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Change Management

Definitions

Term
Definition
HorizonChanges which are on the Horizon will be represented in a separate section of the Roadmap and are included for information purposes. A Horizon item is a potential change which NHS Digital are aware of, but it has either not been formally submitted into the change process and/or is only an idea or high level concept with little or no specification in place. It indicates items which are further into the future and for which it is yet to be determined whether it will progress and if so which of the change routes it will progress through.
Managed Capacity

The main route for progressing new and uplifted Standards which apply to all relevant Suppliers and which are likely to have a Published specification. Where these have an Effective Date, all relevant Suppliers will be obliged to have achieved compliance with these items by the given date as per the terms of the Catalogue Agreement. Changes in this route will fall into one of four categories:

  • SRO priorities
  • Legislative and Regulatory change
  • Minor and Patch uplifts
  • Other

These items will only be commissioned via the Roadmap and Suppliers are expected to incorporate any development cost within their List Price. Some items in Managed Capacity may be associated with incentive payments for delivery of the change within a certain time boundary.

Opportunity Item

Opportunities for Suppliers to engage with NHS Digital and the change requestor to collaborate on the definition of specifications and to deliver certain changes early ahead of publication to the wider market where applicable. These will be commissioned via the most appropriate Framework or Procurement vehicle in current operation. Changes in this route will fall into one of two categories:

  • Alpha/Definition/FoT - opportunities for Suppliers to co-produce specifications before they are Published to all other relevant Suppliers through Managed Capacity and given an Effective Date if applicable.
  • Other opportunities - opportunities for development of new Capabilities or standalone features which do not have to be delivered by Foundation Solution Suppliers and which may allow a Supplier to bring a new product to market and/or for existing products to be pulled in from specialist Suppliers rather than forcing additional development on a limited number of Suppliers.
Feasibility AssessmentOpportunities for Suppliers to collaborate with NHS Digital and/or the change requestor to provide information and analysis to assess the feasibility of a new change request before it progresses through another route. These may be either optional or mandatory for Suppliers depending on the nature of the assessment required.
Urgent Change

Change requests which impact Standards and Capabilities which need to be progressed quickly outside of the usual change management principles. These will account for only a highly restricted volume of change meeting one of two criteria:

  • National information or cyber security incidents as classified by the appropriate body
  • Inappropriate, incorrect or missing drug or patient safety guidelines/alerts and other clinical safety issues and incidents as determined by an appropriate body
Draft

This is the status associated with specifications for a new or uplifted Capability or Standard which are still going through definition and elaboration with stakeholders.

    • Draft specifications will be released to Suppliers for review via the Confluence Roadmap page and iterated as often as possible
    • There will be opportunities for Suppliers to engage and feedback on Draft specifications
    • Suppliers can begin development when a specification is at Draft status, although they do so at their own risk

At Draft status there will be a Supplier facing Roadmap page on which detail of the specification is released as it becomes available.

Published

This is the status associated with specifications for a new or uplifted Capability or Standard which are fully defined, agreed and signed off and are not expected to change. Where there is a need for minor or patch uplift, this will be handled as described in the Versioning section. Suppliers would be expected to be working towards achieving compliance with a specification when it is given this status. There may be some Standards and Capabilities which do not progress beyond this status in which case they would be advisory or reflect some other scenario where it remains optional at that point.

A checklist will be in place to ensure that before this status is awarded, the specification is adequately defined and ready for implementation with all necessary assurance, implementation and guidance documentation in place to enable a Supplier to complete development at minimal risk.

At this point a full version of the Confluence page will be released. In the case of uplifts to existing Standards and Capabilities, this will be a complete, refreshed version of the page e.g. if there is an uplift to Data Standards, the changes will be on or linked to from the relevant Roadmap page and are likely to only show the specific requirements which are changing until it is Published, when a full updated version of the Data Standards page with a revised version number will be made available and will sit alongside the Effective version.

Effective

This is the status associated with Standards with which all relevant Suppliers are required to have achieved compliance.

It is the status associated with Capabilities which have been included within the scope of a Framework request and hence which Suppliers are able to onboard Solutions against and sell via a Framework.

When the Effective Date is reached, the old Effective page will be replaced by the new one with an uplifted version number. The old one will be given a status of Retired and moved to an alternate location on Confluence.

All relevant SuppliersSuppliers have the choice as to which Capabilities they choose to offer through the Catalogue and as such there are different Standards with which they will need to be compliant. Therefore if a change to a Standard is not applicable to the products and Capabilities the Supplier is offering, then that change is not relevant to them. The Roadmap will indicate the Capabilities and Standards which will be impacted by a particular item on the Roadmap.
Achieved complianceThis means that a Supplier has been awarded a DevMAC for the Roadmap item.
Effective Date

The date on which the Standard or Capability becomes Effective. It is the date by which all relevant Suppliers will need to have achieved compliance with the change item.

Effective Dates only apply to changes in the Managed Capacity and Urgent Change routes. Some items in the Managed Capacity route may not have an Effective Date, but may be associated with incentive payments for delivery over a certain time period. Those items which do have an Effective Date are mandated for delivery by all relevant Suppliers.

Backstop DateThis term means the same as Effective Date and should not be used.
Retired

This is the status associated with old versions of a Capability or Standard which have been uplifted or replaced. These pages may be superseded by a new Published or Effective specification.

These pages will remain available for reference in an alternate location on Confluence.

DeprecatedThis is the status associated with Capabilities or Standards which are not yet Retired because products are in live service and still need to be supported. Those Suppliers with pre-existing compliance must maintain this, those with no compliance are not obligated to comply with these Standards.
ClosedThis is the status associated with a change request which will not be progressing. It is recognised that some change requests are submitted into the process and then are not taken forward at some point for a variety of reasons, therefore this status will be used to indicate to Suppliers that a change which had previously appeared on the Roadmap is now no longer required and they should not continue work on it. Changes at this status will remain on the Roadmap for a period of time to ensure awareness.
MandatedThis term describes a Standard within the Managed Capacity route which Suppliers must deliver and which has been given an Effective Date by which all relevant Suppliers must have achieved compliance. Use of this term should be avoided where possible, instead referring to the Effective Date.
Incentive itemThe term Incentive Item or other terms regarding incentive payments and incentivisation refer to additional funding which may be associated with particular items on the Roadmap. These may be available and applied at the discretion of the Framework and Catalogue Authority and could be applied based on Suppliers maintaining compliance with Effective Dates, for delivery of a change ahead of an Effective Date, or for delivery of items which do not have an Effective Date over a certain bounded time period. 
Versioning

This is defined in the Versioning section

Roadmap

The Digital Care Services Roadmap, known simply as 'the Roadmap', serves two primary purposes:

    • An overarching, summary view of ALL change requests relating to new and uplifted Standards and Capabilities regardless of which change route they will progress through. This will be published for all interested stakeholders to view. NB. All Roadmap items will also be represented via the pages on Confluence with the ability to sort and order to view those relevant to particular Capabilities.
    • The only method for commissioning mandated change progressing through the Managed Capacity route and therefore showing the Standards with which Suppliers are obliged to maintain compliance under the terms of the Catalogue Agreement
Priority StandardThis term is used to identify those changes to Standards and Capabilities which have been identified by the NHS England SROs group as the most important and top priority items for the forthcoming period. The Priority Standards may progress through any of the defined change routes, but once in the Managed Capacity route will have an Effective Date. Wherever possible, these items and the associated Effective Dates will be issued for Supplier feedback and agreed in advance of a Framework opportunity such that Suppliers are aware of their obligations and can price accordingly.
FeatureA change which does not impact a Standard or Capability.


Lifecycle of Standards and Capabilities

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The Full Assessment process is triggered either by a change passing the Entry Assessment or following completion of an Opportunity Item where a change now needs to be published for all relevant Suppliers to implement.  The Full Assessment process determines the route by which the change will be progressed and considers the details and parameters of that change such that it is clear to Suppliers what will need to be delivered and when. Some of the elements of this Full Assessment process have sub-processes and more detailed checklists etc. which are detailed below where applicable. In the case where a change is moving from an Opportunity Item or Feasibility Assessment into the Full Assessment process, then a new change form is not required and a discussion will be held between the Digital Care Services Change team and the change requestor to validate the original details given on the form and amend as necessary ahead of completing the Full Assessment.

The Full Assessment process will include analysis of the elements listed below in order to determine the most appropriate change route for this request and the parameters associated with it. This will be completed by the Digital Care Services Change team, engaging the support of the relevant subject matter experts and Suppliers on each of the elements of this as required to ensure a consistent and fully considered assessment. This will include consultation with representatives from Business Analysis, Technical Architecture, Solutions Assurance, Service Management, Information Governance, Finance, Commercial, Buying Catalogue, Clinicians and other system users and other specialist teams as required, as well as Suppliers. Supplier engagement in this process will be managed via the RFI process, the Feasibility Assessment route or another suitable procurement vehicle or commissioning route which is available at the time. Depending on the nature of the change in question and the Capabilities and standards which are impacted, this engagement may either be mandatory or optional for Suppliers.

  • Align to Capabilities and Standards Model
  • Alignments and Dependencies (with other work)
  • Consider Dates and Timescales
  • Consider Incentives and Funding
  • Sizing and Complexity
  • Urgent Change assessment
  • Prioritisation
  • Materiality
  • Confirm Effective Date and incentives (if applicable)

Further information regarding the details of each of these aspects of the assessment is included below. At any point of this assessment process, it may be necessary to escalate either by convening a meeting between relevant stakeholders or by sending to a board or other governance group to make a final decision on certain elements of the change assessment. This will be particularly important for prioritisation where the NHS England SRO group will determine the key strategic priorities for the subsequent period.  Once all the details are agreed, the Roadmap entry can be updated and the change will progress into one of the defined change routes.

The following table sets out some general guidelines for assessing the most suitable change route, however this is not exhaustive and change requests will need to be considered case by case:

Guideline / CriterionIf 'yes', which change route
Meets Urgent Change assessment criteriaUrgent Change
New Capability or standalone feature which does not need to be developed by a Foundation Solution SupplierOther Opportunity
Programme not ready to progress, further information and Supplier feedback required and/or need to understand the extent to which something is possibleRFI / Feasibility Assessment
Regulatory or legislative changeManaged Capacity
National or international Standard with clear Effective DateManaged Capacity
Work item such as a new interface or messaging spec which requires pilot testing or collaboration on development of the specificationAlpha / FoT Opportunity
Change request which has already progressed through Opportunity Items route in some casesManaged Capacity


The Roadmap will be published as a living document for all relevant stakeholders, but is especially important for Suppliers and Buyers. Ahead of each new iteration of the Framework, the content of the Roadmap will be consulted on with the NHS England CCIO and SRO group to determine the key strategic priorities for the next period and the associated Effective Dates. This will also be discussed with Suppliers to assess the achievability of the changes to become Effective during the lifecycle of the Framework. This may result in the need for some reassessment and the adjustment of items on the Roadmap, however Suppliers would be able to account for this in their costing and pricing analysis for the subsequent Framework. Should there be any impact on items within the current live Framework or items which a Supplier has already begun working on, then this would be discussed with the Supplier as required. Appropriate governance forums will be in place to ensure Suppliers are fully informed about amendments to the Roadmap and have the opportunity to provide feedback and challenge regarding this and any other aspect of the change process. It should also be noted that the Catalogue Agreement does not restrict the ad hoc resetting of List Price if required subject to the conditions set out in the Commercial Standard and Framework Agreement.


Align to Standards and Capabilities Model

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The change request will need to be aligned to the Capabilities and Standards Model to determine whether it is:

  • a new Standard or Capability
  • a change/uplift to an existing Standard or Capability
  • a replacement of an existing Standard or Capability

This assessment will also consider which of the Capabilities and Standards are impacted by the change request. This is crucial information for Suppliers as it will determine which Roadmap items they need to be most aware of based on the Capabilities which their Solution supports. This information will be set out on the Roadmap and applicable Confluence pages. An additional element of this to be considered alongside the sizing/complexity assessment is the iteration of the version number and whether the change request constitutes a major, minor or patch uplift to the impacted Standards and Capabilities. The definitions and approach to versioning and patch, minor and major changes are set out in the section below.

Alignments and Dependencies

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The change request will need to be assessed against other known work items to consider any alignments and dependencies with other work which is on the Roadmap or is progressing through the change process. Dependencies may impact the change route and timescales for delivery and commissioning of the change. Alignments may mean that the change is not required or can be merged with other work to prevent duplication of effort. These details will be provided, where known, by the change requestor in the change request form and will then be validated by the Digital Care Services Change team and a subject matter expert review group. Where applicable, any necessary details will be highlighted via the Roadmap. It may also be necessary to consult with Suppliers via the RFI mechanism on this aspect of the assessment process.

Set Dates and Timescales

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Any key timescales, deadlines and required Effective Dates associated with the change request will be considered along with the reasons for these. The validity of an Effective Date will need to be verified and a objective rationale for the date will need to be provided e.g. legislative or regulatory changes, hard dependencies. This information will be made available to Suppliers where possible.

All mandatory changes in the Managed Capacity route will have an Effective Date. However there will also be items in this route which are Published but do not have an Effective Date. Incentives for delivery of the change may be offered for items with or without an Effective Date. This aspect of the Full Assessment process will be an initial consideration of these dates which will then be confirmed following the completion of the assessment process. For items which are likely to progress via Opportunity Items, then this will consider the timescales and parameters for the commissioning and competition process and there would then be a reassessment and setting of a final Effective Date for all relevant Suppliers should the change then move into Managed Capacity. Timescales and delivery dates for Urgent Changes are likely to be considered and discussed outside this assessment process on a case by case basis.

An additional part of this may also include the consideration of incentives and if and when they may be applied to the change.

Suppliers will have the opportunity to provide feedback on the achievability of Effective Dates assigned to items in the Managed Capacity route ahead of the Framework in which they are due to become Effective and will be consulted via the appropriate mechanisms in any case.

Determine Incentives and Funding

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Opportunity Items and Urgent Changes are likely to have additional and separate funding beyond the List Price set by Suppliers. The amount and source of this funding will need to be agreed as part of determining the parameters of the Opportunity Item or commissioning an Urgent Change.

Any resource and capacity required by Suppliers for development of Managed Capacity items will need to be covered under the List Price agreed at the start of a Framework, although it should be noted that the Catalogue Agreement does not restrict the ad hoc resetting of the List Price subject to the conditions set out in the Commercial Standard and the Framework Agreement if required. Managed Capacity items will only be commissioned via the Roadmap and may not be funded in any other way, particularly in the case of regulatory or legislative change. However, there will be some items in the Managed Capacity route where incentives are available to Suppliers to encourage delivery of the change within a bounded time period. Incentivisation may be offered whether the change has an Effective Date or not. As per the Change Management and Roadmap Content ancillary document, a list of Standards for potential incentivisation will be maintained by the Catalogue Authority.

Some draft guidelines for when an incentive may be attached to a particular change item have been compiled as follows:.

No incentives are likely to be offered if:

  • Suppliers have already been funded for the change by an alternate mechanism (with the possible exception of Opportunity Items dependent on the arrangements for the Opportunity Item)
  • There is insufficient time between the start of a Framework and the Effective Date of the change item and/or in the case of the first Framework, the Effective Date is before the Framework must go live (e.g. January 2020) 
  • The change has been mandated via other mechanisms e.g. ISN or legislation/regulation

Incentives may be offered if:

  • It is an important change with high perceived Supplier difficulty
  • The Effective Date is well into the future, but significant benefit to the Authority is identified
  • The item falls into the Managed Capacity - Other category and there is no set Effective Date, but there is significant benefit to the change and the Authority would like to encourage Suppliers to deliver the change during a certain bounded time period

Sizing and Complexity

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Digital Care Services are looking to avoid commissioning single large change items, instead aiming to chunk up work into smaller deliverables to offer greater flexibility to Suppliers in how they deliver work and to ensure that all available capacity is not taken up by a single item. Therefore an assessment of the size and complexity of the change will be required. It is recognised that Suppliers have different systems and architectures and therefore what is a small change for one Supplier, may be a big change for another. Therefore it will be necessary to seek Supplier input on this aspect of the assessment process.

Suppliers will be engaged using the RFI and Feasibility Assessment routes and/or any other appropriate commercial mechanism as required to gain input on this aspect of the assessment process.

Urgent Change Assessment

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The change request will be assessed against the criteria set out in the Change Management and Roadmap Content ancillary document to determine whether it may be classed as an Urgent Change and hence progressed via that route.

Prioritisation

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The high priority strategic changes for the next period and in particular the next Framework will be identified by the NHS England CCIO with the support of the NHS England Senior Responsible Owners (SRO) group. This will set the most important changes for the subsequent time period and indicate the desired Effective Date by which Suppliers will need to have achieved compliance. The SRO priorities form one of the categories of work items within the Managed Capacity change route and this information will be shown via the Roadmap. Change requests progressing through the Opportunity Items route may also be identified as SRO priorities and this will indicate that these items are likely to be progressed as a priority. 

The change items which have been identified as key strategic priorities by the SRO group will and published via the Roadmap in advance of a Framework opportunity being issued to allow for Suppliers to analyse the ask, assess the feasibility and set a suitable List Price to account for the development work required. Where Suppliers wish to challenge these items and the Effective Dates given against them, then this will be taken on board and fed back to the SRO group where the reasoning is justifiable and material.

Materiality

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As described in the Principles section, changes impacting Standards will be handled differently to those impacting Capabilities due to the way in which they are linked to the Catalogue Agreement and Frameworks. As such and given that Standards and Capabilities are linked, it is necessary to assess whether a change to a Standard has a significant impact on the scope of one or more Capabilities. This is known as the Materiality assessment. To summarise:

  • Standards are linked directly to the Catalogue Agreement and Suppliers must maintain compliance with Standards as per the terms of that agreement. As such, Standards can be introduced independently of the Frameworks.
  • Capabilities are linked directly to the Frameworks, therefore any change which introduces a new Capability or alters the scope of an existing Capability in a significant manner can only be introduced along with a new Framework opportunity, although may be published at any point.

The majority of Standards are linked to Capabilities (and vice versa), therefore a key part of the change assessment process is to establish which Standards and Capabilities the change will impact (as set out above) and hence if there is a material impact on the scope of one or more Capabilities. The main principles of the Materiality assessment are as follows:

  • Each change will be treated independently with respect to the Materiality assessment process i.e. if there have been previous changes impacting the same Capability within the life-cycle of the Framework, this is of no consequence
  • If changes are merged for some reason then this should be reassessed as a whole as a new work item

The Materiality assessment is only applicable to items in the Managed Capacity change route. It is anticipated that only a limited number of changes would be considered as material and the Opportunity Items route could be used as an alternative for delivery in some cases to progress the delivery of a Capability prior to a new Framework. This is a subjective assessment in which stakeholders will be involved as required, but the following diagram sets out some guidelines and key aspects which should be considered as part of this:  



The table below summarises the content of the process set out above.

TestMateriality Assessment likely outcome
New Capability or FeatureMaterial (or to Opportunity Item route)
Only impacts Overarching Standard or Interoperability StandardNot Material
Fully covered by existing Epics and Acceptance CriteriaNot Material
One or more Epics or Acceptance Criteria to be REMOVEDNot Material
One or more Epics or Acceptance Criteria to be ADDEDMaterial
Change to Epics or Acceptance Criteria which required changes to Epic(s) and/or DOES impact what a Supplier has to doMaterial
Change to Epics or Acceptance Criteria which only impact Acceptance Criteria and/or DOES NOT impact what a Supplier has to doNot Material


The consequences of these outcomes are as follows:

  • If the change DOES NOT have a material impact on the scope of a Capability, then it can be introduced at any point irrespective of Framework life-cycles with fair warning, likely via the Managed Capacity route as per the terms of the Change Management and Roadmap Content ancillary document
  • If the change DOES have a material impact on the scope of a Capability, then it can only become Effective when a subsequent Framework opportunity is made available for Suppliers. However it may be that the change could follow the Opportunity Items route ahead of this and there is no restriction on developing and issuing a Published specification such that Suppliers can begin working towards it in advance of supporting it via the next Framework if they wish to do so. 


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The Roadmap will include a summary of information to ensure Suppliers are fully aware of the changes that are required and the opportunities which are available to them. Some of the data items are common to all change routes, and other data items are specific to a particular change route. The table below sets out the information to be included. Horizon items are not included in this table as they will not have been assigned to a change route and there is likely to be limited information available about the change. Dependent on the final form presentation of the Roadmap, certain information, such as the change route, may not be given in distinct fields and may instead be represented in an alternate format, such as in labelled swim lanes or with colour coding or sections.


Field nameField content
TitleA unique name for the change
DescriptionA very brief summary of the change
Date addedThe date the item was added to the Roadmap 
Type

All Roadmap entries will be set to a type of 'Roadmap'

NB. Once the change specification is Published, the equivalent field on the page for the Published specification will be updated to one of the other options (i.e. Overarching, Interoperability, Capability Specific, Context Specific) to reflect the type of entity the change relates to e.g. if it is a change to the Prescribing Standard, this entry would then become 'Capability Specific Standard' 

Standards/CapabilitiesList of the existing Standards and/or Capabilities which are impacted by the change
Change Route

Which of the designated change routes the item is going through or Horizon if not yet determined. Options for:

  • Managed Capacity - SRO priority
  • Managed Capacity - Legislation/Regulation
  • Managed Capacity - Minor/Patch uplifts
  • Managed Capacity - Other
  • Opportunity Item - Alpha/FoT
  • Opportunity Item - Other opportunity
  • Feasibility Assessment
  • Urgent Change
  • Horizon

NB. This is likely to be represented in a different format on the Roadmap view rather than in a separate field

Change Type

An indication as to the type of change this is:

  • New (brand new standard/capability not specified before e.g. GP Data, DCH)
  • Uplift (uplift to an existing spec e.g. eMED3)
  • Replace (replacement of an existing Standard e.g. PCRM, NHS ID)
Status

The status of the change item, which also includes the status of the specification within that. Options to be:

  • Confirmed (change items which have completed the assessment process and have been assigned to a change route, indicating that they will be progressed)
  • Open competition (used only for Opportunity items where the open competition process is in progress)
  • Draft (definition of the change specification is ongoing and Suppliers are being engaged in some way)
  • Published (specification for the change is finalised and available for Suppliers. May be assigned an Effective Date at this point, but some changes may not progress beyond this)
  • Effective (move to this status when the Effective Date is reached, it indicates that this is now a live specification with which Suppliers will be compliant)
  • Closed (indicates items which are now not going to be progressed for some reason)

NB. This field will be marked as 'n/a' for Horizon items. There will only be one Status entry for each Roadmap item

Effective Date

The Effective Date of the change

NB. This will not be set for some items in Managed Capacity and does not apply to Opportunity Items or Horizon

Incentives / FundingAn indication of whether additional incentives or funding will be available for this change 
Incentive DatesThe dates during which the incentive applies
ID

A unique ID for the Roadmap entry in the format "RMXX"

NB. Once the change specification is Published, the equivalent field on the page for the Published specification will be updated to reflect the type of entity that this is  e.g. if it is a change to the Prescribing Standard, this entry would become 'S14' ; if this is a new or replace item, then a new ID in the same format will be created.

Version

The version number of the Roadmap entry in the format a.b.c to indicate when changes have been made to the Roadmap entry, such as a new draft specification being issued or an amendment to one of the parameters associated with the change.

NB. Once the change specification is Published, the equivalent field on the page for the Published specification will be updated in alignment with the version number of the Standard or Capability which is being uplifted or be set to 1.0.0 if this is a new or replace item. 


In addition to the Roadmap, each Capability and Standard on Confluence contains a Roadmap section linking to a page which details any Roadmap items related to that Capability or Standard and the details of that change.  There is also a central Roadmap page on Confluence where a full list of Roadmap items will be available with a summary of information similar to the above.

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