Category: Service Provision

Services devised, developed and run to fulfill specific needs.

Cooking up new ideas: Solihull Lighten Up

As Solihull Lighten Up goes from strength to strength, we’ve been looking at ways we can improve the service, to help improve the health and wellbeing of more people across Solihull. So we’re pleased to announce we’re planning some exciting changes.

Bob, one of the Lighten Up Help Centre staff

Solihull Lighten Up is a weight management service offering people a package of support tailored to their needs. As well as vouchers for commercial weight loss groups, it offers a range of extra specialist help and advice, including phone support from staff at our Lighten Up Help Centre and free referrals to activity groups in the area.

For people with slightly more complex needs (including people with learning disabilities, disabled people and their carers, people with mental health issues and recent ex-smokers) Solihull Lighten Up also offers up to 12 months of one-to-one support from a Behaviour Change Advisor or Dietitian.

It’s been running since Spring 2016 and in its first year, 772 clients lost a total of 2567.6kg, or 404st 3lbs. That’s an average of over half a stone each!

Having now talked to and worked with hundreds of people and numerous partner organisations in the area, we’re now liaising with commissioners to start implementing some new ideas, based on the conversations and feedback we’ve had.

Alternatives to weight management groups

For most of the people Solihull Lighten Up supports, weight management groups like Weight Watchers and Slimming World work really well. In the first year of service delivery, we supported over 800 people to go to groups (backed up by regular phonecalls from Lighten Up Help Centre staff) and, for most of these people, membership of a group was a good way to kickstart their weight loss.

But, for some people, groups are just not a perfect fit. There might be a practical reason; perhaps meeting times clash with work, or there are insurmountable childcare issues. Or it might be something less obvious; some people just don’t feel able to make the big lifestyle and dietary changes required by a group straight away, and some need more support with physical activity.

So we’re designing our own new 12-week weight management programme, strongly influenced by feedback from the people we work with. Delivered in community venues across Solihull, it will be family-friendly, so that kids can join in, with plenty of healthy eating and physical activity sessions.

The Solihull Lighten Up team has already taken on a new Behaviour Change advisor, Kavita, to enable us to do more tailored support, and we’ll be launching the new programme soon. We hope that, by offering some carefully designed alternatives, we’ll help more people to adopt the Behaviour Change principles that we know create long-term lifestyle change.

New “slow cooker” sessions

We currently run a few different cookery sessions. Many of our staff, across all our services, have been trained as Cooking Mentors and they run sessions showing people how to cook simple healthy recipes on a budget.

The feedback has been really positive and we’ve seen a demand for more healthy cooking support, especially for people who are short on time and space at home. So – with the support of Solihull Council – we’re putting together a “slow cooker” course.

Participants will be given a slow cooker that they can plug in anywhere at home (it doesn’t even have to go in the kitchen!), together with demonstrations and a variety of easy healthy recipes. Slow cookers are associated with winter meals but we have plenty of ideas for summer dishes that we look forward to sharing too!

If you live in Solihull and you’d like to kick-start your weight loss journey with a bit of extra help, contact us to find out if you are eligible for the Solihull Lighten Up programme. Contact our Lighten Up call centre on 0800 599 9880 or via email on lighten.up@nhs.net.

Lessons learned from Pre-Diabetes referrals

The Pre-Diabetes Courses we run as part of the National Diabetes Prevention Programme have been running for over a year now. Interestingly, referrals to the course dropped (to almost unviable levels) and then rose again significantly during that time – but why? We thought we’d share some of the lessons we’ve learned about the referral process since we’ve been running the course.

During the Pre-Diabetes Course pilot period, which started in late 2015, patients came to us via a mailshot from their GP. When someone was diagnosed with Pre-Diabetes, they received a letter from their surgery, which included a leaflet from us explaining what the Gateway course offered, with contact details. If they wanted to go on the course, they called or emailed to sign up.

This worked really well. By March 2016, we’d received around 600 referrals, and had run over 30 courses, with a 92% retention rate. Feedback from patients was overwhelmingly positive. The success of our pilot, along with others, contributed to the programme being rolled out nationally.

A worrying change

However, things changed when we amended the referral process.

Under the new process, referrals came from people who had received an NHS Health Check. If a Health Check revealed Pre-Diabetes, GPs sent the patient’s details to us, and we called them on the phone to personally invite them onto the course. It sounded like a good idea.

But, despite the personal touch, the number of referrals dropped dramatically. Even worse, very few of the patients who’d agreed to go onto the course over the phone actually turned up on the day! The people who did come along were still achieving great results, so we knew the problem wasn’t with the course itself, but we were struggling to get enough people through the doors to make each course viable.

So we approached our commissioners (Birmingham South Central CCG) and worked with them to go back to mailshots. We picked up the cost of the leaflets and postage ourselves, and started working with GPs to start getting them sent out to patients again.

Back on track

Now – happily – the number of referrals is shooting up again. In just the last four weeks, we’ve run ten courses (with 15 people on each course) and more than 65 people are on the waiting list to go on a course in the next few weeks.

So why do the mailshots work so much better than a personal phonecall? We think it’s down to the following factors:

  • Awareness. Put simply, fewer people were hearing about the course. When we switched to the phone method, we were only passed the details of people who’d had a Health Check, rather than everyone who’d been diagnosed. Without leaflets, GPs were less likely to suggest the course to people, and we weren’t able to promote it as easily.
  • GPs’ authority. People take more notice of something when they hear it from their GP, so when the GPs sent our leaflet to their patients, it implied that the course was “approved”. When we contacted people ourselves – even though we were phoning people personally, telling them their GP had asked us to call, and allowing them to sign up there and then – it just didn’t hold the same weight.
  • Letting the patient lead. Perhaps counter-intuitively, requiring the patient to refer themselves turned out to be a lot more successful than phoning and asking them to sign up. Why? Well, we’ve said this before, but letting the client lead their own support is beneficial for everyone. Giving the patient the reins and allowing them to decide what action to take and when (rather than telling them what to do, and suggesting we know best) creates resilience and sustainability. In other words, those who make the decision to refer themselves to the Pre-Diabetes Course are much more likely to turn up, and much more likely to stay on track once they’ve joined.

The Gateway Pre-Diabetes Course – better than a handout!

Anyone can read about taking steps to reduce their HbA1c levels, but going on a course with other people is much more likely to make it happen.

Course attendees making healthy salsa!

The biggest difference is the social interaction. When people with similar conditions get together and start talking about their experiences, they receive extra benefits that they wouldn’t get from making changes on their own. They are happier to talk about things like weight loss and physical exercise without feeling judged, and they inspire each other.

We’ve seen people who meet on the course start their own walking groups, share healthy recipes and exercise tips, and start good habits that spread throughout whole families!

Learning is a lot more fun in a group, and the Gateway Pre-Diabetes Course includes many hands-on activities, like games and cooking sessions.

If you’ve been diagnosed with Pre-Diabetes and you’d like to take part in a Gateway Pre-Diabetes Course, call Gateway on 0121 456 7820 and ask to speak to someone from the Pre-Diabetes team.

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.

Saving time for GPs and money for the NHS

Social prescribing” (sometimes called “care navigation” or “care co-ordination”) is a bit of a buzz topic at the moment. Although similar approaches have been used for many years, the financial squeeze on clinical services is greater than ever, leading to greater interest in alternative pathways.

Social prescribing refers to the idea of GPs and other primary care professionals referring people to a range of local, non-clinical services, and treating people in a more holistic way; looking at the “whole person” and taking into account social, economic and environmental factors.

But does it work? Our experience running the Pregnancy Outreach Workers Service, Health Trainers and Gateway Healthy Futures, tells us that the answer is a resounding “yes”… but that creating a successful service depends on a number of factors.

Saving time and money… building resilience

Gateway Healthy Futures Team
Gateway Healthy Futures, a pilot programme that finished at the end of September 2016, was designed specifically to reduce the number of unnecessary GP visits by providing patients with a non-clinical alternative. GPs referred patients who had presented with risks including social isolation, low reported wellbeing, ongoing mental health conditions, alcohol or substance misuse, and financial hardship, and the Healthy Futures Practice Navigators provided them with practical support, reassurance and a point of contact.

It’s an idea that we had been batting around for a couple of years before we had the opportunity to develop it. Eventually, it came to fruition thanks to My Healthcare, a consortium of GPs in South Birmingham. Gateway Healthy Futures was one of a series of projects funded by MyHealthcare with money provided by the Prime Minister’s Challenge Fund.

It’s now five months since the Gateway Healthy Futures service ended, but we’re pleased to see initial reports from its formal evaluation (which was carried out by international development consultancy Mott Macdonald) are very positive. It shows that Gateway Healthy Futures reduced the time people spent with their GP (when a social intervention was more appropriate), and that the people our Practice Navigators worked with significantly increased their self-reliance and self-care during and after the support.

“…GPs are happy with the service because it is reducing the burden of social needs patients on primary care.”

“Feedback from patients … indicates that self-resilience levels have increased due to the scheme. Anecdotally, there is evidence of behaviour change; the scheme has helped some patients to understand that the GP is not always the most appropriate source of support for helping with non-clinical issues.”

The Gateway Healthy Futures service was also found to be cost-effective.

“The use of non-clinical staff members instead of GPs is cheaper by around one third of the cost.”

“… had [Gateway] not intervened, patients would likely have been referred on to social services at a much greater additional cost; the care navigation service is estimated to represent a saving in this scenario of approximately £10 per hour.”

Lessons for the future

One element that was key to the success of Gateway Healthy Futures was being able to work with GPs who engaged with the service. Because we already had a relationship with MyHealthcare (via Health Trainers) and the GPs had been involved with Gateway Healthy Futures from the start, they had confidence that it would work. This benefited everyone involved – including the patients, who trusted their GP’s recommendation and were more likely to engage themselves.

And thanks to experience gained from our other services, in particular from over a decade of running the Pregnancy Outreach Workers Service, we were also able to employ and train the right kind of staff. Our Practice Navigators provided a flexible, understanding and open-minded service, providing “whole person” support.

Rather than falling into the trap of “doing what’s best” for patients, without really consulting with them on a deeper level, Gateway’s services generally let the patient lead the support. We believe that asking someone what their priorities are, believing them, and working with them to build self-confidence and resilience creates a programme of support that is more successful and more sustainable.

Richard, Health Trainer

Health Trainers service at risk: please help

If you value the Health Trainers service, then we want to hear from you.

The latest round of cuts to services in Birmingham is being discussed as part of the Birmingham City Council’s budget consultation, and one of the services highlighted as being at risk is the Health Trainers service.

Health Trainers are one of the few discretionary services provided by Public Health (ie they are not statutory services), which means they are most susceptible to cuts. It’s possible that funding to the Health Trainers service will be cut dramatically, if not completely, later this year. We are currently putting together a response to the consultation to explain why Health Trainers are important to the city, and to thousands of people who receive their support.

One of the letters we’ve already received is from a woman explaining how her mother was helped by Beckie, a Gateway Health Trainer.
If you have benefited from a working with a Health Trainer, please let us know how they helped. What was your experience? What would your situation be like now if it wasn’t for your Health Trainer?

If you haven’t been supported directly, but you understand the value of the service, maybe as a partner or referrer, we’d still be very grateful for your feedback.

You can send comments to us via email at MichelleS@gatewayfs.org, or write to us at: Gateway Family Services, 5th Floor, Chamber of Commerce House, 75 Harborne Road, Edgbaston, Birmingham B15 3DH, and we’ll include your comments in the response we give to the consultation next week.

Alternatively, you can respond to the consultation directly by filling out the Council survey before next Wednesday, 18th January.

And if you’d like some inspiration, read on to hear why we think this service is so important…

Health Trainers: we give you extra!

The Health Trainer service isn’t just about weight management; it’s a long term, preventative service. Health Trainers help people to make lifestyle changes that have far-reaching consequences and so reduce the impact on other services.

Health Trainer Wayne visiting a local homeless hostel last month
In the last year, our Health Trainers have supported more than 2,000 people to increase their physical activity and to eat more healthily. But they’ve also helped hundreds of people to learn how to budget and to learn how to cook. They’ve helped people who were at risk of diabetes, or high blood pressure, to reduce their risk in the long term. They’ve set up group activities – which increase physical activity and reduce social isolation – and signposted people to many more. They’ve even helped people with housing issues, benefits claims and access to food parcels; issues that aren’t medical but nevertheless have a big impact on health.

Like all of Gateway’s services, our Health Trainers are an adaptable, flexible team. They offer home visits and phone support as well as community consultations. They respond to need as it happens and they put their wide network of contacts and skills to good use. They offer practical advice, but they also offer time, and someone to talk to.

More than 40% of the people Gateway Health Trainers have supported in the last year are from vulnerable groups, such as older people, people with mental health issues, and people who have an issue with substance misuse. And around 65% of Health Trainer clients are from deprived areas of the city. We know that people in these groups are much less likely to access resources on their own, which is why access to a Health Trainer is so vital: many of the people we work with would not otherwise receive any ongoing support at all.

Please help us to show why the service should stay.

Need a community interpreter?

As our newest Community Interpreters prepare to receive their qualifications and start work, we’re putting the word out to community organisations in Birmingham: the Gateway Interpreting Agency is here to help!

Does your organisation need interpreting support?

The Gateway Interpreting Agency provides specialist interpreting services to community, voluntary and public sector organisations. We are especially interested to hear from organisations working with hard-to-reach communities in Birmingham, who might need access to qualified community interpreters. Our interpreters are trained to CERTA Level 2, but have also been specially trained in safeguarding, confidentiality and other specialist skills that community work requires.

When our current trainees qualify, it will increase the list of languages we cover to 26:

Amharic Arabic Bengali Creole
Dutch Farsi French Hindi
Hindko Italian Kurdish Lithuanian
Mirpuri Oromo Polish Portuguese
Punjabi Pushtu Romanian Russian
Somali Spanish Sudanese Tigrinya
Urdu Vietnamese    

Our interpreters are already successfully working with a number of organisations, including Refugee Action (in fact, Gateway interpreters welcomed the first Syrian refugees to Birmingham!) and charities like WAITS, who work with victims of domestic abuse:

“Gateway’s interpreting service has been extremely useful to us in helping us to communicate effectively with clients despite the language barriers. Booking has always been efficient, prompt and straightforward. The interpreters are professional, friendly and have always delivered an excellent service. Thank you so much.” — Natalie Clarke, WAITS

If your community organisation needs interpreters and you’d like to find out more about using the Gateway Interpreting Agency, give us a call on 0121 456 7820.

(We are NOT currently taking on more interpreters. However, if you are fluent in Albanian, Tigrinya, Mandarin or Spanish, get in touch; we might be interested in speaking to you about future recruitment.)

What is a community interpreter?

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Course tutor Sarah Clay with new interpreter Joanna

All of our interpreters have experience of interpreting in the community and the public sector, including social work, health and education. We’re particularly interested in working with people who have been unemployed for a while and want to get back into work, using the language skills they already have to do something practical and rewarding.

The Gateway Community Interpreting course formalises people’s previous experience, cementing their knowledge, giving them a qualification and a platform to progress with confidence.

All of our recruits complete the CERTA Level 2 Award in Preparation for Work in Community Interpreting. This nationally recognised qualification gives interpreters the knowledge, skills and techniques needed to work in the context of public services, including health, housing, education, welfare and social services.

Sarah and Joanna
Course tutor Sarah Clay with new interpreter Anca

However, the Community Interpreting course we run at Gateway also adds a greater emphasis to the topics of data protection, boundaries and confidentiality, and safeguarding. Because of our extensive experience working with vulnerable people, we know how important it is for an interpreter to have this knowledge and to use these extra skills professionally.

The course is expensive for us to run so, although we heavily subsidise it, each new recruit pays a contribution towards their training. However, as a Community Interest Company (CIC), all of Gateway Interpreting Agency’s profits are directly invested back into our community work and services. The interpreters we’ve taken on so far tell us they like the fact that the agency cut of the money they’re generating goes into serving the community and not into someone’s pocket.

Meet some of the new recruits

Our latest recruits speak a number of the languages we’ve seen a need for in Birmingham over the last few months – both through our current agency work, and through our other services, including Pregnancy Outreach Workers, Health Trainers and Gateway Healthy Futures.

Polish: Eva and Joanna

Eva has already been working as an interpreter for two and a half years but took the opportunity to gain a certificate in the hope that this will bring more work. She’s primarily worked in health settings but the course has enabled her to broaden her knowledge of the wider public sector. She says, “I like helping people and the feedback you get as an interpreter is very rewarding. I especially like the fact that Gateway works with organisations like Women’s Aid – I’m looking forward to doing more community work.”

Joanna’s background is in Adult Education, but she has found herself interpreting on a casual basis more and more as part of her work in a Further Education college. She says, “I’ve been helping Polish-speaking people to fill in forms for things like housing and benefits for many years now – so I thought I might as well start to use my skills professionally. There’s a big Polish community in Birmingham but people just aren’t aware of the help and support that’s available to them. As a Community Interpreter I’ll be able to help people understand more about living here and how everything works.”

Bengali and the Sylheti dialect: Najma and Nurpashan

Najma has been a social worker in Birmingham for 20 years, so community work is a big part of her life. She wants to move into interpreting so that she can maintain a work/life balance whilst continuing to work in the community. She says, “after doing a few interpreting jobs through another agency, I wanted to do a qualification to consolidate my knowledge – you could say it’s putting my practice into theory! This Gateway course is a great opportunity.”

Nurpashan took a career break from Local Authority work to raise her children, but has been interpreting for family and friends all her life. She says, “interpreting is very rewarding when you can help someone to access the support they need. But when you’re interpreting for family it’s easy to go into advice mode! This course has helped me to stay impartial, keeping my opinions out of it and just concentrating on the words.”

Anca: Romanian

Anca has worked in the health sector for three years but has found herself acting as interpreter many times. Now she’s formalising that experience with a qualification. She says, “although I work in health, I’ve been helping people with all sorts of issues, including housing and even law. When you’re new to the country and don’t speak the language you don’t always understand the systems and it’s easy to find yourself in trouble with fines or even court. Becoming a qualified interpreter will give me more opportunities to help people.”

Paul: Creole, Dutch, French, Hindi, Italian, Portuguese, Punjabi, Romanian, Spanish…

Paul is a language sponge! He loves learning about new cultures and admits he seems to have a gift for learning new languages. He says, “I’d done some interpreting work in-house in previous roles, and translated for friends and family, but I recently decided to get some formal qualifications. I’ve already done an Introduction to a Diploma in Public Service Interpreting (DPSI), but the community aspect of the Gateway course appealed to me. I enjoy broadening my knowledge and look forward to working in more community settings.”

The power of prevention

They say “prevention is better than cure”. But despite grand promises of investment to the NHS, the Government is still cutting preventative services.

£10 billion?

In a speech on 5th October, Theresa May said that the Conservative party would be investing an extra £10 billion in the NHS. It sounds great, doesn’t it? But last week, Dr Sarah Wollaston – Conservative MP and Chair of the Commons Health Committee – pointed out that the figure is misleading.

Sarah Wollaston MP
Dr Sarah Wollaston MP

Dr Wollaston (pictured) told BBC Radio 4’s Today programme: “You can only arrive at the £10 billion by shifting money from public health budgets, and health education and training, and also by changing the date at which you calculate real-terms increases.”

In real terms, the figure is more like £4.5 billion, and it won’t go towards public health services. It isn’t obvious from the headlines, but areas like social care and prevention are not receiving a financial boost at all; they have been cut. And there are plans for more cuts next year, and the year after that.

When waiting lists are getting longer, and help becoming so much harder to find, this talk of “giving the NHS more than they asked for” is misleading and potentially dangerous. It would be easy for people to get the impression that money is available, but being spent unwisely when, in fact, the money is just not there.

Prevention is cheaper than cure

GP and hospital costs far outweigh the costs of preventative services. So why not spend money on early intervention for things like obesity, diabetes, mental health crises and smoking-related disease, before they get to the stage of needing expensive GP and hospital care? It seems ridiculous.

Take the Gateway pre-diabetes course. People with a high level of HbA1c – indicating a high risk of developing diabetes – are referred to us to learn how to better manage their diet and lifestyle, in a course of sessions over nine months. Results so far show that more than 80% of patients reduce their HbA1c level thanks to the course, with 66% of patients showing that they are no longer at risk by the end of the course. The total cost per patient is as little as £130.

Compare this to the cost of a lifetime of diabetes. As well as GP and outpatient appointments, people with diabetes require long term medication and supplies. Diabetes can cause a huge number of complications; illnesses which come with their own costs for the NHS. And let’s not forget the hidden costs for the wider public purse, which include the costs of absenteeism, disability and social benefits, and early retirement.

It’s important to remember that health spending isn’t just about GPs and hospitals. Often, these are the reactive costs – the costs that occur when the opportunity to prevent has already passed. Investing in the preventative elements, like social care and public health, is the best chance we have to reign in spending. And who knows, if it was ever properly resourced, we may even see savings.

We thought this video, made for LBC by Full Fact, an independent fact checking organisation, summed up the issues with the Prime Minister’s “£10 billion” statement quite nicely.

Reducing risk: the Gateway Pre-Diabetes Course

The results are starting to come in from the first people to complete our Pre-Diabetes Course – and we’re hearing some brilliant success stories.

The most important results are the HbA1c levels, which signify whether a person is classed as being at risk of diabetes. A reading of under 42 mmol/mol is normal, but a reading of between 42 and 47 is classed as “pre-diabetic”.

We’re very pleased to see that 66% of the clients who’ve sent in results so far have reduced their HbA1c levels since starting the course nine months ago, to a point where they are no longer at risk of Type 2 Diabetes. This is tremendous news and a great indication of the hard work that everyone has been putting in.

A further 15% have reduced their HbA1c levels, but are currently still classed as “pre-diabetic”; that is, they are still at risk of becoming diabetic. However, everyone who’s been on the course is now armed with important information about the preventative action they can take, including healthy eating, physical activity, food preparation, and managing portion sizes.

The lifestyle changes made by our course attendees also means that many of them have lost weight. An amazing 71% of attendees for whom we have results have lost weight since starting the course. Of these, 14% are no longer “obese” and 17% are no longer “overweight”. One person has lost a spectacular 16kg (that’s more than two and a half stone!)

Roger’s Story

One course attendee who is definitely seeing the benefits of a healthier lifestyle is Roger Taft. Roger came to us in December with an HbA1c reading of 46, which put him at the top end of the “pre-diabetes” category. Roger had already made some changes on his own before being referred to Gateway – he’d started cutting down on snacks and had started riding a bike – but the course helped him to focus on the lifestyle changes that would reduce his diabetes risk.

You can hear Roger’s story in his own words, and find out just how much his life has changed, in the video below.

Gateway’s Pre-Diabetes Course is commissioned by Birmingham South Central CCG, which is a Demonstrator site for the National Diabetes Prevention Programme. The course is for people who have been referred by their doctor because they are at risk of becoming diabetic. It runs for nine months and is designed to get people thinking about diet and exercise, and making lifestyle changes that will help them to become healthier.

How have I helped you today?

We thought we’d have a bit of a change from our usual fortnightly blog post and rather than a story from one of our services focus on something a bit more pictorial, with photos and comments from people we’re currently working with.  Hearing what people think of us and what they’re achieving or the changes they’re making is really important.  It’s essential in terms of us making sure we’re providing what people need and getting the level of support right but at the same time the information is often encouraging and thought provoking.

To make gathering this type of information quick and easy our Outreach Staff all have the www.impactassessmentapp.com installed on their phones.  At the end of each appointment or visit they use the app to gather a few simple things; a comment in response to the question “How have I helped you today”, a satisfaction rating – done by using a sliding scale and if they’re willing a photo, a bit of audio or even video.  We think it’s really important to record the comment as it’s said, sometimes the Outreach Worker will pass the phone to the client so they can type in what they want to say themselves or if not it’s entered exactly as it is said so it remains in the client’s voice.

We thought we’d give you an insight by showing you just a little of who we’ve been working with and what we’ve been doing together over the past few weeks.

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Jenny (right), her baby daughter and Collette, Pregnancy Outreach Worker

“I am happier than I have been in a long time.  I love my new flat and have been along to the Children’s Centre where there are lots of groups going on which I’m going to go to.”

 

daibetes-group-2
Ken, who’s reached week 9 of our Pre Diabetes Programme

“I now have smaller portions, more fruit, more veg and I exercise more.  All the talk about healthy options has been noted! “

 

 

 

 

june-hf
June, a recent referral into the Healthy Futures Service

“By telling me all the things that are available if I need them you’ve helped me realise there are still things available for me to do.”

 

 

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Mohammed, Pre Diabetes Programme

“I’ve gained knowledge about food but I’ve also made friends.”                    

 

 

 

xiaoli-pow
Xiaoli, client of the Pregnancy Outreach Worker Service

“We’ve talked about my birth plan and the things to expect when I deliver.  I feel I understand a bit more about labour now.”

 

 

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Jody (left) and her Pregnancy Outreach Worker, Sarah

“We’ve looked at properties together and we’ve also filled in the Sure Start Grant form.” 

 

 

 

 

Paul one of our Health Futures
Paul who was referred to our Healthy Futures service by his GP.

“You’ve referred me to a couple of activities I can go to this week. I’m looking forward to going to them, it gets me out of the house, I’m sick of looking at the four walls.” 

 

 

margaret-hf
Margaret who was also referred to our Healthy Futures Service by her GP

 

“You’ve helped me fill in the PIP application and given me a bit more confidence.”       

 

From the information we’ve collected via the app we also know that over the past six months we have provided one to one support to 1424 people and as we gather some basic demographic information we know various things like age and work status.  We can see that we’re working with a wide range of people which is important.

In terms of age the largest single group are those aged 50-64 with 420 people falling into this group but then in total 1045 were of working age,  321 people were over 65 and at the other end of the scale 43 were aged 18 or younger.

In terms of work 439 were in either full time or part time employment and 648 were unemployed,  then 45 were in full time education and 292 were retired.

Satisfaction – we talked about this at the start and how at the end of each appointment or visit we ask people to rate their satisfaction or happiness by indicating where they feel they are on a sliding scale, which is out of 100.  70% is the average score, so that’s like 7 out of 10, but what we can see is that 57% is the average people are scoring at the start of their support but by the end it’s increased to 77%.  This shows that satisfaction increases significantly as time goes on, but then that stands to reason as when people start to see or feel the effect of what they’re doing then their belief and confidence grows in us and the changes we’re making together.

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.”