Author: Katherine Hewitt

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

Health Trainers closure: reflecting on success

Gateway’s Health Trainers service, offering one-to-one support and advice to people who want to make lifestyle changes, will be closing at the end of September.

Health Trainer Wayne pictured at our Family Health and Wellbeing Day
Last week, we looked at some of the numbers and showed how successful the service has been during almost a decade of operation. Gateway Health Trainers supported more than 18,000 people over the years, with more than 90% of people completing their support, and 84% of those achieving or part-achieving their goals.

This week, we thought we’d share some more personal stories, both from the Health Trainers themselves and the people they’ve supported.

Beckie is moving over to work for Gateway’s Pre-Diabetes team, but here she reflects on her year as a Health Trainer and tells us about one of her most memorable clients during that time.

Ralph came to the Health Trainers from the Lighten Up service. Here, he tells us what he has found most satisfying about being a Health Trainer. Sometimes, the successes aren’t as obvious as you think!

Contrary to popular belief, the Health Trainers service wasn’t just about weight loss or physical activity (although of course they helped people with that too!) Many people reported improved mental health and wellbeing, reduced their alcohol intake, or became less socially isolated thanks to their Health Trainer.

Wayne (pictured above at our Health and Wellbeing Day in July) told us how one of his clients came in for help with her weight management, but went on to make many other changes.

“Once she’d made the decision to lose some weight, it felt easier for her to make other changes in her life too,” he says. “One of those things was smoking. She knew she had wanted to stop smoking for a while – especially after one of her grandchildren made a comment about it, saying ‘nanny, you don’t smell very nice’, so the next time she came to see me, she asked about smoking cessation services and I was able to refer her straight away to a stop smoking clinic. A lot of people think it’s really difficult to stop smoking without putting on weight, but because she’d made the decision to change, and made the changes in tandem, she found it a lot easier than she thought.”

Health Trainers pictured in 2016. Margaret is on the far left.
Health Trainer Margaret (left) told us about one of her clients, who was referred for weight loss, but whose issues went a bit deeper than that. “She rarely left the house,” says Margaret, “so she wasn’t doing any physical activity at all. She also had a diagnosed Obsessive Compulsive Disorder which meant that she had a lot of discomfort around eating. She hated certain foods because of her phobia of crumbs and dirt, and didn’t eat any fruit or vegetables.

“So I supported her by taking things really steady and helping her to mentally prepare for the changes to meals. First we substituted just one item of food at a time in each meal for a piece of fruit or veg. Then we started getting her out of the house, for just two or three minutes a day. And she really worked hard. Every time I met her she was going out for longer and longer periods of time and eating more and more healthy foods.

“By the end of the support, she had already lost a stone and a half, and was walking down the road to meet me in different locations. I’m so proud of her! And it’s so rewarding for me, too. I have really loved this job.”

As you can see, the service means a lot to staff and their clients. We hope that, in a future without Health Trainers, people will continue to get the support they need.

End of an era: a celebration of the Health Trainers service

It’s a sad time for Gateway, as funding from Birmingham Public Health comes to an end for one of our longest-running services.

Gateway Health Trainers, pictured in 2011. Wayne (back row, left), Hana (front row, left) and Richard (front row, centre) are still with the service

The popular Health Trainers service, offering one-to-one support and advice to people who want to make lifestyle changes, has been decommissioned and will finish at the end of September.

All our Health Trainers are now working hard to finalise arrangements with their remaining clients and get everyone to a place where they feel they have achieved at least some of their goals.

Although it’s a sad time for us, it’s also bittersweet, as we reflect upon the Health Trainers’ many successes and achievements. So we thought this would be a good opportunity to have a look back at the service and share some of the stories and statistics with you.

The Health Trainers service was started in 2008. By the time the funding ends, we will have worked with more than 18,000 South Birmingham residents, with more than 90% completing their support.

Over the last two years, the service has changed very slightly. Rather than focusing our support in the most deprived areas of Birmingham, we now focus on people with a level of vulnerability. This can include recent offenders, people with substance misuse, people who have experienced domestic abuse, or mental ill health, and people who are in temporary accommodation. More than a third of the 2000 people we work with every year are in this group.

When a Health Trainer starts working with someone new, they help them to come up with a set of achievable goals to work towards. These often include losing weight and becoming more physically active, but they also include stopping smoking, or even becoming more confident and socially active.

Over the last decade, Gateway’s Health Trainers helped people to achieve, or part-achieve, the goals they set themselves in 84% of cases. For example:

  • Physical activity: 91% of the people we worked with needed to increase their levels of physical activity, and 85% did
  • Nutrition: Of those who were eating less than the recommended level of fruit and veg, 52% of those classed as “low” and 60% of those classed as “very low” resolved the risk
  • Alcohol: 45% of those who had a risk relating to drinking more than the recommended level of alcohol resolved that risk
  • Mental health: More than two-thirds saw an improvement in their mental wellbeing, according to WEMWBS measurements at the beginning and end of support

Dr. Asfia Aftab is a GP Partner at Vicarage Road Surgery, one of the GP surgeries that Gateway Health Trainers worked with. When told about the end of the service, she said, “I am sad to hear this news. As you know, we had a great experience with Health Trainer services for our patients in Kings Heath and say they were a very valuable part of the primary care services we provided. We had a lot of great anecdotal feedback from patients.”

As Josh explains, below, Health Trainers is a “whole person” service and one of the biggest benefits of the service has been the ability to offer people time. Time to build up a rapport, learn as much as possible about a person, and really talk things through.

Josh came to Gateway after completing a degree in Psychology; first as a volunteer, and then as a Health Trainer. He has used the skills and knowledge gained as part of his degree to back up his work with Gateway, helping people to make significant lifestyle and behavioural changes.

Become our new Chair

THE APPLICATION DEADLINE FOR THIS VACANCY HAS PASSED

We’re looking for a new Chair to join and lead our established Board.  Over the past 11 years we have carved a strong reputation for the design and delivery of health and social care services. Equally we have gained a wealth of experience in a variety of fields and we have the ability to provide work that is, effective, high quality and cost effective. 

We need to grow and are looking for a person who can help us identify and secure new opportunities.  Also we are looking to raise our profile so we would like help to navigate us into advantageous new networks and forums. 

Knowledge of social enterprise or the wider not for profit sector would also be advantageous along with previous experience of being part of a Board.

This is a voluntary role.

Might you be interested?  If so please have a look at the information below.  There’s a full advert and then a Role Description.

If you’re not sure if the role would be for you, or if you have questions, our current Chair is available for a chat.  Further details of this and how to apply are in the advert. PLEASE NOTE: THE APPLICATION DEADLINE FOR THIS VACANCY HAS PASSED

Advert Aug 17

Chair Role Description  

 

Health Trainers: experts who add value

Could your organisation benefit from Gateway Health Trainers’ expertise?

The Health Trainers service can now be tailored to the needs of a specific group or organisation, and commissioned directly. As well as traditional one-to-one support, Health Trainers now design and lead flexible wellbeing programmes for groups in a range of settings. If you are looking for creative ways to motivate your workforce or client base, a Health Trainer could be just the ticket.

Health Trainer group at the Signing Tree
Health Trainer Richard (top row, 3rd from left) with interpreters and clients at the Signing Tree, where we have been working with BID Services to run a signed Health Trainer group.

After all, Health Trainers aren’t just about physical exercise and healthy eating; they offer preventative health advice and encouragement that changes people’s lives.

As well as weight management advice, Health Trainers help people to learn how to budget and how to cook. They help people who smoke, or are at risk of diabetes or high blood pressure, to reduce their risk in the long term. They help people to become more confident and more socially active, as well as offering practical help with things like housing, benefits, and finances.

Over 40% of the people we worked with last year have both physical and mental health needs. We understand healthy living goes hand in hand with good mental health, so our Health Trainers know what to do and who to involve to reach that balance.

We also know there are strong links between good health and wellbeing, and employment. Over the last decade we’ve supported many people back into work by helping them to reduce their anxiety and build their resilience. For those already in work, support from a Health Trainer can help to build confidence, lower sickness rates and raise morale.

Could this kind of support help your organisation too?

Over the last year, Gateway Health Trainers have worked not just alongside GPs in their surgeries, but with an increasing number of local organisations including Jobcentres, Cerebral Palsy Midlands, the Signing Tree and Better Pathways. Health Trainers’ tried and tested methods can be tailored to add value to all kinds of other services. Give us a ring on 0121 456 7820 to find out more.

Case Study: Better Pathways

Better Pathways (formerly BITA Pathways) is a mental health charity in Birmingham which specialises in offering training and work opportunities for adults with mental health problems. Gateway Health Trainer Wayne (pictured) got in touch with Michael Summers, a Recovery and Employment Adviser, to create a six-week Health Trainer package for service users at Better Pathways, supplementing the great work they already do around mental health recovery and employability.

Health Trainer Wayne pictured at the Gateway Family Health and Wellbeing Day

The first thing Wayne did with the ten people who were referred into the sessions was to get everyone to start a food diary.

“It’s one of the easiest things you can do to kick-start a healthy lifestyle change, and yet it’s one of the most eye-opening,” explained Wayne. “It helps us to start to see patterns, and from there you can start making really simple changes.”

Mohammed’s diary showed that he rarely ate fresh food, but ate microwave meals twice a day. Together, he and Wayne looked at the food labels of some of his regular meals and Wayne pointed out the high levels of salt he was consuming. Mohammed started replacing some of the ready-meals with fresh fruit and veg, and managed to cut his intake to just two microwave meals a week. It’s a simple change, but it’s likely to drastically reduce his risk of having a stroke or a heart attack.

Dale was eating a lot of snacks throughout the day – and his food diary helped him to notice just how many! Thanks to the food diary and the weekly sessions with Wayne, he found it a lot easier than he thought he would to stop buying them, and put temptation out of his way. Not only is he losing weight as a result, but he’s saving so much money, he’s decided to save up for a bike!

As well as healthy eating advice, which included some fun, hands-on cookery sessions, Wayne offered one-to-one advice for everyone who came on the course. He also helped Better Pathways to set up a walking group for service users, which now meets every Friday for a sociable half-hour walk round the park – another simple lifestyle change that impacts mental wellbeing as well as physical health.

The positive social element of the Health Trainer support was a nice surprise for many of the participants – who started arriving earlier and earlier each week just to have a natter and a cup of tea, and continue to walk together regularly. But the biggest change was weight loss, with all ten clients losing weight as a direct result of the course. As a group, they lost a total of 5 stone 3 pounds (33kg)!

Michael, a Recovery and Employment Adviser at Better Pathways, says, “we believe that healthy living goes hand in hand with healthy mental health, so having the service with us was a huge benefit to our clients. All of them reported benefits such as weight loss, healthy eating, and knowing how to cook.”

You can hear more from Michael in the video below.

Wayne says, “it’s been really rewarding to see people make such big changes in just six weeks. I’m really proud of everyone I’ve worked with at Better Pathways. Not only have people lost weight – and they’ve lost a lot of weight! – they’ve gained confidence and made new friends. It just shows, no matter where you are in life and what your abilities are, a lot can happen if you have the right support.”

If you would like to talk about working with Gateway to deliver a Health Trainer service at your organisation or workplace, please contact Jemma Abbott on 0121 456 7820.

A note – and a message for GPs

Our funding from Birmingham Public Health comes to an end in September, when the Health Trainers service will be decommissioned. We’re continuing to support everyone who’s already been referred into the service, but after the end of September we will no longer be running the service in the same way.

Some of Gateway’s Health Trainers, past and present

The numbers show that Health Trainers has been a popular and successful service. By the time the funding ends, we will have worked with more than 18,000 South Birmingham residents, 85% of whom were referred by their GP or another member of practice staff. Health Trainers have assisted people to achieve or part-achieve the goals they set themselves in 84% of cases.

We’d like to express our gratitude to GPs for the way they’ve worked with us and supported our Health Trainers over the years. Many GPs hosted a Health Trainer in their surgeries and our Health Trainers tell us they really appreciate the way the GP Practices made them feel part of the team. Thank you for making them feel so welcome and valued.

We’re very keen to continue providing Health Trainer support to surgeries, as well as to other agencies and organisations, which is why we’ve come up with a cost-effective, flexible package for GPs. If you’re a GP or Practice Manager, please contact us to find out more about how we can continue our partnership.

POWS: so much more than pregnancy outreach

When you hear “Pregnancy Outreach Work”, what do you think of? Breastfeeding education, perhaps? Blood pressure checks, or birth plans?

The truth is, the women we work with need much, much more than this. The risks our Pregnancy Outreach Workers Service (POWS) clients have include:

  • substance misuse
  • domestic abuse
  • safeguarding
  • mental ill health
  • housing and homelessness
  • issues linked to being a recent arrival to the UK
  • other issues linked to financial hardship

The Pregnancy Outreach Workers Service (POWS) provides crucial extra, early interventions needed to support women with these issues – often because no-one else can.

POWs are able to work with woman from a very early stage of pregnancy; often from as early as 10 weeks. Take away POWS, and the standard maternity pathway means no extra support until the Health Visitor gets involved at 26-28 weeks.

We can do this because of our close relationship with midwives, who alert us to women who would benefit from an early intervention. It means that we can start to tackle – and often resolve – issues as soon as possible, reducing risks that might otherwise have affected the unborn child.

As well as filling this gap, POWs work alongside many other services, including Housing Officers, Midwives, FNPs, Social Workers and the emergency services, to create a “wraparound” support service for families. And we do so in an efficient, cost-effective way.

Housing

More than two thirds of our clients have a housing risk. Around 47% are in temporary accommodation (eg living on a friend’s sofa, or in a B&B or hostel) and another 21% are in accommodation that, although more stable, is completely unsuitable for bringing up a baby (access issues, no power, problems with damp or rodents, etc).

POWS help women to access the support they need, including helping them to understand systems and processes, to access and fill in forms, to make homelessness and housing benefit applications, to bid on properties, and to furnish social letting properties (which are usually let without curtains, carpets or any furniture or white goods).

Importantly, POWS support also enables other services and agencies to do their jobs more efficiently. Having a POW on hand to offer social, emotional and practical support means that a Housing Officer, for example, can concentrate solely on their remit: finding a tenant suitable accommodation. POWS also save time for Housing Officers further down the line, because those who receive our support are more likely to understand how to sustain their tenancy. Together, we create a more efficient and less costly system.

Mental health

Nearly two-thirds (65%) of the women supported by POWS have a mental health need, but many would not have any support if it wasn’t for POWS.

All sorts of mental health problems, including “low level” depression and anxiety, can begin or escalate when a woman is pregnant or in her child’s first year. But with the right social support, many mental health risks can be reduced.

For women with a diagnosed mental health condition they’re struggling to control (medically “high risk”), POWS offer practical support, including help to manage medication and attend appointments. However, many of the women we see are medically “low risk”, with low reported wellbeing, or high levels of anxiety. Because they don’t meet the criteria of a clinically diagnosed mental health condition, they don’t qualify for extra support from other services. For these women, the one-to-one support a POW gives is vital, and has been proven to help.

We use the nationally-recognised DASS (Depression Anxiety and Stress Scales) to measure our impact and 50% of the women we worked with in the last year have seen an improvement in their DASS score as a result of support.

What’s more, a clinical study by researchers at the University of Birmingham, published last year, showed that the intervention of a POW was “beneficial in preventing postnatal depression in women with two or more social risk factors”.

Safeguarding

Most of the safeguarding advice for new mothers is based around the child. Of course, the safety of the child is paramount, but children aren’t the only people who need protection and support.

Collecting food and toiletries for our “baby bank”

So while social services and midwives are focusing on the child, our focus is on mum.

Just over a quarter of the women POWS support officially meet the threshold of “vulnerable adult”. Around a third of our clients have a child protection plan in place for the unborn baby. Often, we’re looking at a “double whammy”: a vulnerable adult with a protection plan in place for her unborn child.

If mum leads a chaotic lifestyle, with intermittent or no support from family or friends, then working on her own to build up the sorts of routines and networks that she will need as a parent – and that social workers and family courts will approve of – can be virtually impossible.

With a POW, however, there’s hope.

Not only will the POW work one-to-one with mum to come up with an action plan, helping her to tackle issues in a methodical way and providing her with important contacts, but she will also liaise with social workers and other services to ensure that they are aware of the changes being made.

In this way, mum is supported to be the best possible parent she can be, and mum and baby have a better chance of staying together.

This isn’t just a better outcome for mum and baby – it’s cost-efficient, too. The approximate cost of removing a child and caring for them in the foster system runs into tens of thousands of pounds.

Put simply: POWS solve issues and save money.

Chloe’s story

Chloe (not her real name) is a great example of the ways in which POWS can step in to break the cycle and stop someone slipping through the cracks. When we met Chloe, her two children had been taken into care and she had just found out she was pregnant again. She was deeply unhappy with her situation and desperate for things to change, but didn’t know where to start. Chloe has been brave enough to talk about what happened next.

 

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.