both the hospital and community. Being open and transparent: We will ensure that all proactive press releases and statements (as appropriate) are published using internet and via social media. Develop an on-line press office to compliment press office team service which is easier to access out of hours. Helping to mitigate risk: There will be occasions when media relations is reactive and we need to ensure that we have a robust system in place for providing crisis communications support quickly, effectively and efficiently Working with the lead for business continuity in the Trust we will work on a Media on-call policy and also look to expand the number of trained spokespeople who are confident in working with the media. We will also develop a series of generic media responses that could be used adapted for a media issue. We have also started to develop a closer working relationship with partnering organisations such as CCG and Walsall Council and cross borough Communications Groups, by networking this can help to anticipate and build resilience for negative media coverage. 9. External communications and marketing The principles of good communication will be adhered to in all PR material and marketing activity. The Communications Team will continue to support colleagues in developing materials and presentations to ensure that they adhere to the brand values and corporate style and tone. Communicating and marketing to GPs From April 2013 Primary Care Trusts were abolished and Clinical Commissioning Groups (CCG) were established. This was part of the major changes to the NHS Structure as set out in the 2010 White Paper Equity and Excellence - Liberating the NHS which became law under the Health and Social Care Act

13 Reputation and relationships with GPs will be critical to the success of Walsall Healthcare NHS Trust over the coming years as a greater proportion of activity could be placed with alternative providers in primary care or the private sector. GPs are moving centre stage in commissioning; the introduction of any willing provider and a more dynamic market is also likely to increase their influence in helping their patients to choose healthcare providers. As the marketing proposition begins with the customer, GPs will hold the purse strings and their buying decisions make them crucial customers for every trust. All 63 GP practices within Walsall are represented by the Walsall Clinical Commissiong Group and are a key stakeholder for the Trust both with regards to referral of patients and commissioning of the Trust clinical services. Mid Staffordshire NHS Foundation Trust was formally dissolved in February 2014 and the Trust has already seen a considerable increase in the number of patients coming to us from this area. Therefore, we have will also need to communicate with CCGs from further afield such as NHS South East Staffordshire and Seisdon Peninsula CCG. With this in mind we need to ensure that we clearly assess this growing audience and its requirements and develop a clear strategy for GP engagement and marketing. On-line continues to become a growing way that GPs access information (source Pulse Magazine) although they still utilise print materials to support training and Continuing Professional Development (CPD). Pulse and GP are excellent publications and websites which are read by some 40,000 GPs each and also offer us a conduit to talk to this audience on a wider scale. Annually review what we tools we use to communicate, survey their usefulness and look for areas to improve Identify clearly with Divisions potential growth areas for services which we can promote Enhance clinician (consultant ) to clinician (GP) communication Develop further tools such as clinician /patient case studies to promote the benefits of the services offered Develop GP Connect section on Trust website to become an invaluable source of information for GPs and news and download support materials Grow attendance at GP events such as the monthly symposiums and other engagement events In Your Shoes The Trust will hold a re-run of patient In Your Shoes sessions in April These are to be delivered through a programme of rolling events and give patients the opportunity to share their experiences of the Trust. Feedback will be used to help shape future activity in the Trust and will be helpful in understanding what to communicate to our audiences. The Communications team will provide the support to help cascade the outcomes throughout the organisation and externally to the public/patients 13

14 Develop the framework for any follow-up sessions or the next run of In Your Shoes within a given timescale Service level marketing and patient information An important part of the on-going marketing strategy will be the development of service level marketing and communication plans designed to increase the profile of specific services. Other marketing communications will be aimed at providing service information to existing and potential referrers and users on the Trusts services. Devise individual marketing plans with divisions to promote specific services Ensure all patient materials are brand consistent, fit for purpose and communicate key benefits of the services Develop new methods of presenting service information for example, patient case studies. In addition we have introduced TV screens in outpatient areas where we promote key messages to patients and carers. We will continue to keep abreast of emerging technologies which would be of benefit to colleagues, patients and visitors and could provide financial benefits to seize commercial opportunities such as advertising and commercial sponsorship of all or some of our digital channels. 10. Internal Communications We recognise that our colleagues are the best advocates for the Trust and what they say to their friends and family about their workplace is key to public perception. In 2011 the Trust introduced its change programme For One and All to embed the Trust values and promises at the heart of everything we do. The Colleague Connect engagement programme was then launched in 2013 as an evolution of the colleague facing For One and All programme. We have listened to and learned from the ideas, feedback and aspirations of our colleagues which they have shared in a number of feedback sessions over the year. Part of the feedback has shown that communication is vital to the success of delivering and shaping the future strategy of Walsall Healthcare NHS Trust and enhancing colleagues experience. We will therefore continue to further develop and embed the Connect programme using internal communication techniques, working closely with Senior Executives and the Organisational Development team. One of key challenges arising from Colleague Connect events was communication of information. As there are over 4000 people currently working in the Trust across multi-site locations, communicating can be challenging. In addition not all colleagues have access to a computer or service, so one communication method does not fit all. Effective internal two-way communications is pivotal to supporting a dynamic culture of colleague engagement. The Communications Department employs a wide range of communications techniques to ensure that we are maximising the opportunity for colleagues to see and engage with the information given. Colleagues also have a duty to ensure that 14

15 communication is a two-way process which they seek out information that is relevant to them, act upon it and make use of feedback mechanisms. We will continue to review communication channels, tactics and flow on a regular basis to ensure that we are using the right techniques and improving colleague understanding of key information. Internal Communications activity Trust Board The Trust Board operates in a spirit of openness and transparency and holds monthly Board meetings in public.board papers and meeting dates are made available to colleague via the internet. Board Walk Board walks take place prior to the public board meeting on a monthly basis. Executive Directors and Non-Executive Directors meet teams from across the Trust to learn about and understand roles and issues within their areas. Key information from both the Trust Board and Board Walks will be cascaded to colleagues using the appropriate channels Continue to develop the virtual network to share board information i.e. Virtual Boardroom. Trust Connect Trust Connect is a bi-monthly publication which was launched in June It is designed in a newspaper style format, which is distributed to all colleagues via payroll. An editorial committee ensures that there is the right balance of information in the publication which shares Trust news, events and important corporate messages. A longer term objective will be to extend pagination and distribution (possibly to patients and visitors) to include advertising which will help to self-fund the newspaper. Develop an on-going campaign for sourcing good news stories through the divisions and corporate directorates Annually review the cost and distribution of the publication to ensure that it is value for money Senior Management Team Connect The Chief Executive hosts a monthly session, Team Connect (formally known as Team Brief) with senior members of the management team to brief them on the main priorities for the coming month and any issues/concerns that need to be flagged i.e. end of year performance. There is also a regular presentation by teams across the organisation on topical areas. A team connect update sheet and podcast are also provided to all colleague via the intranet. 15

16 Develop a strategy to increase the number of senior management attending Team Connect Ensure a balance of corporate, hospital and community presentations Make sessions more interactive Encourage senior managers to share their feedback from team meetings Chief Executives Update The Communications Department issues a weekly bulletin to all colleagues, via . The update contains the Chief Executive s outlook for the week along with key messages, good news stories and activities happening across the trust. This was revamped in 2013 and is accessible on the intranet. We will aim to review that we are providing the right format on a regular basis by asking all colleague via a survey twice per year. Ensure that the Chief Executives Outlook remains topical and has a balance of hospital and community news Global The purpose of global is to communicate quickly to all colleagues with highly important messages. To ensure the appropriateness of a global request, the Communications Team is the only conduit available to send out a global. Review the global guidelines annually to ensure that they are fit for purpose and colleagues understand how and why to send this type of communication Awards and events We monitor the local area and health arena to ascertain if there are awards and events which we could enter or attend and work in conjunction with clinical teams to ensure award entries and inspiring and engaging to support entries. Through the use of communication champions and internal colleague communications ask colleagues to let the communications team know if they would/are entering award Scan the health landscape to identify opportunities to enter awards for the Trust that will enhance its reputation Intranet The intranet was redesigned in mid-2013 to incorporate a much more intuitive, more modern and the ability for individuals to update their areas was made easier. Digital communications is explored in more detail in section

17 Screensavers Screensavers have been introduced to the Trust as a valuable method of communicating an instant message, for example, a ward closure or hand washing message. The Communications team manages the facilitation of the requests for screensaver messages. The communications team will develop a rolling programme corporate, seasonal and targeted messages which will can be changed on a weekly basis as appropriate. Communications Champions In order to help facilitate the process of two-way communication and further position us as an integrated Trust we will establish a network of communications champions in each Directorate to carry and reinforce messages and to ensure colleagues feel able to communicate ideas, issues and innovations both ways. In the future we will look to recruit new champions throughout the year to increase the amount of information and stories which we can share both internally and externally. Will also feature Communication Champions in Trust Connect and use as appropriate at events. Finally, there is no guarantee that electronic and paper communication will reach all colleagues; therefore it is imperative that face-to-face communication is used where possible. Senior managers and the Executive Team should continue to be as visible as possible. 11. A new world of communications Online communications and social media in particular, have revolutionised communications and information sharing world-wide. This revolution in digital technology provides a range of new and exciting opportunities for the Trust to engage with its stakeholders. It also allows us to be very responsive to breaking stories in the media whereby we can place key messages and news in the public arena in an immediate 24/7 fashion. The Communications Team currently uses social media to communicate good news stories about the Trust, raise awareness of events and fundraising activities and gauge valuable feedback about our services and the patient experience. We aim to continue development in this area and explore further opportunities to use social media to enhance the patient experience. Where appropriate and beneficial we will develop the Trust s presence on social networking sites (for example Facebook, Twitter, MySpace). Key priorities in the development of new media will include engaging with new and existing stakeholders using a variety of interactive tools such as blogging, hosting webinars; interactive surveys, and podcasts, providing key spokespeople with the Trust to engage with audiences using these more innovative methods. 17

18 Over the next 3 years we plan to increase our Twitter following by 75% by pushing messages with advanced targeting, using digital advertising to grow our follow base especially linked around specific campaigns, for example to drive nurse recruitment. We will also measure sentiment and trending. With Facebook and Twitter we will also to continue to drive awareness amongst all stakeholders by providing the link on materials and at events. Our colleague intranet and public website have both been recently redeveloped to maximise their potential as effective communication vehicles. Our website alone received over 200,000 hits during 2013 and it is therefore an important part our communication toolkit. We aim to refresh design and content regularly to ensure that we are providing the information that users need and providing the latest information and news that we want to present. The Communications Department also offers a basic design function which supports internal requests for material design such as posters, leaflets and any corporate materials i.e. screensavers and bulletins. 12. Measurement and review The Communications team uses an external press cuttings services and google alerts to monitor and measure press coverage. The department will issue a quarterly review of press coverage showing sentiment, advertising equivalent and brand message. The objectives described in this strategy will also be reviewed on an on-going and regular basis and will be formally reported to the Executive Team as required and to Trust the Board annually. There are a number of performance indicators that will help us assess the success of the communications we are undertaking: Positive reputation and brand recognition with patients, public and stakeholders via surveys and media evaluation Increase in referrals and shifts in our activity Public awareness of our work and our role locally and nationally Colleague satisfaction and engagement using Pulse Surveys and on-going Colleague Connect programme to measure Return on investment for our work we will align costs of communications with value for money and where appropriate look at how we can self-fund some areas of communications activities. It is proposed that the following methods will be applied to assess outcomes Patient feedback gathered through surveys and members network Media evaluation Annual audit of communications channels and annual review of strategy ( to ensure that it remains current and fit for purpose) Feedback through Communications Champion network Social media analysis 18

19 13. Conclusion The delivery of this Communications strategy will help ensure that Walsall Healthcare NHS Trust continues to be trusted by patients to deliver their care, has a good reputation to ensure public and commissioner confidence in services and delivery and provides patients with the best possible experience of care. The success of this strategy is dependent on everyone who works for the Trust, day-to-day communication and engagement with patients, carers and the public creates a lasting impression of the organisation and therefore needs to be fully embraced and supported by all colleagues. 19

20 Appendix One 20