Author: Katherine Hewitt

Healthy Futures Practice Navigator at work

What’s the future for Healthy Futures?

Unfortunately, we’ve had to stop taking referrals to our social prescribing service Healthy Futures again, leaving dozens of vulnerable people in Birmingham without support. Right now, we simply don’t have the money to continue.

Back in February, we announced that we would be continuing to fund the service using our own savings. At the time, we knew there was a risk we wouldn’t secure external funding before the allocated reserves ran out. Now, sadly, that risk has become a reality. We’ve had to stop taking referrals and our Wellbeing Navigators have spent the last two months winding down people’s support.

How Healthy Futures works

Margaret, Healthy Futures Wellbeing Navigator
Margaret, Healthy Futures Wellbeing Navigator

We have two Healthy Futures outreach workers, or Wellbeing Navigators: Ralph and Margaret, who work with people who’ve been referred by their GP. We work in partnership with SDSMyHealthcare, a consortium of GPs in Birmingham, and receive referrals from them and other organisations in the area.

Ralph, Healthy Futures Wellbeing Navigator
Ralph, Healthy Futures Wellbeing Navigator

Put bluntly, Healthy Futures clients are usually “frequent flyers” at their GP surgery — but it’s not medical help they need, it’s social.

When someone is referred into the service, Ralph or Margaret will go out to visit them and find out what they need.

Issues they support people with include housing (many are in hostels or temporary accommodation), financial hardship (many are entitled to benefits but are not receiving them, or have difficulty managing them), alcohol or substance misuse, and ongoing mental health issues like anxiety and depression. Some just need a bit of direction to help them start forming their own friendships and networks. The support given is practical, emotional and, importantly, builds people’s independence.

Here are some examples of the feedback we’ve had from Healthy Futures clients in just the last six weeks.

Judith* is in her 50s and unemployed:

I feel more positive and less confused about my benefits now, thanks for calling them today for me, and helping to sort it and update things with them. I feel like I have my mojo back. I think walking more is helping me too, and your support.

James* is in his 40s and has seen a few support workers over the years. He said to Ralph:

I have had a few issues and problems with support workers in the past, even still these days, but not with you. You don’t judge me, you listen to me, and I know how much you really want to help me. I can see that you really care.

Laura* is a mum in her 30s. She works full time but she and her child have been living in temporary accommodation:

I will look forward to my appointment with [the outreach worker] at Anawim [women’s centre], thanks so much for referring me to her, and telling me more about the support they provide. I am sure they will be of great help to me, like you. I am feeling upbeat.

Cath* is in her 50s and currently unable to work due to her depression:

Thanks so much, I really do feel the need to move on in my life now to look at volunteering and work, either temporary or otherwise. It’s thanks to you I feel like that. You have been so patient and supportive.

We know there is huge demand for the service; since February we have a steady stream of referrals from GPs.

And we know that the service works: an official study carried out in 2017 found that Healthy Futures is a cost-effective way to reduce the time people spend with their GP (when a social intervention is more appropriate), and significantly increases people’s self-reliance and self-care.

But, despite searching and applying for funding from many sources, we haven’t yet been able to secure any external funding and, unfortunately, we just can’t continue under our own steam.

A country in crisis?

Over the last year we’ve applied for many bids and tenders, and there are more in the pipeline, but haven’t won any funding for Healthy Futures so far. Occasionally we have been pipped to the post by larger organisations or partnerships whose reputation will allow them to reach more people — dare we say, it seems that quantity is sometimes given priority over quality.

We’ve even looked at crowdfunding — asking members of the public to donate — but really, should this be necessary?

Of course we understand that not every service can be funded, but it’s clear that more and more money is being needed across the third sector. Feedback tells us that every social fund we apply for is massively oversubscribed; for example, the Challenge Fund told us they had received more than twice as many applications as they’d been expecting. Building Connections told us they had a £9m budget but if they had funded everyone who applied they would have needed a £191m budget.

It feels like the country is in crisis when it comes to social support. It’s frustrating to watch and, believe us, even more frustrating to experience.

Watch the video

Watch the video below to find out how Margaret recently helped someone who had had to move house because of ill health, but found herself socially isolated in an area she didn’t know.

*names have been changed

ashtray

Helping people to stop smoking

Almost three quarters of smokers say they would like to quit.

But it’s not easy. More than a third (39%) go on to attempt it each year but only a small proportion (about 5%) successfully stop smoking.

However, did you know that with specialist support — for example from a structured smoking cessation course — smokers are up to four times more likely to successfully quit, compared to those who try and stop without any support?

stoptober 2018That’s why we are using our extensive experience to provide tailored courses, held in the workplace, for businesses who want to help their employees to quit.

Over the last month, we’ve been helping groups of employees to prepare to give up smoking with some tailored Quit Smoking courses for Stoptober, but we’d love to extend this offer to more companies and workplaces.

Supporting your employees to stop smoking won’t just benefit their health – it will be benefit your business. According to Public Health England, people who smoke take an average of two or three days more sick leave per year. Together with lost productivity from regular cigarette breaks, employees who smoke are estimated to cost UK businesses £7.5 billion a year.

Smoking is something that Gateway’s health and wellbeing teams have been helping people with for many years (you might be interested in this blog post we published in 2013, The Smoking Challenge, about the ways in which our Health Trainers and Pregnancy Outreach Workers tackled the subject with the people they worked with). So we’ve used our extensive experience to design sessions that we know will engage people, and help them to build the confidence to make important changes.

As a not-for-profit CIC, any profit we make is reinvested in the education, employment, health and wellbeing of the people we work with across the West Midlands.

What happens on a smoking cessation course?

The smoking cessation courses that Gateway runs are led by a qualified smoking cessation facilitator and take place on site, at your place of work. We can accommodate up to 15 people per session and each session (which lasts around an hour) is tailored to the people in the group.

The sessions focus on preparation: the group leaders encourage people to look ahead to a time when they no longer smoke, and then they go through all the typical worries that smokers have about giving up.

For example, a lot of people worry about putting on weight, or struggling to control their mood swings — so there are sessions on managing stress and combating food cravings.

Mental wellbeing is very important so the courses cover the “Five Ways to Wellbeing”, too. It’s all about making lifestyle changes and feeling in control.

smoothie bikeAs well as the taught elements, there are plenty of opportunities for discussion — because we know from experience that sharing experiences and worries as a group really helps people to make positive changes. Like all of our work, these courses include a lot of client-led planning and support.

We can also help people to access further healthy activities if they want to (and they often do, once they start making changes!). We can even bring some fun healthy activities into the workplace, like the Smoothie Bike.

By looking ahead and focusing on behaviour change, Gateway smoking cessation courses build resilience and make sure people who want to give up smoking are as prepared as they can be when they finally quit. Statistics show that being prepared and following “stages” not only helps people to stop but, more importantly, helps the changes to stick.

If you’d like to support your employees to stop smoking, give Jemma Abbott at Gateway a call on 0121 456 7820 and ask about smoking cessation. We look forward to helping you create a healthier workplace!

smartphone

Going digital to extend healthy benefits

Over the last year, we’ve started encouraging people to use a digital app to stay in touch after their health and wellbeing courses end.

WhatsApp App - Zoom by Christoph ScholzBecause so many people on our 12 week Lighten Up For Life course were telling us they wanted to keep in contact with each other, we decided to make it part of the process. Now, when the 12 weeks are up, if people are interested, we help them to create a group chat, using the popular messaging service WhatsApp.

We’ve found that this doesn’t just help people to sustain the behavioural changes they’ve made over the time they’ve been doing the course – there’s also an important social aspect. Lots of people told us they enjoyed the social side of the meetings, including some who said this was the only social interaction they’d had in a while, so WhatsApp helps people to develop and extend these social relationships. It also allows us to extend the intervention for slightly longer, and to wind down support rather than ending it abruptly when the 12 weeks are up.

Health and Wellbeing Facilitator Beckie says, “we now have groups from courses we’ve run at Bosworth and Crabtree Hall using WhatsApp. They use it to inform each other of their progress, any issues they’ve had, recipe ideas, and generally to see how each other are and share ideas.”

It also seems to increase the likelihood of people doing further healthy activities. We think this is because they now have an ongoing peer support group based around a common interest.

Gateway Health and Wellbeing teamBeckie (pictured second from left) says, “five people who were on a course together at Bosworth have now joined a local ‘sitting yoga’ exercise group – none of them were doing an activity before but now they all attend this together. Another lady who attended one of our first 12 week courses has now set up a healthy eating and meditation group of her own. She said she wouldn’t have had the confidence or knowledge to do something like this if it hadn’t been for our group.”

Like everything we do at Gateway, this initiative came from – and has been led by – the people we work with. Course participants told us they wanted to keep in touch, so we helped them to make it happen. We decided on WhatsApp because many people already use it and if they don’t, it’s free to set up and simple to use. Our Health and Wellbeing Facilitators help people to install the app on their phones, then stay in the WhatsApp group for a short time after the course has ended, answering questions and giving encouragement. Eventually, we phase out our input and the group continues on its own.

Out of interest, we have found WhatsApp groups to be more successful and longer-lasting than Facebook groups. This is reflected in this study from 2015, which found that WhatsApp groups successfully helped people who were trying to stop smoking. Researchers theorised that Whatsapp has fewer distractions than Facebook, and that digital interventions like this work better when people can only use it on their phones.

Having seen the benefits, we are now expanding the idea, and staff in all our services that have a social aspect – including Five Ways to Wellbeing courses, the Maternity Voices Partnership, Patient Health Forums, and Peer Educators – now give people the option of joining a group chat if they want to.

Gateway Health and Wellbeing team

Local businesses get a taste of new Workplace Wellbeing services

Margaret, Jemma and Reshma with the Smoothie BikeOn 19th July, we officially launched our Workplace Wellbeing services with a free Workplace Health Taster Day.

The hospitality suite at the Chamber of Commerce building became a “health centre” for the day, with free activities including blood pressure and BMI checks (with personalised advice based on the results), an introduction to Tai Chi, impairment goggles that highlight the effects of alcohol, and even a smoothie bike, creating pedal-powered healthy drinks!

Marri on a smoothie bike
Finance Administrator Marri pedalled for his smoothie in record time!

Representatives from more than 60 local employers — including most of the organisations based at the Chamber building, Morrisons supermarket, Newman University and the Chamber itself — came along. They received a range of free support and advice from our experienced health professionals, with many choosing to pop back throughout the day to get involved in as many different activities as possible.

For these employers and employees, the Taster Day was a chance to find out how small health changes and preventative checks could have a big impact on working life.

Educating and supporting staff to actively manage their wellbeing has been shown to reduce absences and sickness levels, and to improve staff retention, motivation and productivity. Our Health and Wellbeing Facilitators gave BMI and blood pressure checks, which can be a really important indicator of wider issues or underlying health problems. Activities like the smoothie bike and the impairment goggles are fun, but they also provoke some really interesting conversations about health and the impact of good and bad habits, which our Behaviour Change Advisers were on hand to facilitate.

A training opportunity for us

As well as promoting our Workplace Wellbeing services, and testing our expanded offer, the Taster Day was really useful for our staff to gain more experience working with people from the corporate sector. Although our Health and Wellbeing Facilitators have worked with thousands of individuals in local communities over the years, supporting people in the workplace is slightly different, so we’re keen to make sure our delivery of these new packages runs as smoothly as possible.

Attendees receive an introduction to Tai Chi
Attendees receive an introduction to Tai Chi
For example, time is much more of a factor when people have been sent by an employer to get a health check within work time, or are visiting in their lunch hour – but our Facilitators quickly got used to the time restrictions at the event. Thanks to their years of previous experience, they were able to complete the mini consultations efficiently, and to spot where the focus of their advice for each person needed to be almost immediately, whilst maintaining their friendly, personal approach.

Because people are referred to our Workplace Wellbeing services by their employer rather than their doctor, these corporate health interventions also have a very slightly different focus. Although Gateway staff still take a “whole person” approach, and work one-to-one with the individual to get a picture of their health, conversations about work need to come to the forefront, and all the advice is given in the context of the workplace.

Ready to work with workplaces

It was wonderful to see how well our staff worked together to create a fun but informative event, and we’d like to thank everyone that came along and helped us create such a buzzing atmosphere. Visitors told us they were inspired by what they’d learned, and were going back to work feeling motivated, which was great to hear! But not only did we have lots of fun, we’ll be able to use what we learned on the day to make future Workplace Wellbeing services even more useful.

If you’d like to find out more about Gateway Workplace Wellbeing packages, or to run a similar event at your workplace, take a look at our Workplace Wellbeing pages or give Jemma or Keith a call on 0121 456 7820.

Gateway’s donations “pad out” foodbank donations campaign

We were horrified to read recent research showing that one in ten girls aged 14-21 have been unable to afford sanitary products. So when we heard about the Birmingham Live “#BrumFeeds” campaign, we knew straight away how we wanted to help.

#BrumFeeds aimed to collect 100 tonnes of food for Trussell Trust foodbanks, by holding the biggest single food donation the city has ever seen. Last Friday, people were encouraged to donate at three city centre locations for “The Big Drop”.

Caroline and Debbie donate to BrumFeeds Big DropAt Gateway, we decided that our contribution should focus on sanitary products. After all, we know that people don’t usually give as many toiletries as they do tins of beans! So office staff held a donation drive in our office, and on Friday we donated hundreds of tampons and sanitary towels to the #BrumFeeds collection point in Victoria Square. You can watch Caroline and Debbie dropping them off in the video below.

We always knew Brummies were a generous lot, but we were pleased to see how many people donated to the campaign. Birmingham Live reported that over a tonne of donations were made in just a few hours! We hope that our donation helped a little bit, and perhaps even raised people’s awareness of the problem of period poverty.

What is Period Poverty?

Put simply, period poverty is the problem of being unable to afford sanitary products.

A January 2018 report from Plan International UK says, “Period poverty has previously been seen as an external issue affecting lower income countries. However, in the context of austerity and the rise of homelessness and foodbank use, combined with a lack of supportive and accessible menstrual health management education, it is also being experienced here in the UK.”

Plan International UK’s survey on menstruation found that one in 10 (10%) of girls have been unable to afford sanitary products. It also found that:

  • One in seven girls (15%) have also struggled to afford sanitary wear.
  • One in seven girls (14%) have had to ask to borrow sanitary wear from a friend due to affordability issues.
  • More than one in ten girls (12%) has had to improvise sanitary wear due to affordability issues.
  • One in five (19%) of girls have changed to a less suitable sanitary product due to cost.

In “I, Daniel Blake”, Katie is caught shoplifting sanitary products. Last year, Rightinfo.org reported that donations of sanitary products to foodbanks increased after the film’s release.
At Gateway, many of the people we work with are living with disadvantage. We know from our experiences with the Pregnancy Outreach Workers Service, and our current social prescribing service Healthy Futures, that women who are facing financial constraints will often go without themselves, so that their families can have food.

We fully support the efforts of charities like The Red Box Project, The Homeless Period and Bloody Good Period to try and dispel some of the myths and embarrassment surrounding periods, and to make tampons, towels and other related toiletries more accessible to everyone who needs them.

Why donate sanitary items to foodbanks?

We often refer people to Trussell Trust foodbanks, and we have our own small bank of food and toiletries for emergencies, but we know from experience that sanitary products are just not something people normally give when they donate to foodbanks.

Indeed, Trussell Trust includes sanitary products in its list of non-food donation items, saying “It’s natural that the first thing anyone thinks to donate to a foodbank is food, but toiletries and hygiene products are also extremely important. Alongside the standard food parcel, foodbanks try to provide […] essential non-food items to adults and children in crisis, helping them maintain dignity and feel human again.”

(“I, Daniel Blake” screenshot: IFC films via rightsinfo.org)

Lighten Up For Life logo

Lighten Up for Summer!

Our weight management course with a difference, Lighten Up For Life, is currently recruiting for May – so if you live in Solihull, have a BMI over 30, and would like some specialist help… read on!

Like other weight management groups, Lighten Up For Life helps people to lose weight by providing a support group with information and regular weigh-ins. But there are some big differences too. For a start: it’s FREE!

preparing healthy pizza at practical session
Session 8 is a practical session – preparing healthy pizza

Unlike many other groups, Lighten Up For Life provides support from a team of professional health specialists, including qualified Health Trainers, a Dietitian and a Behaviour Change Specialist who has formal training in health psychology.

The 12 Lighten Up For Life sessions include physical activities tailored for each group, ways to manage stress, tips about cooking healthy food on a budget, and even help to get your family on board. We welcome partners and family members at the sessions, because if they understand what changes you’re making and why, you’ll be more likely to stick to new routines. (And yes, it’s free for them too!)

Although Lighten Up For Life offers brilliant peer support, and you may even make some lifelong friends, this isn’t a club you’ll be going back to again and again. So in these 12 weeks, we’ll arm you with all the information, tools and support you need to make sure you and your family can continue to live more healthily in the long term.

Successes so far

First LUFL group with their completion certificates
The first group with their completion certificates

Our first Lighten Up For Life groups started in January, and last week our very first group finished their 12 week course. Crucially, all of them say they’re confident that the changes they’ve made over the last three months are lifelong changes.

Group members have told us they feel more optimistic and more knowledgeable about leading a sustainable healthy lifestyle now, and that they’re more active than they had been before – even those who have been to other commercial weight loss groups in the past. We’re really proud of them!

Not only do they all have a greater understanding of government guidelines and how to implement them in their own lives, but they’ve got hands-on, practical knowledge too. Everyone in the group has been able to try new healthy alternatives to favourite treats, and everyone is sharing the information they have learnt with their families. Several members had brought their partners along for at least some of the sessions, and they also lost weight, which is really great to hear.

They’ve also made special mention of the social aspect of the group, so we’ve helped them to set up a WhatsApp group to continue this peer support, and we’ll be in touch in a few months’ time to see how they’re getting on.

Lighten Up For Life is a free 12 week programme, funded by Solihull Metropolitan Borough Council. The next groups are recruiting now and sessions will be at Bosworth Community Centre in Chelmsley Wood. If you’d like to join, call 0121 456 7820 and ask about the Lighten Up For Life 12 week course to find out if you are eligible.

New year, new service: Lighten Up For Life!

The new year will see us launching a new service for people in Solihull: the Lighten Up For Life weight management group.

Lighten Up for Life has been designed as an extension of the Solihull Lighten Up service (SLU), which we’ve been running for a while. SLU supports people in a number of ways, but a very popular option is a weight management group, so we’ve used our in-house specialists – and over a decade of experience – to design a weight management group with a difference.

The free 12 week programme is funded by Solihull Metropolitan Borough Council and sessions will run at two venues (to begin with) in Chelmsley Wood.

The main difference between Lighten Up For Life and other groups is that this is intended to be a distinct 12 week course, rather than a group that people will continue to go to indefinitely. That’s because we believe weight loss should be a sustained, behavioural lifestyle change. By the end of 12 weeks, we hope the people who attend Lighten Up For Life won’t only have lost weight, but will have made the changes required to keep the weight off. We don’t want the people we work with to be attending weight management groups forever – we want to give them the tools they need to make the changes themselves. For life.

Over the last ten years, Gateway has helped thousands of people to lose weight and keep it off, through services like Health Trainers. The Lighten Up For Life team includes para-professional Health Promoters who have been helping people to make sustained lifestyle changes for many years, as well as an experienced Dietitian, and a Behaviour Change Adviser who is a trainee health psychologist.

And, unlike some other weight management groups, Lighten Up For Life isn’t just about diet. The 12 sessions will include physical activities, ways to manage stress, tips about “food and mood”, and the type of social peer support that we know from experience really helps everyone in a group.

We’re really looking forward to delivering the Lighten Up For Life course and we’re delighted that so many people have already signed up for the first sessions in January. If you’d like to join them, call 0121 456 7820 and ask for Lighten Up For Life to find out if you are eligible.

Services close… but people still need help

Every week, our office receives phone calls and emails from people who need help. Sadly, as some of our services – and others around us – are withdrawn, we are finding it harder and harder to offer appropriate support.

We thought it would be interesting to write about the sorts of calls and messages we receive, and share what we do when we can’t help directly.

Reg

Reg* phoned Gateway asking for someone who hasn’t worked here for nearly three years! After some confusion, he explained that he’s just come home from hospital and is recovering from heart surgery. At some point he’d picked up a leaflet for Gateway’s Volunteer Befriender service so he was phoning Gateway to see if he could get some support from a Befriender… not realising that the service closed two years ago after funding ended.

He told us, “I just want someone to talk to, really, on the bad days. I’ve been feeling down recently and I don’t have anyone I can just phone to just have a chat about everything.”

We explained to Reg that we are no longer able to offer a befriending service. We took a guess that he is over 50, and suggested that he contact Age UK, who do have befrienders (although there is a charge for the service), and he said he would look into it. He also said he had a rehab appointment at the hospital later that week and would ask them if they could recommend anything.

Aliyah

Aliyah* phoned wanting to know if she could get a Health Trainer. She’d been told about the service by her GP, and had found Gateway after a web search.

We explained that the service had closed, and she was very understanding, but disappointed. She said, “I’ve been suffering from depression and anxiety for a while, and I’ve put a lot of weight on recently. I want to sort myself out but I feel like I need some support. I’m on ESA so I can’t afford to pay for anything privately.”

A Health Trainer would have been perfect for Aliyah. Unfortunately, all we could do was suggest she go back to her GP.

Sarah

Over the weekend, Sarah* left a comment on a blog post we published about three years ago, when some of our Pregnancy Outreach Workers were seconded as Support Workers to the council’s Temporary Accommodation team. Her comment said, “Hi please is it possible for you to help me and my two children (age under 5). We have been in temporary accommodation in a hotel for three months now and the council can’t offer any help.”

We didn’t publish the comment, but instead contacted Sarah directly. The only contact information she left was an email address, so a POW co-ordinator emailed her first thing on Monday morning with some advice, including links to Shelter, who offer specialist advice and legal support.

How many more?

Phonecalls and messages like this only go to show that the gaps we covered, and the needs we used to meet, are still there. And we have to wonder: how many more people are in need, but unable to get support from anywhere? If we are getting calls like this every week, how many more people are out there needing help and not knowing who to call or where to go?

Reg might be able to get support from an Age UK befriender, but many others wouldn’t even think to ask.

And we are frustrated to have to point Aliyah back to her GP, knowing how busy GPs are. It’s not a clinical intervention she needs; it’s someone who can spend an hour or two with her to chat through her current lifestyle habits and give her a bit of moral support and encouragement. Someone who’ll help her start a food diary, suggest some physical activity suited to her abilities, and come up with a motivational action plan. Someone like… a Health Trainer!

Sarah might have received help from a Temporary Accommodation Support Worker when our POWS were seconded there in the past – although in this case it sounds like she’d already been in touch with the Council and they have been unable to help. Now, all we can do is contact her to tell her that we no longer do this work, signpost her to Shelter, and hope that she receives the email.

So what can we do?

We’ve always prided ourselves on our ability to fill gaps. Although we’re finding it increasingly difficult, it’s what we’ll always try and do.

Many people contact us via the blog after a web search, not realising that the posts were published years ago and the information is out of date. So we’ve added messages to the most popular and relevant blog posts, pointing out that they are reading an old story, and linking to a new Further help and advice page. It covers the most popular topics (housing, safeguarding, befriending and pregnancy) and we’ve tried to make it helpful without overwhelming people with information.

We also keep a directory of services on hand in the office, so that we can try and signpost people who ring us, and we keep in contact with as many other services as possible to make sure it’s up to date.

Keeping ourselves informed is still really important. Having recently started some new work delivering courses, including “5 Ways To Wellbeing”, we are making new contacts, as well as updating what we already know. Everyone at Gateway shares information across the organisation – when we meet with organisations who are new to us, or find out something new, we come back and share it with everyone.

And, despite temptation, we’ve resisted automating our phone system. Instead, we endeavour to answer every call personally. Anyone who phones the office during working hours will speak to a member of staff, who will do their best to help, whatever the question or issue.

All of this doesn’t really add up to the solution we’d like – there are still many gaps, and we’d rather be able to help people ourselves – but it’s better than nothing.

By removing preventative services, the risk is that people’s problems will get much worse before they are able to get the support they need – which of course costs the NHS and the city even more.

And that’s really frustrating.

*names have been changed

New Early Years service may create gaps

Over the next few months, the dedicated Pregnancy Outreach Workers Service (POWS) will be closing. POWS is to be consumed into Birmingham’s new Early Years Health and Wellbeing service, which is a partnership led by Birmingham Community Healthcare NHS Foundation Trust (BCHC), so our POWs will be transferring to new roles with BCHC’s partners Barnardo’s, Spurgeons Children’s Charity, St Paul’s Community Development Trust and Springfield Project.

But what about the gaps?

We’re pleased our POWs will be able to continue to make use of their extensive knowledge and specialist skills, and that Public Health has recognised that this group of vulnerable women exist and need support. But POWS will no longer be an identifiable service, and I’m worried this will leave gaps.

Photo: nikoretro on Flickr (CC BY-SA 2.0)

As yet, there is little information about how exactly mums and mums-to-be who are at risk will be looked after under the broader Early Years service.

Details of the new model of service often refer to “children and families,” but not to pregnant women specifically. Will pregnant women still receive dedicated support from an early stage of pregnancy? And when a child is taken into care, will the mother continue to receive direct, one-to-one support?

We have asked for reassurance, and have received some further comments from Commissioners, but the information is still sparse. In my opinion there is a potential for gaps here which could, over time, become problematic.

Timeliness

At the moment, POWS offers intervention from as soon as a woman knows she’s pregnant. Often, a POW will get involved at 14 or 16 weeks – sometimes as early as ten – and the earlier we get there, the more we can do. Once the POW receives the woman’s contact details, she’ll be in touch within 48 hours.

These early weeks, while the baby is in the initial stages of development, are always vital, but even more so when a woman has complex needs. Amongst many other things, POWs can help women stop drug use or smoking, ensure she’s eating (and eating the right things), identify suitable accommodation, and make sure she is engaging with midwifery services and attending appointments.

Commissioners have told us: “The health visitors within the new service will receive referrals from midwifery in line with need. Where the woman is vulnerable or has additional needs this will be before 26 weeks.”

The earliest time mentioned in the documentation we have seen is 20 weeks, more than halfway through pregnancy.

Dedicated time, responsiveness and intensity of support

The information we have about the new model talks about an initial visit, and then a second visit. We know this isn’t enough for women with complex needs. Much of a POWs’ work is unpredictable and can include a lot of one-to-one crisis management. For example: taking women to appointments, providing phone and text message support at any time, supporting homeless women to ring round the Housing department and hostels, helping women to remove themselves from domestic abuse and taking them to a safe place, and providing support during mental health crises, including out-of-hours chats and accompanying women to get support from the Community Psychiatric team.

When we raised this with Commissioners, we were told: “The new integrated service will be able to meet needs of the type you set out. There will be the integration with other services across the city ensuring that the service responds at the right time and in the right way, especially as you say in situations of homelessness and DV. The single cross service record will provide assurance on the services and level of engagement of an individual which will also assist the service in supporting women through their pregnancies.”

What we’re not clear about is who will be providing this support. We’re not clear if women will have the chance to build a one-to-one relationship with a support worker who can help her to navigate through services, provide a single point of contact with regular phonecalls/texts and visits, and provide moral support.

Child Protection Plans

The potential gap that troubles us the most is safeguarding. When a child is taken into care, who is there for mum?

Women with a safeguarding need make up about 20% (80-90) of the women POWS support annually, with about 50 of these needing intensive support – between half a day and a day a week. Where a woman is facing the removal of her baby, the POW is often pivotal: ensuring mum understands what is being said, and being on hand to make sure she takes the necessary action in relation to the Child Protection Plan.

But, again, we’re not sure who will provide this support in the new model.

Commissioners told us: “The provision of support to enable parents to develop the skills they need to parent well and the provision of step down services for those who are in the social care system are important elements of the new model.

“Within the new model no specific timeframes have been set for support to this group, it is our expectation that support is provided in line with need. This flexibility will help to build upon the approach currently operated within the POWS service.

“The new model is health visitor led with the health visitors identifying and brokering support for children and families in line with need.”

But will it provide intensive support for mum? I would really like to be reassured that women will get the continuity, trust and flexibility that they need in these circumstances.

REASSURANCE

I feel like Commissioners have given us the opportunity to have our say. I’ve filled in impact assessment forms with input from the POWs, and when I’ve raised my concerns I’ve been invited to say where the gaps are.

But I’m just not convinced we’re being listened to or understood. Although I’ve received responses, they feel flimsy. I don’t feel they’ve been detailed enough to provide me with reassurance, and this leaves me worried.

I really hope the new service will prove me wrong.

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.

 

If you are affected by the issues in this story, please click here to see a list of links and phone numbers that might be able to help.

*Fatima’s name has been changed