Category: Hard to Reach

People who may have significant barriers to accessing services, reluctance to use them.

photo by Bhavishya Goel

POWS changing lives: Suad and Fatima’s story

Suad has been working as a Pregnancy Outreach Worker for over six years. Because of her language skills, she works mainly with people who are new arrivals to the country.

Suad (pictured) says, “the POWs’ strength comes from being able to work one-to-one with mum. Many of the women I work with come from a background where women don’t have many rights, so in a lot of cases it’s my job to educate and empower them. I help them understand that they have rights, and that they have a voice.”

Fatima’s story

One of the women Suad worked with is Fatima*.

Originally from Yemen, Fatima had grown up in a small farming village where the culture dictated that girls weren’t allowed to go to school. So she had never learned to read or write and, even though she spoke Arabic, she often found it difficult to make herself understood.

At around the age of 20, Fatima moved to the UK with her husband to live with him, his mother and his two sisters, and over the next six years, she had three children.

During her fourth pregnancy, Fatima’s midwife referred her to POWS and she was assigned to Suad.

“It was difficult to communicate at first,” says Suad, “but I worked out pretty quickly that Fatima had been systematically abused and isolated by her husband and his family. When she was with them, she had been beaten every day. She’d only just managed to leave them, after six years of abuse.”

Fatima’s husband’s family had made sure that she only ever left the house either alone without her children, or with a family member. But one day she found herself outside, alone and with two of her children. So instead of going to the shops, she went to her neighbour’s house for help.

The neighbour, a friend of Fatima’s own family, who understood the situation (and had in fact contacted police in the past, although Fatima had declined their help) immediately put her in a taxi to Fatima’s uncle’s house, and told the husband’s family she didn’t know where she’d gone.

Now, with no belongings and no benefits, living in her uncle’s house with a baby on the way, Fatima needed urgent help. She had a supportive midwife, but she hadn’t been able to fill in any forms or pass any security tests, because she couldn’t speak English, and couldn’t read or write, even in Arabic. She didn’t know how to access any services or even what kind of help she was entitled to.

Over the three months that Suad supported Fatima, she helped her to apply for the benefits she was entitled to, as well as finding baby clothes and equipment for her, putting her in touch with a family solicitor, and getting her onto the housing waiting list.

When Suad finished supporting Fatima, she was still living with her uncle and two of her children, but her story is far from over. Her remaining son is still living with her husband’s family and, sadly, doesn’t have contact with his mum.

Thanks to the midwife who referred Fatima to Suad, and the support services that Suad has been able to help Fatima to access, including a family solicitor, Fatima is continuing to build a new life and working towards bringing her own family back together.

*Fatima’s name has been changed

Grant will help over 100 people improve their wellbeing

Thanks to a Discovery Grant from the Santander Foundation, we will be able to develop and deliver a new course this year – one that will help over 100 people in Birmingham to improve their mental health.

The course is designed around the “Five Ways to Wellbeing“, an evidence-based government strategy that sets out five simple actions a person can take to improve their wellbeing. The grant will allow us not only to develop the content for a five-session course, but to trial its delivery in eight venues around the city.

Mental wellbeing is a vital part of living well. This course is one that we have wanted to pilot for a while, so we’re really pleased to have been chosen to receive a grant that will help us to do this. The grant will help not only with research and development costs, but with practical costs too: things like training materials, room hire and the cost of a facilitator in each venue.

We’re already talking to a number of other local organisations about delivering the course to a range of people. As well as our community sector partners, we’re also speaking to employers because we feel this course could be really valuable in terms of encouraging healthier workforces. One place we’re looking to work is within the NHS; we think this could be a good way for the NHS to support the commitment made in its Five Year Forward View ‘to ensure the NHS as an employer sets a national example in the support it offers its own staff to stay healthy’.

The Gateway Five Ways to Wellbeing course

The course we’re developing will encourage participants to take part in activities based on the Five Ways to Wellbeing.

Like all of Gateway’s work, the content of each session will flexible, allowing participants to lead, and identifying and building on the strengths they already have.

The “five ways” are all simple suggestions – small steps that it will be easy to take – and based around self-awareness. By becoming more mindful of your own wellbeing, you can build confidence and resilience, and so reduce health risks.

“Be active” encourages physical activity because, put simply, exercise makes you feel better! The course will allow each group to tailor this step to their own mobility and fitness levels – so it could be anything from a ten minute stretch, or a walk in the park, to a bike ride or regular swim. As on our Pre-Diabetes courses, we’ll be encouraging people to decide as a group what activities they’d like to do – then we’ll help them to do it.

“Connect” will encourage participants to engage with the people around them. We’ll be looking at relationships and how to build them, whether that’s friends, family or neighbours. Gateway’s own staff and staff at the partner organisations will be able to direct people to activities in the area where they can meet likeminded people, and we’ll also be encouraging the people in the group to connect with each other to take part in future activities, if they want to.

“Give” is another way to create connections. After all, doing something for someone else is really rewarding, and it can be something as small as a smile! We’ll be looking at the ways in which people are already giving (whether they realise it or not) and how making some time to treat yourself can make it easier to do things for others. If people want to give more back to their communities, we may be able to put people in touch with volunteering opportunities, too.

“Keep learning” is all about challenging yourself to learn something new, or reconnecting with an old hobby or interest. Whether people want to learn to cook, learn a practical skill, or take on a new responsibility at home or work, we’ll be there to support them. We’ll be encouraging people to share their own skills and experiences with the others in the group and we’ll also be looking at other local activities and groups where people can try something new.

“Take notice” is probably the most important step for the people we will be working with. Becoming more aware of the world around you, and giving yourself time to reflect, is vital to your mental wellbeing. We’ll be encouraging people to take a little more notice of the little things, and to take time out for themselves, each day. So many of us complete our daily routines without taking much notice of nature or the changing seasons, but taking some time to reflect on the smallest experiences each day can help you to appreciate what matters to you.

We’re really pleased to have been chosen to receive a Santander Foundation Discovery Grant. Even the smallest funding awards – this one is £5000 – can make a huge difference to our work. We are looking forward to delivering this pilot course to at least 100 people, and hope that it will open the doors to allow us to support many more.

Could we deliver the Five Ways To Wellbeing course at your workplace? For more information, contact Michelle Smitten on 0121 456 7820.

Health Trainer group at the Signing Tree

Positive partnerships: strength in numbers!

Forming strong partnerships with other local organisations is a very important part of Gateway’s work.

By sharing resources we are able to provide a more cost-effective, joined-up service – both as an individual organisation and as a sector. In an environment where budgets are shrinking, effective partnerships mean less duplication of work, which saves vital resources. It also means less “pushing from pillar to post” for clients, easier access to services and one point of contact to help someone navigate through services.

People rarely have one issue they need support with, so all our services have always worked in partnership with other organisations, either formally or informally. Over the last couple of years, however, partnership work has become even more important to the Health Trainer service as they have started working with broader groups of people, reaching out to communities who might not otherwise be able to access the service.

Health Trainers at The Signing Tree

One partnership that we’ve set up relatively recently is with BID Services, a charity supporting people who are deaf, hard of hearing, visually impaired or have a dual sensory loss. BID Services runs a social enterprise called the Signing Tree, based at the Deaf Cultural Centre in Ladywood – and it’s here we now run a Health Trainer service with interpreters (one provided by Gateway, and the other by BID).

Gateway Health Trainer Richard, pictured, says, “I visit the Signing Tree once a month, where I set up a classroom together with two interpreters. If it wasn’t for them, the communication barrier would definitely be a sticking point – I don’t think many of the people I see at the Signing Tree would contact the Health Trainer service otherwise. The interpreters are brilliant – they actually get involved and help me to provide an informative yet fun session each month. We have 15 clients per session and it’s very popular – in fact last time, I had to turn four people away.”

Bhavana Jamin, Specialist Enablement Co-ordinator at BID, says, “This has been a positive experience for all the deaf people involved. The trainers make the pace of the sessions meet the clients’ needs and by this the clients became confident to participate and engage with the sessions. They gain access to information about their health and wellbeing that they may not be able to access from other areas, so they now have some knowledge of healthy food choices, and the information is presented visually.

“Word of mouth has been used to promote these sessions within the community and I now have a waiting list of people who would also like training in the future. So I look forward to working with Gateway again in the future.”

Strong partnerships allow us to do several things, especially when clients have more complex needs. They enable us to have an up-to-date knowledge of the issues that people in Birmingham are facing, so we can adapt the services we offer and respond to need as quickly and usefully as possible. It means more opportunity to help clients prioritise their needs, and to deal with issues in a way that suits the individual, by taking the services to them.

As well as the Signing Tree, we now also deliver services in partnership with a number of other organisations, including Jobcentres in South Birmingham, and Cerebral Palsy Midlands, based in Harborne.

If you would like to know more about working with Gateway, whether that’s to work with our Health Trainer service, or any other Gateway services, for example the Pregnancy Outreach Workers Service, do contact us – we’d be very pleased to hear from you.

Stocking up on emergency supplies

Every day, our outreach workers visit clients all over Birmingham who are in need. Could you help us to help them?

Two of our outreach services, Gateway Healthy Futures and the Pregnancy Outreach Workers Service (POWS), work with people who are in the most “at risk” categories – and each week our staff are seeing more people in dire need of basic essentials from our food and baby bank. Could you help us to stock up?

Who we are working with

The Gateway Healthy Futures service provides a one-stop-shop for people with a wide range of social needs. GPs can refer anyone that needs non-medical help, so that includes people who have issues around things like housing, alcohol, finances, benefits, social isolation, and much more. Our Practice Navigators provide reassurance and a point of contact for the people they work with, as well as vital practical support.

One of the people recently referred to us by her GP is Angie*, who’s in her 50s and lives in Kings Norton. One of our Practice Navigators, Lindsey, visited Angie on a Monday morning a few weeks ago – and it’s a good job she did, as you’ll hear in the video:

We don’t normally start asking for donations until we are planning our Christmas Hampers, but we’d like to be able to stock up on more emergency essentials, so that we can offer practical help to people like Angie all year round. (Of course, this will be as well as the help we give them to access all the support they’re entitled to, and signposting them to other agencies for support.)

How can you help?

To help us stock up, we’ve expanded our donations list to include things that our Gateway Healthy Futures clients might need, as well as our POWS clients. If you’re able to donate any of the below items, they would be gratefully accepted at our offices: Floor 5, Chamber of Commerce, 75 Harborne Road, B15 3DH. Alternatively give us a ring on 0121 456 7820 and we can arrange pickup. We’d also love it if you could share this list with your contacts.

Imperishable food (unopened):
Tins – beans, soup, custard, peas, beans, fish (tuna, mackerel, pilchards) etc.
Rice
Flour
Herbs and spices
Lentils
Pasta
Pasta sauces/jars of sauce
Biscuits
Some sweets and chocolate would be nice

Toiletries (unopened) for men and women:
Toilet rolls
Toothpaste/toothbrushes
Shampoo/soap/shower gel
Body lotion/moisturiser/hand cream

Other useful items for men and women:
Packs of underwear, socks (these need to be new)
Woolly hats, gloves, blankets (second hand is fine if clean and in good condition)
Slippers – with backs, not slip-on (these need to be new)

Pregnancy Outreach Workers Service (POWS)
POWS works with pregnant women who have a low medical risk and high social risk, dealing with issues including temporary accommodation, homelessness, substance misuse, domestic abuse, offending, newly arrived communities, poor mental health and safeguarding. So our donations list for POWS clients includes some extras that will be especially helpful to new mums and mums-to-be.

Toiletries (unopened) for POWS clients, including:
Sanitary towels – the larger “maxi pad” type is better for new mums
Newborn nappies
Baby wipes
Cotton wool
Baby bath wash
Baby lotion
Baby clothes – up to twelve months as we have little space to store them (second hand is fine if clean and in good condition)
Books and toys for mums who may also have older children (second hand is fine if clean and in good condition)

We’ve also updated our Amazon wishlist, where you can buy items and choose to have them sent directly to our office.

Thank you very much.

Social support for GP patients

As Gateway Healthy Futures is in month 10 of its pilot period, we want to show you the range of support the service offers, by letting you hear two patients’ stories, in their own words.

mini_docGateway Healthy Futures is a GP-referred service, supporting patients with a broad range of social needs. GPs can refer anyone that needs non-medical help, and they’ll get one-to-one support from an experienced para-professional.

What sort of social needs?

From the discussions that took place before we started, we had made a few assumptions about the support that people would need. We had expected to see mostly older people, and for their issues to centre on long term conditions or isolation. We also expected that the level of support provided would vary, from a fairly light touch to working with people more intensively. But we quickly found that the cases being referred to us are a lot more complex than this.

Rather than the frail, elderly demographic that we were expecting, around 70% of the people GPs refer to us are under 65 – and all have needed intensive support from a para-professional Practice Navigator, rather than lower-level support from a Volunteer Befriender.

The most common issues GPs refer patients to us with are related to mental health (for example low reported wellbeing). Social isolation is a big issue, but this isn’t usually related to age – the reasons are many and varied. As well as people who want support to manage long term conditions, we are seeing a lot of alcohol dependency, anxiety and depression, accommodation issues and financial hardship.

How do we help?

The model we use is flexible and so it works for everyone, young and old. The Practice Navigators work one-to-one with patients to come up with a credible action plan, based not just on the needs highlighted by their GP, but on the patient’s own lifestyle and the pace that suits them. We help people to start living more independently almost immediately, and the network Gateway has built up over the years means that we can signpost people to a huge range of other services for help going forward.

Gateway Healthy Futures was designed, and is being piloted, in partnership with MyHealthcare. To find out more, or to refer patients into the service, GPs and Practice Managers should call 0121 456 7820 and ask for Gateway Healthy Futures.

Meet Arlene, Aisha and Brandon

ArleneArlene Lawrence (pictured) is a Practice Navigator with Gateway Healthy Futures. She joined the team from a background in childcare and family work and has been supporting a number of patients with very different needs.

Each patient gets around ten sessions of support, depending on their needs, and these sessions are patient-driven. Practice Navigators work closely with their clients to come up with an action plan based on their own priorities, which is often hugely helpful in itself as it forces people to focus.

Two of Arlene’s clients, Aisha and Brandon, have recorded some audio so you can hear their stories in their own words.

Aisha’s story

Aisha is in her 30s. She suffers from anxiety and depression and is dependent on alcohol, which has led to her leaving work and missing rent payments. Aisha’s immediate concern was that her landlord was taking her to court over unpaid rent, but she and Arlene have also talked through what she wants and needs in the longer term.

They’ve only been working together for a few weeks but Arlene has already accompanied Aisha to housing meetings, and to the court hearing. She’s referred Aisha to a recovery agency, a counselling organisation and a Health Trainer and – thanks to Arlene’s ongoing support – Aisha has been making the appointments. In the clip Aisha explains the difference the support has made and positive impact Gateway Healthy Futures has had on her life.

Arlene says, “it’s hard because I’m here in a professional capacity, but I do give out a lot of hugs! A lot of people just haven’t had any level of support before, so you have to work together to create the boundaries. Working with Aisha to create an action plan has been beneficial because she knows there’s a cut-off date and she’s had to decide exactly what she wants out of this support and her future. She’s already made a lot of positive changes.”

Brandon’s story

Brandon is 20 and has a learning disability, with related anxiety and depression. He has been living at home but because his family life is quite chaotic, he wants to start living independently. However, until he was referred to Gateway Healthy Futures, he didn’t know where to begin.

Arlene has worked with Brandon to come up with an action plan based on his immediate needs – in this case, applying for the PIP payments he was entitled to – and what he would like to do in the future. He indicated that he wasn’t sure whether he wanted to go to college or straight into work, so Arlene accompanied him to a college for people with learning difficulties to find out more about completing his GCSEs, and helped him to prepare for job interviews by helping him to find clothes and bus fare. In the audio clip, they’re on their way to Rathbone’s – an organisation that Brandon hadn’t been aware of before he met Arlene – who have helped him to find a flat with supported living.

Arlene says, “working with Brandon makes me feel quite positive about young people! The flat where he’ll be living, down the road from his mum’s, is perfect. He’ll have company from his housemates, and six hours of support a week, with cookery lessons and sports activities available to him. He’s finding out what he wants out of life and he’s on track to get a warehouse job or something similar. It’s looking good for him now.”

Gateway Healthy Futures: making a difference

The Gateway Healthy Futures service helps patients who need social support, and we’re keen to take more referrals from GPs to show the benefits of this pilot work.

What is Gateway Healthy Futures?

Gateway Healthy Futures is here to support people with a broad range of social needs. GPs can refer anyone that needs non-medical help, so that includes people who have issues around housing, alcohol, finances, benefits, social isolation, and much more.

Our Practice Navigators support people from the age of 18 upwards, working alongside other services and organisations across the city to provide patients with one-to-one tailored support.

Whether someone just needs a cup of tea and a friendly chat to get through the day, or whether they have complex needs that will require a range of specialist help, Gateway Healthy Futures provides a one-stop-shop into which GPs can refer patients for a range of support.

As part of the Gateway family, our Practice Navigators are skilled para-professionals with a huge network at their fingertips – so if they can’t help, they will know someone who can.

Gateway Healthy Futures was designed, and is being piloted, in partnership with MyHealthcare. To find out more, or to refer patients into the service, GPs and Practice Managers should call 0121 456 7820 and ask for Gateway Healthy Futures.

Read on to find out how the service helped Diane who, without the support of a Practice Navigator, might otherwise have fallen through the net.

Diane’s story

Diane’s GP referred her into the Gateway Healthy Futures service in October last year and she was assigned to Judith, a Practice Navigator.

DianeAt their first meeting Judith and Diane discussed how Diane’s ill health and learning difficulties have knock-on effects for her everyday life. For example, cooking is hard work: she can’t stand for long, finds it hard to grip a knife, and sometimes forgets when things are in the oven.

She finds using the telephone really stressful and struggles with reading due to her dyslexia, so she finds it difficult to manage her paperwork, including bills. She told Judith she was concerned about money, and would like more people to talk to.

The little things

Diane was anxious, lonely and at risk, but it was clear that some help with the little things could set her on the road to a happier, more independent lifestyle.

One of the first things Judith did was to phone the DWP on Diane’s behalf to begin the process of claiming for PIP (Personal Independence Payments; the successor to Disability Living Allowance) in order to help ease Diane’s financial pressures. Diane had also heard about a class she wanted to attend, so they worked out which buses she could take to get there. And they talked about ways in which she could save money, perhaps by changing energy suppliers.

Judith helped Diane set up a filing system, and phoned banks and utility companies to set up new arrangements. She helped her to fill in the application forms for PIP, and then to understand the many letters she received relating to the application.

Financial hardship

We often find that it takes some time before the people we work with feel able to be completely honest about financial hardship and, indeed, it was a couple of months before Judith found out just how little Diane was living on. She was going days without food and had stopped going out because she couldn’t afford bus fare. PIP money would give her a lifeline.

However, after being assessed in December, Diane’s PIP application was declined.

Judith was able to give Diane emergency help over Christmas by giving her bus money from our Hardship Fund, and food parcels from our food bank, including a Christmas hamper, but it was obvious that she would need a longer term solution. With Diane’s need for it increasing all the time, Judith stepped up the pressure to approve the PIP payment.

She got in touch with other services in Birmingham for advice, and wrote a letter to the DWP asking them to reconsider Diane’s circumstances, giving them some extra information that hadn’t come to light as part of the application process and assessment. However, the application was refused a second and third time.

A positive outcome

Finally, Diane’s appeal for PIP went to court.

With the help of an adviser from Freshwinds, Judith and Diane gathered as much evidence as they could to support Diane’s appeal. In May, some four months after Judith’s first phonecall to the DWP, Diane attended a tribunal, accompanied by Judith, and was awarded a “daily living” payment at the standard rate.

Diane’s support from Judith has now ended, but she will still see a Gateway Befriender every now and again to carry on with some phased-down support. Thanks to Judith pushing for a positive outcome, she can now afford food and bus fare, so she’s started going regularly to classes and clubs, where she meets people for coffee and the occasional dance. Her paperwork still causes her some anxiety, but she is much more organised and feels much more able to cope with everyday life.

News about the Gateway Health Trainers service

Health Trainer Richard with a clientAfter a period of uncertainty, we’re pleased to be able to confirm that the Gateway Health Trainers service will be continuing until at least March 2017.

Unfortunately, Birmingham Public Health has indeed ended their funding for Lighten Up, meaning that the Gateway Lighten Up service will end (although it will continue in Solihull).

Health Trainers: onwards and upwards

As Gateway Lighten Up stops taking referrals, we’re expecting an increase of referrals into Gateway Health Trainers. Of course, a Health Trainer is not a replacement for Lighten Up – we’re not a call centre, so we don’t have the capacity to work with as many people – but we can offer an alternative for at least some of the people who would have used Lighten Up, with one-to-one meetings, in person, for people who are looking to make lifestyle changes.

Working with more vulnerable people

New targets for us this year mean that Health Trainers are going to be focusing more on South Birmingham’s vulnerable communities. The service has always been open to everyone in South Birmingham, but this year we will start to specifically target more of the harder-to-reach communities: homeless people, people who’ve experienced domestic violence and substance misuse, and young people.

So we’ve been going out and talking directly with some of the agencies who work with vulnerable people, including Birmingham’s Homeless Services, women’s refuges, probation services and colleges, to make sure they know how to refer into Health Trainers and how we can help.

In fact, the number of Health Trainer clients who fall into the “vulnerable” category has risen anyway over the last three or four years… but in many cases we don’t find out until the client’s been with us for a while. It’s hard to admit you’re struggling, but our Health Trainers work hard to build up the sort of relationship where a client can disclose their personal circumstances and ask for help.

In one case, for example, one of our Health Trainers was working with a woman who was struggling to eat healthily. Eventually she admitted she was finding it particularly hard because she didn’t have a fridge, oven, or hob. Luckily, because South Birmingham Health Trainers are part of Gateway, they have a good knowledge of the support available, and access to an up-to-date network of extremely useful contacts. We helped her by working with her to find out what support was available to her from other agencies, as well as offering food parcels from our own foodbank and others in the city.

Because of the rising number of people who need this kind of extra help, Gateway Health Trainers have also been working with a group of GPs in Northfield, and Birmingham CAB, to offer a pilot programme called the Wellbeing Advisor Scheme. The service combines Health Trainers with social support from CAB to meet the needs of patients who are presenting with an increasing range of social issues, including debt, caring responsibilities, housing problems and social isolation. We often find that, once social issues begin to get sorted out, people are more open to lifestyle changes, so putting them together in this way makes a lot of sense.

… and a bit of good news!

health trainersFinally, Gateway Health Trainers have recently been given a boost, thanks to some new equipment: specialist scales from Benenden. These bariatric scales are designed especially for people who are morbidly obese – but they’re also extremely accurate, so we’re very pleased to be able to use them instead of standard scales. It also means that, rather than having to send people above a certain weight back to their GP to be weighed, we can now do it ourselves. Thanks, Benenden!

Clinical study shows that POWS improve maternal mental health

We talk about “evidence-based” services a lot, but for social interventions such as our Pregnancy Outreach Workers Service (POWS) it can be difficult to find proof that the service is successful without resorting to anecdotes and self-reported data.

mum-and-baby

However, a group of researchers at the University of Birmingham, funded by CLAHRC (Collaboration for Leadership in Applied Research and Care) West Midlands, have recently published their findings from a clinical study into the POW service – and we’re very pleased to note that it shows clear statistical evidence of benefit to the women we support, particularly with regards to their mental health.

The study

The research took the form of a Randomised Controlled Trial (RCT) – the most academically rigorous way of determining whether a cause-effect relation exists between treatment and outcome.

It looked at 1324 women, some of whom received standard maternity care and some of whom were supported by POWS, and compared outcomes such as antenatal attendance, postnatal depression and mother-to-infant bonding.

The findings

The study found that mother-to-infant bonding is better when mum has the support of a POW.

It also found that, for women who have two or more social risk factors, the intervention of a Pregnancy Outreach Worker was beneficial in preventing postnatal depression.

The study adds, “this finding is important for women and their families given the known effect of maternal depression on longer term childhood outcomes”. It concludes:

This trial provides evidence that a lay support service targeted to women with two or more social risk factors improves aspects of maternal psychological health relative to controls; such improvements are likely to be of lasting impact due to the known effect of maternal depression and poor attachment on longer term childhood outcomes.

This, together with the relatively low costs of the service, means that consideration should be given by policymakers to introduction of a lay support service.

When the trial was being carried out, we worked with a much wider group of women than we do now. The research showed that our interventions have the biggest impact on women with two more more social risk factors – and it is this group that we now work with exclusively.

Our POWs work hard to offer early help to women who are at risk; to make sure that baby arrives safely, and to support mum to be the best parent she possibly can. This study is incredibly helpful in validating the work our brilliant POWs do, and we’re delighted to see it published.

You can read the full study on the BMJ Open website here.

Health Trainers go above and beyond

When you hear the term Health Trainer, you might think of the work they do to support people to diet and get down to the gym.

Health Trainers Josh and WayneBut a Health Trainer’s work isn’t all about healthy eating and exercise. Health Trainers, like all of our services, support the whole person.

We know that people who are in debt or worrying about their housing are less likely to stop smoking or to start eating well. Once someone feels like their life is on a more even keel, however, they are more likely to become physically healthier.

So, for us, it’s important that Health Trainers look at all the issues that their clients face and support them with any changes they want to make. This might mean signposting someone to another agency for help with substance misuse, finances, domestic abuse or housing; or it might mean giving them the opportunity to find – and the confidence to join – community groups or classes.

Health Trainers, like all Gateway’s staff, are trained extensively to equip clients with the latest information on, for example, changes to the benefits system and other social issues that could affect them.

They’re also experts in behavioural change, and the principles of behaviour change apply across the board – so seeing a Health Trainer, and learning how to recognise patterns of unhelpful behaviour, can have a positive impact on all areas of a person’s life.

And, of course, being part of Gateway means that Health Trainers have access to a huge knowledge base and network. So although they can’t be experts in everything, they are experts in finding someone who is!

In some cases Health Trainers get involved with organising groups, classes and events themselves. Just this week we received a letter from Pauline at the Long Term Conditions group that we help to run:

“…we would not have been able to continue with the group meetings without Gateway’s help. All the members of our small committee have long term health conditions and, as each year passes, we depend more and more on Gateway to expertly manage our budget, make all the arrangements for our speakers, catering and venue, arrange transport for those who need it and generally and enthusiastically make tea, answer questions, assist the less able with their lunch and much more………and all with a smile. They also help us to complete the CCG forms and signpost us to services that can help with specific problems…..as well as encouraging those who are able to go to the meetings that enable us to contribute our opinions (and needs) on health and social services matters.”

Wellbeing Advisor Scheme

One way in which we are currently building on the work that Health Trainers do, and evolving the service, is via a new Wellbeing Advisor scheme.

This is a pilot we set up with a group of nine Northfield Practices within Cross City CCG who form the Northfield Alliance.

All the practices have a Health Trainer assigned to them, so they’re already familiar with the service, but one practice and GP in particular, Dr Peter Arora from Jiggins Lane Surgery, wanted a service that also met the needs of patients who were presenting with an increasing range of social issues, including debt, caring responsibilities, housing problems and social isolation.

So we met with Dr Arora and our Health Trainer Commissioner, Elaine George, to agree how we might be able to support clients, and what sort of referral pathway would work best.

Now, GPs and other practice staff at Northfield Alliance practices directly refer to Health Trainers as before, but the referral form lists any additional social issues and Gateway effectively takes responsibility for that client and any interaction or engagement they have with other agencies.

walkingOur main partner in the scheme is Citizens Advice Bureau (CAB) and in agreeing to be referred to the scheme, patients agree to a referral to both Health Trainers and CAB. Obviously for some people, their social issue takes precedence and in those cases we refer them to CAB initially, but then follow up at a later date to establish if they are at the point at which they’d like to work with a Health Trainer for lifestyle support.

While CAB are the main partner, Health Trainers also direct people to other agencies, such as our own Befriending Service, and of course through setting up group activities themselves such as EXTEND classes, Long Term Conditions groups, and walking groups.

Being able to support the whole person, and provide behaviour change tools to influence all aspects of their life, from health, to wellbeing via finance and housing means, we believe, more sustainable results for that person, less pressure on services such as GP, Social Services, DWP etc and a happier, healthier population.

Sharing our knowledge with the Child Poverty Commission

Did you know that Birmingham has a Child Poverty Commission? The cross-partner Commission, which includes the Council, the University of Birmingham and The Children’s Society, was set up in March last year to look at ways of reducing child poverty and making sure children are not disadvantaged by their background.

It’s early days for this group, though, and the first stage is for them to get the fullest picture of the extent of the issue. So we’re very pleased that they’ve asked us to get involved and share our knowledge.

At its launch, the Council’s press release about the Commission said:

“As well as asking professionals to give evidence, the commission wants to listen to the everyday experiences of children and families living in poverty and understand poverty from their perspective and bring to life the stories of children and families behind the hard statistics.”

We were asked by the City Council to get involved as they recognise that our Pregnancy Outreach Workers Service (POWS) works with some of the most in-need families in the city. The Commission is keen to see case studies and information compiled via our Impact Assessment App, but they’re also really keen to hear some experiences first hand, so they’ll be visiting us in a few weeks’ time to meet some of the families we work with and hear how life is for them.

POWs’ experiences of Child Poverty

mother-babyPOWs support some of the most vulnerable women and families in the city, and they come face to face with child poverty on a daily basis. The issue is immense… and it’s growing.

Some of the women we work with don’t yet have a child so, in these cases, “child poverty” includes the strong potential for the baby to be born into poverty.

More than 75% of the women we support record “Financial Hardship” as a current issue when they are assessed. This means they have unmanaged debt, rent arrears, or a low income and, in many cases, all three. For many of the women we visit, we also record that their living accommodation is unsuitable. This could mean overcrowded, in need of repair, or unsafe, and of course we have to take into account the imminent arrival of a baby. The main barrier the women have to changing this is financial hardship.

Since the POW service changed last April to working with the most vulnerable women only, we’ve seen demand for food parcels and hardship payments double. We are also seeing a growing number of women who are underweight or suffering from dietary deficiencies. This issue becomes a real danger during pregnancy, both to mother and child.

Although we do what we can, there’s a limit. Frequently, despite the hard work of our POWs, we’re not able to make things all that much better. To be honest, we often feel a bit helpless. So we’re very pleased to be able to talk about our experiences to the Commission and, hopefully, help to make a difference.

Celina’s Story

Celina* came to the UK from the Caribbean because she had been suffering domestic abuse from her partner (she has actually suffered a miscarriage in the past as a result of the abuse). Legally she should have returned to her home country by now, but her partner has been threatening her family and she is understandably frightened to return.

Celina’s had a lot of complications and medical issues during and since the birth, but her baby is doing OK. Like most of the women POWS support, Celina has dire financial hardship, and because she is now an overstayer, she doesn’t have any access to funds at all. She cannot claim any financial support and wouldn’t be allowed to work even if she could. She has told us she is worried for her own survival.

Just before Christmas, Celina’s Pregnancy Outreach Worker Jacque took Celina a Christmas hamper which included a few essentials – food, baby items and toiletries – as well as a couple of treats for mum and baby. You can hear Celina’s reaction in the video below.

*name has been changed