Feasibility Study Report
Commissioned by Ewyas Harold Group Parish Council
presented by Clever Elephant
1. Background and purpose
3. Delivery and findings
3.1 Wider consultation with local providers
3.2 Pre planning assessment
3.3 Joint working between the Group Parish Council and Golden Valley GP Practice
3.4 Consulting with neighbouring Parish Councils
3.5 Working Group Options Discussion
3.6 Group Parish Council Workshop
3.7 Local Community Consultation
4. Other research
4.1 Identifying potential sources of funding
4.2 Identifying good practice
4.3 Identifying possible governance structures
Appendix 1. Organisations Consulted
1. Background and purpose
The Feasibility Study was commissioned in December 2015 by the Ewyas Harold Group Parish Council (EHGPC) following an Awards for All grant for this work to be undertaken. The EHGPC had purchased the former St. John Kemble Church having secured a loan from the Public Works Loan Board in January 2015.
The study was to ascertain if the proposed Health and Well Being Centre, referred to as the Kemble Centre, on the site of the former Roman Catholic Church was a feasible proposal. Local consultations had been carried out as part of the Parish Plan in 2012 the results of which supported the purchase of the redundant church in the centre of the village. Further consultation via a postal questionnaire in all households in the EHGPC area and an online survey with a 33% response rate, endorsed the need for a Health and Wellbeing Centre for the wider Golden Valley area. This included the Golden Valley GP Practice’s 6,000 patients and the surrounding parishes.
The aims and aspirations for services being delivered through the proposed Centre were to promote, support and facilitate independence, self help, early intervention and prevention within the community and reduce the need for hospital visits and stays. This would be achieved through greater integration and cooperation between the Golden Valley GP Practice and a range of other providers to meet the needs of the community and complement existing provision.
The outcome of the Feasibility Study was to determine the most viable option to enable the Kemble Centre to come to fruition. A realistic business case taking account of all the required components to be a success needed to be identified.
The political and economical context, locally and nationally, was an important element to understanding the opportunities and risks. Austerity measures and cut backs were being implemented alongside the recognised need to transform health and social care provision to support their viability and longer term sustainability.
Following the production and adoption of the Feasibility Study, the next stage is to produce a Business Development Plan (BDP). This will set out the plans for the next phase and the specific tasks needed to continue to develop and progress the proposed model. This would include further work with the interested stakeholders and the local community in the Golden Valley to identify the optimum structure and funding available for both capital and revenue costs to achieve a realistic outcome.
The Feasibility Study was in two stages, firstly to understand the information established through the earlier consultations taking account of the aspirations and concerns put forward. And secondly to carry our further consultation with a wider range of stakeholders, with the findings being evaluated to inform the options for the proposed Centre.
A small Working Group to oversee and contribute to the work had been set up over two years ago by the EHGPC. This group consisted of representatives from the EHGPC, the GP Practice, Herefordshire Council and the Delivering Differently in Neighbourhoods Project, a one year initiative delivered by Herefordshire Council. Their work to date had included community consultations, awareness raising events and successful funding applications and subsequent work on the Feasibility Study commission. Monthly meetings of the Working Group were held throughout the Feasibility Study period from December 2015 to June 2016 and regular reports were made to the Ewyas Harold Group Parish Council.
2.1 Documentation Review
The background work already undertaken on the proposed development was studied which included the 2012 Parish Plan, household surveys, a Sounding Board session held in June 2015 and the subsequent outline bid submitted to Herefordshire’s Clinical Commissioning Group (HCCG) for NHS Primary Care Transformation Fund (PCTF).
The work carried out to date clearly supported the need for locally delivered wellbeing services. The Golden Valley GP Practice had contributed their views on services that could be delivered through a Health and Wellbeing Centre and that combined with the information from the consultations had informed the outline proposal for the PCTF funding. The aspirations for the Centre also clearly aligned with Herefordshire Council’s support for community hubs across the County.
The aim of the proposed Centre is in line with the new NHS Planning Guidance – “Delivering the Forward View”, published in December 2015. The guidance covers 2016/17 to 2020/21 and sets out the Sustainability and Transformation Plan (STP). It states that the STP must cover better integration and local authority services including new care models, primary care access and infrastructure, technology roll-out and drive clinical priorities such as diabetes prevention, learning disability, cancer and mental health.
The guidance states that plans for new care models will need to have a clear and powerful vision with high quality care including prevention and cover self care and patient empowerment. This will be achieved through the improved reach and quality of local processes including involvement of the community and voluntary sector.
Local policies were studied which included Understanding Herefordshire 2015, the Joint Strategic Needs Assessment 2013 and Herefordshire’s five year Health and Wellbeing Strategy 2016. The vision and challenges set out in these documents support the need for the development of the proposed Centre. The rural sparsity and access to services combined with an above average ageing population are key challenges. The documents recognise that rural communities can be better served through the provision of increased community resilience and capacity with local co-ordination.
The Delivering Differently in Neighbourhoods and the Case Study on the Golden Valley provided very useful background and local data as it had scoped the local community initiatives in the same geographic area to identify rural solutions to health and social care.
The information gathered to date from both the earlier consultations and from the documents studied informed the design of the next stage of research and engagement.
2.2 Next research phase
The Working Group helped to identify the range of stakeholders to involve, both those involved earlier to continue the conversation and with others as yet not involved, but who could inform the potential way forward for the Centre.
In forming an engagement plan, it was agreed that information was required from the following areas to contribute to the Feasibility Study.
1. Wider consultation with local providers to gauge levels of interest, potential use and areas of concern
2. Engaging the Planning Authority to determine the possibilities for the site
3. Joint working between EHGPC and the GP practice
4. Consulting with neighbouring Parish Councils
5. Consultation with local residents
Research on other specific areas was also need to help inform developments.
1. Identifying potential sources of funding, both capital and revenue
2. Seeking examples of good practice from elsewhere
3. Scoping governance and management structures
Chapter 3 details the findings from the consultation and Chapter 4 details the research undertaken.
3. Delivery and findings
3.1 Wider consultation with local providers to gauge levels of interest, potential use and areas for concern
A total of 22 interviews were undertaken which covered the spread of sectors involved with the following:
local and neighbouring voluntary and community initiatives
local and neighbouring community facilities and other premises
existing and potential service providers in the statutory, voluntary and private sectors
people and organisations who had already expressed an interest or concern about the proposed Centre
The interviews explained the stage of development that the EHGPC had reached in determining the future of the Former Roman Catholic Church site and ascertained their views on the proposal. Views were sought on the following:
• perceived benefits, for individuals and other groups
• compatibility and complementarities with existing provision, especially existing community halls and local health and social care activity in the area
• any specific concerns regarding the location, potential use, how it might impact positively or negatively on other provision in the area
• how they might make use of such a facility themselves
• what resources they could contribute to the running of the centre
In collating the responses, everyone who contributed agreed with the potential benefit a new Health and Wellbeing Centre could provide. The opportunity to provide such a facility adjacent to the existing GP Surgery was welcomed, as it was generally recognised that the current Surgery is up to capacity and more space could provide a greater range of services.
In terms of compatibility, providers of both local community facilities and local services thought that the proposed health and wellbeing services would be an asset to the area.
Neighbouring villages with existing and proposed community facilities in Peterchurch and Garway were interested to know of the proposals and especially how provision could be compatible and of mutual benefit.
Several organisations could potentially foresee a need to use the Centre’s facilities. However both the public and voluntary sector organisations expressed their doubts about paying for this due to financial constraints.
In researching the local provision based from other local community facilities there is definitely a need for small rooms for hire as this is currently not available in the village.
Of the service providers interviewed, the question of whether the proposed Centre could provide a base from which to work in the Golden Valley was relevant to six organisations. The following expressed an interest:
• Herefordshire Carers Support
• Age UK Hereford and Localities
• Health Visitors
• Osteopath, private sector
The findings and learning from the Kington Centre, a similar community resource established over a year ago illustrated that although a good deal of interest had been shown by service providers, a fundamental issue is the budgetary constraints being faced. Having the means to pay for use of the Centre as well as the capacity to deliver services locally had proved to be a challenge and the take up had been slower than anticipated.
3.2 Engaging the Planning Authority to determine the possibilities for the site
A pre-planning assessment meeting was held in February at the former Roman Catholic Church site with a Senior Planning Officer from Herefordshire Council. The advice provided in principle is that support would be given to replace the existing building to provide a community facility for health and wellbeing with ancillary car parking. There would be specific considerations to take into account such as the size and quality of the building and the layout of the car park.
3.3 Joint working between the GP practice and the GPC
A sounding board session had taken place in June 2015 which included members of the Group Parish Council, GP Surgery, Kemble Centre Steering Group and Herefordshire Council’s Ward member. The discussion focused on the need for extending the GP Practice service offer supported with wider health and wellbeing services and activities supplied by other agencies, especially the voluntary and community sector.
A PCTF bid formed from the basis of the joint discussions and evidence of need from the GP Practice, had been submitted in 2015 which received positive feedback. The outline bid proposed a new Centre on the site of the former Roman Catholic Church that would provide additional space for the GP Practice and other providers. In February 2016 a further outline bid was required, which was developed with support from EHGPC, Herefordshire Council and Clever Elephant and submitted by the Golden Valley GP Practice.
The GPC and the GP Practice team met in March 2016 to discuss the opportunities and risks of going ahead with the PCTF funding opportunity. This was the first time the two organisations had come together to discuss specifically how the project could be developed and what the model could be, with the focus being on the level of resources, capabilities and commitment to pursue this. Many questions were identified, in particular accountability for the funds should they be awarded and how the project would be “owned” and “managed”.
A second meeting took place in April 2016 between GPC representatives and the GPs and Practice Manager as a follow up to the meeting in March. Information had by this stage been forthcoming from the One Herefordshire Board’s Transformation Plans that detailed potential for the Golden Valley to be involved under the “Community Collaboration” strand of work, that focused on a Locality approach integrating service provision in response to the needs of the local population. These plans would require collaboration of the three GP Practices operating in the Golden Valley locality to coordinate services. The PCTF funding, if secured, would provide an ideal opportunity for the capital investment to provide a hub for this collaborative approach.
The outcome of the second meeting was unanimous agreement of the three doctors to go ahead with the PCTF bid and to progress how this might fit with the local transformation plans of One Herefordshire. This approach was endorsed by the GPC.
3.4 Consulting with neighbouring Parish Councils
The EHGPC wrote to all neighbouring Parish Councils to request an invitation to a meeting to present the information on the proposed Centre and seek their views. A Communications Brief and short questionnaire was produced to support consistency of approach to the information given and sought.
The following Parish Councils were contacted with eight responding.
• Abbeydore & Bacton
The findings from the meetings attended by GPC representatives were collated, with the general consensus being support for the proposal whilst acknowledging the fact that the project is in its early stages of development. The Parish Councils that were specifically asked if they would consider making a financial contribution to the Centre in the future responded positively.
One concern raised was the proximity to other potential health and well being centres and possible displacement and duplication. The issue of public transport routes into Hereford was also raised as some villages are better served than others in this regard and therefore local people may select to continue with this option. These points would be taken into account as the project developed. It was agreed with all Parish Councils that the project was at very early stages of development and that communications would be ongoing.
3.5 Working Group Options discussion
The findings to date were compiled into three options that were discussed with the Working Group at their April meeting. The three options are:
1. A Locality Health and Wellbeing Centre that has the Golden Valley GP Practice central to the provision.
2. A Locality Health and Wellbeing Centre that is a community owned and run resource for a range of providers including the GP Practice.
3. A Locality Health and Wellbeing Resource with small scale affordable housing provision above.
Option 1 – A Locality Health and Wellbeing Centre
The Centre would be a 7 day venue for primary, community health services, hospital specialists, social care and the local community to come together to offer a better service to patients and the wider community and would work closely with neighbouring GP practices.
The Golden Valley GP Practice would be central to this option combined with other service providers and local voluntary and community activity. There is also the possibility of hiring space to private sector providers of health and wellbeing services, such as therapists.
The management and co-ordination of the day to day running is as yet unclear. It is too soon to determine how this would best work, there was a suggestion of involving volunteers.
Services it could offer are:
dementia and mental health nurses
health visitors and midwives
aortic aneurysm screening
local base for Public Health Healthy Lifestyles consultations
leg ulcer club
youth arts groups
carers support group
community sports and arts
The ownership, governance and management of this model are yet to be fully discussed due to the stage of development reached. The conversation has begun between the EHGPC and the Golden Valley GP Surgery on this matter and needs to be progressed further.
Option 2 – Locality Health and Wellbeing Centre that is a community owned and run resource
This option is put forward on the basis that the Centre will not be an extension of the Golden Valley GP Practice. It would be a Community Resource focused on local voluntary and community activity and involvement which hires out smaller spaces and rooms to private and voluntary sector providers of preventative social care/health and wellbeing services and activities. New community initiatives that may stem from this model could be
community transport, good neighbourhood schemes, befriending service etc. It would be a central hub to promote community activity and resilience.
It may also provide space for clinical and community health services as in Option 1 on an ad hoc basis as local GP Practices would have access to the facilities.
Services it could offer are:
• carers support group
• leg ulcer club
• youth art groups
• small exercise classes e.g. for older people
• falls prevention
• local community transport
• good neighbourhood scheme
• arts groups
• complementary therapies
• health visitors
The management for this option has yet to be considered. It is envisaged that co-ordination of the day to day running would be carried out by volunteers.
Option 3 – A Locality Health and Wellbeing Resource attached to a small scale affordable housing provision
The third option would be a possible small social housing development incorporating community facilities. It is envisaged that two small flats could be provided on the first floor of the building with community facilities on the ground floor. The rental income from the accommodation could contribute to the running costs of the community facilities. The possibility of working collaboratively with a Housing Association for the management of the accommodation and tenancies was put forward. An outline set of plans for this options were presented on a voluntary basis to the Working Group to aid the discussion. This option needs further development and consideration.
To support the Working Group’s consideration of all the options a list of fundamental requirements for a successful outcome was produced to assist with the assessment of opportunities and risks. These are as follows:
1. Vision, drive and commitment
2. Ownership and commitment of management group of people to:
i. develop and manage the capital project
ii. agree governance and management structures
ii. develop and establish ongoing co-ordination for the running of the Centre
3. Consensus and ownership of majority of local population
4. Engagement of architect and planning permission granted
5. Capital funding secured and sources of revenue funding identified
6. Business case for financial security to make sustainable e.g. social enterprise
7. Mixed economy of use and revenue to succeed and the capacity to co-ordinate and
8. Legal structure and capabilities and resources required
9. Ownership of land/building established and relationships and accounting clarified
10. Well organised and managed Centre, including the reception service
11. Monitoring and evaluation, data management and accounts systems to measure levels of use, sustainability, outputs and outcomes
12. Ongoing planning, business and financial and daily organisation/co-ordination
(Please note, this is not an exhaustive list).
Risks were assessed in particular on Option 1, as this was the preferred model to progress. This was presently being developed through the work on the PCTF bid for funding.
The Working Group agreed that Option 1 was the preferred model to develop. However,
given the current circumstances due to the early stage of development of this model, there were a number of actions identified to get a clearer understanding of how the many queries and risks identified by the Working Group could be addressed.
It was agreed that a Workshop should be held for all EHGPC Parish Councillors so that the Working Group could report back on the findings of the Study to date so that these could be discussed by the whole Council.
3.6 Ewyas Harold Group Parish Council Workshop
This purpose of the Workshop was for the EHGPC to be brought up to date with the Feasibility Study’s research findings and opportunities identified through the consultations with both local community and statutory sector providers and in the local and national policy context. This would then give the EHGPC the chance to discuss the possibilities arising from the Working Group’s Options discussion and to contribute their views.
It also provided the opportunity to plan and make arrangements for the Open Annual Meeting on 10th May when the EHGPC would present an update on “the story so far” and seek feedback and views from local people attending. The Workshop was attended by four Parish Councillors, the Parish Council Clerk and Herefordshire Council’s Ward Member.
The researcher reported on the recent meeting with the One Herefordshire’s Director of Communities which took place after the Working Group’s Options discussion.
One Herefordshire is a combination of the organisations who are responsible for health and social care in the County. The proposed transformation plans included an ambition for health and social care services to be delivered in Localities under the Collaborative Communities work strand. The aspirations for the Kemble Centre and the proposal for a Golden Valley Locality within One Herefordshire’s Transformation Plan share a very similar set of aims and ambitions. This meant that the proposals for the Kemble Centre could be developed with support from One Herefordshire in terms of creating a Localities Board and integrating all health and wellbeing provision including health services, social services, voluntary and community services and private sector services. It was clear from the initial conversation that developing this project within the local transformation framework could be a real advantage in helping to realise the ambitions for the Kemble Centre.
The GPC workshop discussed the information gathered from the Study to date, including the Working Group’s Options Discussion and the information just received about the opportunities presented through One Herefordshire’s transformation plans.
The GPC agreed that the opportunity to combine the developments with One Herefordshire plans and the potential to secure the PCTF capital funds needed further development. This would involve the three GP Practices in the Golden Valley, and discussions with the other two practices had yet to take place.
Questions were raised and early consideration given to the ownership and management of a new health and well being centre being funded through the PCTF fund and the implications for this. It was agreed that the pros and cons of all possibilities needed to be fully understood and that this piece of work needs to be carried out in the near future.
The Parish Councillors at the Workshop also discussed and agreed the content of the presentations to be made to the Open Public Meeting.
3.7 Consultation with local residents at the Open Annual Meeting of EHGPC
The GPC’s Annual Public Event was held on May 10th when everyone was invited to learn about the “Site of the Roman Catholic Church, the story so far”. The event was attended by eleven members of the public plus Parish Councillors and representatives from Herefordshire Council. Presentations were given by the GPC Chairman on the work of the Parish Council, followed by an overview of developments specific to the proposed Kemble Centre by the Parish Councillor who Chairs the Working Group . Herefordshire Council presented a summary of the Delivering Differently in Neighbourhoods project and Clever Elephant presented an overview of the Feasibility Study.
Questions were taken from the attendees, which asked for more information on the proposed development, the local consultation and what services may be provided, should the Centre go ahead. There appeared to be a general consensus that a local health and wellbeing centre could be an asset.
The Chairman on behalf of the GPC emphasised that communications would be ongoing as the project developed.
4. Other Research
To further inform the GPC’s considerations of the most feasible option, good practice from other Health and Wellbeing Centres elsewhere and potential sources of funding were explored.
4.1 Identifying potential sources of funding, both capital and revenue
Initial exploration of possible funding sources had been carried out with the following possibilities identified.
• Big Lottery Reaching Communities Building Fund – the programme is for projects that result in building stronger communities, working actively together to tackle their problems; healthier and more active people and communities. The size of the capital grants can be substantial.
• Garfield Weston – funds are available for specific activities, including capital projects, such as buildings and equipment and also organisational core costs . Grants are awarded from £1,000 to over £100,000.
• Potential for sponsorships and local fundraising
These possible funding sources would be in addition to the PCTF fund if it goes ahead, for Option 1. For Option 2, the above possibilities would be the major focus plus any others that could be identified nearer the time. Option 3 for housing development would have to be supported and funded differently, with the possibility of working with a local Housing Association.
4.2 Seeking examples of good practice from elsewhere
The Assistant Director, Policy of the King’s Fund assisted with identifying other models elsewhere that could provide useful learning. These are as follows:
1. Kernow Clinical Commissioning Group, Cornwall
This model involves a number of Localities working across Cornwall where the GP Practices are working in consortia together and with other providers. The aim is to help everyone to make better use of the skills and resources from health, social care and voluntary sector organisations in Cornwall and the Isles of Scilly as well as from people and their communities.
2. Bromley by Bow Centre, London
The Bromley by Bow Centre is on a much bigger scale than that envisaged for the Kemble Centre but does illustrate the engagement of GPs and the possibilities. The Health Centre section of the Centre provides GP services plus others such as psychologist, health visitors, baby clinic, antenatal clinic, family planning, blood clinics, new patient health checks and nurse clinics
3. The For All Living Healthily Company, Weston Super Mare
The For All Living Healthily Company in Weston-super-Mare provides health and well being services through a locality health centre, plus other support services. The Locality Health Centre is run as part of its social enterprise and provides the General Practice medical services for the area including doctor’s surgeries and nurse-led clinics. Services include: support and treatment for diabetes, heart and respiratory disease, vaccination clinics, antenatal clinics, health visitors, support to stop Smoking and sexual health advice for young people.
4.3 Scoping governance and management structures
Initial scoping was undertaken into the types of legal entities for the proposed Centre. However it was too early in the development for this to be usefully discussed at this stage.
The types of legal entity commonly identified and that need to be considered are as follows:
• Charitable Company – the charity is both a company and a charity, meaning it has a legal identity, so it can enter into contracts and borrow money, and trustees have limited liability if the charity is sued or incurs debts. Trustees act as directors of the company.
• Community Benefit Society (BenCom) – a type of Industrial and Provident Society. BenComs are membership organisations. They conduct business for the benefit of the community and are run and managed by their members. They are required to submit annual returns to the Financial Services Authority. They can become charities, but only if they pursue exclusively charitable objectives (as defined by law).
• Social Enterprise – primarily organisations that trade in the market place but with a benefit to the community. A Community Interest Company (CIC) is a particular form of social enterprise which is registered as a company and governed by a governing document (Mem and Arts). Their assets must be “locked” i.e. used exclusively to meet the objectives of the CIC. CICs are not eligible to be registered as charities because they are capable of providing non-charitable benefits.
• Limited Liability Partnership (LLP) – the partners are the members of the LLP. However LLPs exist exclusively “for business purposes” and are not eligible to be registered as charities. LLPs may sometimes be formed by charities in order to generate trading income.
• Charitable Incorporated Organisation (CIO) – a category of not for profit organisation introduced to simplify the requirements experienced by organisations that are both charities and companies. CIOs register with the Charity Commission alone and are required to submit annual returns to the Commission, but not to Companies House. There are two governance models: membership-based (Associate) or trustee-based (Foundation).
Further work on this is needed in the next phase of development.
Based on the research findings carried out to inform the Feasibility Study and the opportunities presented by the transformation of local health and social services, the preferred model is Option 1.
This would provide the most sustainable and viable way forward due to the strengths identified. The Kemble Centre to be successful would need to have a multi sector, mixed economy approach but also needs at least one key ‘anchor tenant’ to provide stability. This model focuses on the expansion of health and social care services provided by the local GP Surgery, which would provide this stability for the longer term. Complementary therapies should also be considered as part of the range of services and they could also provide an additional income stream.
Local voluntary and community activities could be spawned from the Centre as the research into other local initiatives demonstrate strong community involvement focused around a physical base. The research findings from the Delivering Differently in Neighbourhoods Project identifies the value of social capital and community hubs as key ingredients in supporting residents’ health and well-being.
There are a number of outstanding issues to address to make progress towards realising this model, notwithstanding the need to secure access to NHS England’s PCTF funding. The project was selected and submitted to NHS England by the Herefordshire Clinical Commissioning Group in early July. Further information was awaited on the application process at the time of writing.
The potential for creating a Golden Valley Locality in line with One Herefordshire’s Transformation Plans could fit ideally with this model. This approach would provide the opportunity not only to integrate services provided, but also to co-ordinate the use of the physical infrastructure through the many community and other facilities across the Locality as part of the service offer to the wider local population. This would address the concerns raised in neighbouring parishes about possible displacement of services provided in their parishes.
This of course depends on all stakeholders coming together to share this vision, including the neighbouring GP Surgeries at Kingstone and Much Birch.
There are two stages to making the project a reality:
1. Project development to realise the physical structure
2. Project development to determine the governance and management arrangements
The first focused on the process of securing capital funding and planning permission and the second on the partnership agreement that would need to be drawn up between the EHGPC and Golden Valley GP Surgery.
The project is understandably still at the early design stage whilst still seeking to secure the capital and revenue funding streams. This will become clearer when the outcome of the PCTF bid is made known.
There are many other areas yet to be determined. For example, it is too early in the process to ascertain any specific partnership model for the ownership, governance and management of the Kemble Centre. This will be developed during the coming months.
Therefore the business case for the proposed Locality Health and Wellbeing Centre is still being formed. However, the determination and enthusiasm of members of the EHGPC and the Working Group to continue to work on this model supports the likelihood of success.
The researchers and EHGPC are very grateful for all the contributions which informed the outcome of the Feasibility Study.
Organisations Consulted on the Feasibility Study
Ewyas Harold Group Parish Council and Clever Elephant would like to thank the following organisations for their time and contributions to inform the Feasibility Study.
• Abbeydore & Bacton Parish Council
• Age UK Hereford and Localities
• C.A.R.E. Herefordshire
• Crucorney Parish Council
• Dorstone Front Room
• Ewyas Harold Memorial Hall
• Garway Community Centre
• Garway Parish Council
• Herefordshire Carers Support
• Herefordshire Council, officers and ward member
• Herefordshire Clinical Commissioning Group
• Kentchurch Parish Council
• Local osteopath
• Longtown Parish Council
• One Herefordshire
• Orcop Parish Council
• Peterchurch Parish Council
• St. Michael’s Church Hall
• St. Peter’s Centre
• The King’s Fund
• Vowchurch Parish Council
• Wye Valley Trust Health Visitors
• Wye Valley Trust Neighbourhood Team West Locality