Author: Vicki Fitzgerald

Goodbye from our Chief Executive

Today is my last day at Gateway Family Services, after a wonderful and inspiring eight years.

I am enormously proud of my achievements helping Gateway to become a capable and trusted provider of community services.


Making the decision to leave the NHS and start Gateway Family Services in 2006 wasn’t a hard one. I believed strongly in what we could do and achieve and that we had an opportunity to do things differently.

We started small, but by our first birthday Gateway had over 60 staff and had developed the Pregnancy Outreach Worker and Healthy Heart services. We learned as we went along and we believed in ourselves. By the end of the fifth year we were still running those services as well as apprenticeship programmes all over the Midlands.

As Gateway has grown it has adapted to changing environments and, after a difficult time in recent years, it’s now in a great place.

Thank you

My last eight years have been filled with magic moments, of inspiration, awe, admiration, and pride.

VF-leaving-pic-largeGateway is something to be proud of. It is made up of so many things and, in an Oscar-like fashion, I want to acknowledge those now.

Starting a company is easy – it’s 15 quid to register and there you go! Building an organisation with an identity, a personality, opinions and ambitions, however, is much more difficult. What gives a company its strength is its people, its beliefs, its principles, values and commitment – and that comes from the staff, the partners, the stakeholders and the clients.

I am only able to shout about what Gateway does, and how well it does it, because of the work done by everyone involved. If the commissioners didn’t pay Gateway to deliver; if the staff didn’t deliver, or if the partners didn’t support it, none of it would be possible.

But it’s the staff who are at the core of this organisation. People will always need help, but Gateway’s staff don’t stop until they know people have got the help they (sometimes desperately) need.

It was the staff who came up with the company’s core values, which are at the heart of everything Gateway does:

We do what we say we are going to.
We invest in people.
Everything we do has a positive social impact.
We work hard and never stop learning.

I spend a lot of time (sometimes obsessively) reading the Impact Assessment App – in particular the clients’ responses to the question “how have we helped you” – and I can see first hand what an incredible job the staff do: the lives they change and the difference they make. Every day, I can truthfully say I see all the things I hoped for eight years ago.

I started by wanting to make a difference in people’s lives. The difference they made to mine was an unexpected bonus.

What’s next for me?

vicki_300x225If the decision to start Gateway in 2006 was easy, the decision to leave, eight years on, has been much harder. But it does feel like the right time to move on.

Gateway has been an enormous part of my life. But now that I know it can flourish without me, it’s time for me to find new challenges.

When I joined the Third Sector, I was determined not to whinge about how hard done-by we were. I believed that the power to influence lay in providing good services. Eight years on… well, I probably have become a bit of a whinger – I still believe that good services have the power to influence, but I have learnt that it needs dedication, investment and a systematic approach.

At Gateway I have focussed on evidencing the impact of what we do; capturing, recording and analysing how the organisation can measure its worth.

I have realised that I love doing this and that also it’s the fresh challenge I was looking for. So I have set up a company (for 15 quid!) and I am going to work with Third Sector organisations, providers and commissioners, helping them to measure outcomes and demonstrate the worth of community-led approaches.

What’s next for Gateway?

I’m very pleased to announce that Gateway has a new Chief Executive starting on 30th June 2014 – and it’s a familiar face.

Managers Photos for Website 030Katherine Hewitt has worked in the Senior Management Team for the past three years, setting up new services such as the interpreting agency and the Train to Care team. She knows all there is to know about Gateway, having led the Health and Wellbeing teams to new heights. She is a very safe pair of hands.

I know that being a Chief Executive is challenging at times, but I have great faith in Katherine’s ability and I know she will get all the support she needs from the staff, managers and the Board.

Gateway will always be special to me – it’s given me the skills and courage to make this next brave step. I hope to see everyone again soon in my new business.

Happy birthday, Gateway!

It’s Gateway’s 8th birthday on Monday so we thought this would be a good opportunity to take a look at what we do – and how the different departments within our organisation fit together.

What does Gateway do?

We say that people are best helped by those who are two steps ahead – in other words, people who have experienced problems but have made progress. So we employ people with direct, personal knowledge of the issues our clients face. Often, they’ve overcome similar problems themselves. The people they are supporting will relate to them and their achievements don’t seem too far out of reach.

Our departments cover pregnancy outreach, weight loss and employment training. The common thread is “people who need help” and all of the areas we cover have a direct impact on health and wellbeing, as you can see from our company structure:


Who does Gateway help?

We help anyone with barriers to equality, or who are experiencing marginalisation. The people we help are from some of the most socially deprived communities. Many are undergoing major change and just need a bit of support and extra confidence while that happens.

Think about a time when you’ve had to deal with major change; we’re talking about the type of upheaval that – if you’re lucky – will only happen a couple of times in your life. What support did you have? Who did you call upon for help? For people who can’t rely on friends and family – who perhaps don’t know what support they’re entitled to, or lack the confidence or ability to push for it – we aim to be the next best thing.

The women our Pregnancy Outreach team work with need some extra help to prepare for the birth – not just emotionally or physically, but practically, by supporting them as they tackle external barriers to health – things like debt management, homelessness or domestic abuse.

Other clients across the Gateway spectrum are ready to make other types of major changes in their life – losing weight, recovering from illness, or getting back into employment – and need some extra support to make it happen.

So Health Trainers work within communities, giving people one-to-one motivational support and developing group activities like walking groups. The Lighten Up team supports people through weight loss with telephone support. The Training to Care scheme takes people who have the skills and resources to work in the NHS, and gives them the qualifications and work experience required to apply for jobs. The Gateway Interpreting Agency gives community interpreters professional training and a recognised qualification so that they have a much better chance of employment. Pop Up Talent works with young people to create new ways of working between young people and employers.

All of our clients are on the track to a better life. The link between economic health and physical health and wellbeing are inescapable, so we aim to change lives by improving health, life skills and economic prospects at the same time.

We don’t just “fix it” for people, though; in every corner of our work, our aim is to help communities to support themselves.

How does Gateway do it?

We’re so proud of our eight year history and, although we are responsive to external changes and local government strategies, our core values haven’t changed. We have been doing the same thing for eight years and there’s a reason for that: it works.

Six months ago, in a blog post called Focusing more on people and less on strategy, I wrote about the ways in which governments constantly announce new strategies and “innovative approaches”, only to end up with the same objectives. Gateway, however, has remained consistent.

We haven’t changed – even though strategies have changed – and this means that we can focus on people who need us. Consistency counts. We use our skills and experience to spend our time supporting people. We are lean and efficient; our data is clear and links to outcomes.

In this video, our Chair, Ann Forletta, explains why she joined Gateway last year and how she feels Gateway’s connected way of working really makes a difference.

Budget Consultation: is it asking the right questions?

Here is an extract from the Budget Consultation for Adult Social Care. This is the proposal relating to Gateway’s Pregnancy Outreach Worker Service (POWS):

Proposal 15: Public Health – decommissioning pregnancy outreach

This proposal is to stop funding initiatives around pregnancy support. These services have been running as a pilot for some time and are awaiting evaluation. These services could be supported through the Health Visitor expansion, a responsibility of NHS England. Pregnancy outreach is not a traditional responsibility of the local authority. The cessation of these services will affect the most disadvantaged communities.

Question: Unless the evaluation shows good outcomes, should we decommission these services?

There are two important points I’d like to make about this consultation.

The first is that it refers to POWS as a pilot. The Pregnancy Outreach Worker Service is a contracted service that is performance-managed against a clear set out outcomes. It has been running for seven years and has consistently achieved its contract outcomes.

The second point – my main concern – is about the question you are asked to answer:

Unless the evaluation shows good outcomes, should we decommission these services?

It’s natural to read this and think, “of course a service should be decommissioned if it’s not shown to achieve good outcomes”. I certainly would. But is the public getting the full picture?

The outcomes in our contract cover things like safeguarding, housing, domestic violence, substance misuse, alcohol use and debt management. And we prove, every month, that we deliver on these.

In fact, we place so much importance on measuring our outcomes and impact that we devised a management information system for POWs, based on multiple national outcome frameworks for pregnancy and birth. This includes an Impact Assessment App that gathers direct feedback from the women we help.

But what is “the evaluation” the consultation refers to?

The evaluation that the question refers to – the evaluation upon which the future of POWS will depend – is a Randomised Control Trial (RCT) that took place in 2010-11, the results of which are not yet available.

An RCT, by its very nature, is a clinical trial. Generally, RCTs are set up to assess the effectiveness of medical interventions: drugs, or medical procedures. This one tested the impact of POWS on clinical, more than social, outcomes; things like postnatal depression, whether a mother had suffered an episiotomy tear during the birth, method of delivery (C-section or forceps) and length of stay in hospital.

But POWS is not a clinical service. The RCT couldn’t, and didn’t, cover social interventions … so it doesn’t measure the vast majority of the outcomes the POWs are contracted to achieve.

Why is Birmingham Public Health using an RCT to evaluate the Pregnancy Outreach Workers? Well, it’s the only type of trial they have – it’s the only evaluation method that has the required “academic rigour”.

I understand that RCTs are the gold standard for clinical research, and that the results will have academic rigour. My concern is that other evaluation methods, particularly those that assess social outcomes that are known to increase the risk of infant mortality, should be taken into account. At the moment this is not being considered.

It’s also worth mentioning that we had to change the service to fit the requirements of the trial; it was restricted to first time mothers and we could only work with women already booked with a midwife. After the trial we were able to work with women who had had other children (many in care) and referrals from other agencies, such as hostels, refugee and asylum support services – but we were unable to do this during the evaluation period.

We’re still fulfilling our original aims

The Pregnancy Outreach Service was originally set up as part of Birmingham’s efforts to reduce infant mortality. Of course, no-one can directly reduce infant mortality; all you can do is to try and reduce the risks associated with a poor pregnancy. Some of the risk factors are things that we can’t do anything about, like the age of the mother – but some, like nutrition, or smoking, are factors we can address, so we concentrate on those.

We soon realised that there are social barriers many of our clients need to overcome before we can address their health issues – domestic violence, debt, or homelessness, for example – so we tackle those first and achieve our original outcomes via a slightly longer route.

risks Over the years the service has been running, we have worked collaboratively with commissioners to take these social issues into account and design our outcomes. The screenshot on the left shows just some of the current risks that our POWS are working with.

Reducing these risk factors is what helps to reduce infant mortality. And so, of course, we believe these are the outcomes we should be tested on when the future of the service is being decided.

All services commissioned by the council should be constantly evaluated and we are constantly evaluating ourselves. But it’s frustrating that the future of the service is dependent on one evaluation, which assesses us on a very small area of our work.

We WANT to be evaluated. We want to prove our worth. We deliver on our outcomes every month and we’re proud to show that. I’m not dismissing the RCT – it is important as part of a fair evaluation of the worth of the service. But we are so much more than this.

If you would like to give your views on POWS being decommissioned, you can take part in the Budget Consultation for Adult Social Care by filling in the online consultation questionnaire.

The Proposal relating to POWS is Proposal 15, on page 21 of the Budget Consultation 2014 pdf.

POWs save Birmingham money

It’s no secret that Birmingham has constantly fallen short of its responsibilities in relation to Safeguarding Children. After an Ofsted report was published in October 2013, Ofsted chief inspector Sir Michael Wilshaw branded Birmingham “a national disgrace” and said the city “encapsulated” the worst failings in child protection seen in the country.

The new strategy for improving Children’s Services in Birmingham includes committing almost £10 million for children’s social care. mind-the-gapAt the same time, however – as part of Birmingham City Council 2014-15 Budget and Planning Birmingham’s Future Consultation – there is a proposal to decommission the Pregnancy Outreach Worker Service (POWS).

We know that POWS make a big contribution to the safeguarding of children in Birmingham, so we’re very concerned that losing this service will create an even bigger gap for more vulnerable parents and children to fall through.

POWs work with mothers to safeguard children

In our experience, there are two critical times for mothers that have a direct effect on Safeguarding:

  • throughout the pregnancy, to prepare the mother to be a ‘fit parent’, and
  • after a child has been taken into care.

Preparing the mother is an obvious way to work towards safeguarding, but it also saves money. This time last year, in a blog post called short term cuts make long term holes, I wrote about how our work with just one family – preparing the mother to be a fit parent – saved £20,000. It’s an example of how POWs help to fill the ever-present gap between adult and children’s social care.

Birmingham is recruiting more Health Visitors but, during her pregnancy, a pregnant woman will only see a Health Visitor for a booking visit. Social work and regular Health Visitor appointments begin when the baby is born. After the birth, both Social Worker and Health Visitor are (rightly) there for the child, and will follow the child if he or she is taken into care.

Why is it important for the mother to receive support after a child is taken into care? Because our experience tells us that there is a cycle. After a child is taken into care, the mother:

  • often gets pregnant again
  • requires emotional support
  • can revert to past behaviour – substance misuse, sex work, etc
  • has no statutory support
  • needs follow up and care for contraception
  • often needs ‘bereavement’ type counselling

Stopping the cycle is a crucial part of Safeguarding.

How do POWs save money?

At the moment, POWs support 600 women a year through pregnancy. All of the women we support have social risks and support needs, but about 10% of these are expecting children classified as ‘at risk of significant harm’ or ‘in need of statutory services’ (in other words: ‘known to Social Services’). On average a POW spends 120 hours with a pregnant woman if she is known to Social Services. So, over the course of a year, that is 7,200 hours spent working with women who are known to Social Services, in the pre-natal period.

POWs are not social workers, but they are specially trained and highly experienced workers who work intensively with pregnant women. They can help to stop the care cycle and create more ‘fit parents’. More fit parents means fewer children subject to Safeguarding, which means lower costs for the city and less pressure on Social Services.

With POWS, that £10 million could go a lot further.

2013: a year of successful resolutions

Lots of people use this time of year to come up with new year’s resolutions – goals for making changes to improve themselves – but most people find it easier to reach those goals with a bit of help.

Through our Pregnancy Outreach Workers, Health Trainers, Lighten Up advisors and our Employment Access Skills and Training team, Gateway helps people to make positive changes – and stick to their resolutions – all year round.

So here are some of the more popular resolutions that we hear every year – and some of the ways in which we’ve helped people with similar goals over the last year.

“I want to lose some weight”

wayne with derekMost of our Health Trainer clients, and all of our Lighten Up clients, join our service because they want to lose weight.

Our Health Trainers help people to lose weight with a tailored, personalised programme. They don’t recommend dieting; instead, they help people to make lifestyle changes that will go far beyond the few months they’re with the service.

Read some of the stories from Health Trainer clients like Derek (pictured), who lost weight with help from a Health Trainer last year, in Health Trainers: having a real impact.

The Lighten Up service helps people to lose weight by giving them free access to a slimming group for 12 weeks, then following up with regular phone contact, motivating them to keep up the good work.

Since we took over the service, we’ve seen hundreds of clients lose thousands of pounds in weight, but the most successful to date has been Linda Bartlett. Altogether, counting the weight lost before, during and after her time with Lighten Up, she’s managed to lose a whopping 11 stone.

“I want to get out of debt”

One of the biggest issues our pregnancy outreach workers (POWs) help with is finance management. So many of the families we work with are struggling due to the rising costs of living – not to mention the worry of preparing for an extra mouth to feed.

POWs help clients with some basic money management and budgeting techniques. If needed, they’ll make some of the more difficult phonecalls on a client’s behalf, as well as signposting them to specialist organisations.

In the summer last year, Sharon’s client Claire* said:

I’ve got no debts – Yay! Money Matters have set up payment plans, they’ve really helped me.

You’ve helped me with so much over the past few months. One thing in particular is budgeting, my debts are sorted and I have money in my account. I didn’t always need anything doing but having one-to-one adult conversation makes all the difference – it really does.

Maria recorded her client Saira* explaining how she and her husband had been able to start tackling their debts with the help of the POW service.

This blog post about welfare reforms, from the beginning of last year, explains why Gateway staff are in a good position to help people in this way:

We are in a unique position, our support staff go into people’s homes, they develop a strong bond with their clients and they are trusted – so who better to help? Over the coming weeks we will be ensuring all our staff have a sound basic understanding of the changes [to the benefits system] so they can start the conversation, many already help their clients look at basic budgeting so this is a very practical way of them identifying how the essentials will still be afforded.

The second step will be to effectively signpost people for further support. This is about knowing the best organisation to help that person with their specific needs. For example: benefits advice, financial guidance, debt management and how to manage on a low income. The quality and timeliness of advice will be vital so we are pleased to be a partner in the local bid to the Advice Transition Fund (led by Birmingham CAB) which looks at improving the co-ordination of advice in the city, recognising that the advice and guidance sector has already been harshly affected by cuts.

“I want to learn new skills/get a new job”

Helping people to get through the different stages they need to access their chosen career is one of the initial and key concepts of Gateway. We call it the skills escalator.

In November, we were thrilled to find out that two of our Pregnancy Outreach Workers have been accepted to begin degree courses in Nursing. For both Lynette and Farzana this has been a long term ambition and this is the culmination of a long journey.

We ran a training scheme in 2013 to give interpreters the opportunity to gain a level 2 OCN Community Interpreting qualification. The Community Interpreting Skills course was developed and adapted especially for them and the qualification allows them to work not just for us, but for other agencies and companies. The first trainees qualified in October and by December they were all working as interpreters in the community.

In a blog post from December, we spoke to newly qualified interpreters Paul and Nadine:

As part of his work with another agency, Paul already works with family solicitors around immigration issues, but this new qualification means he will be able to translate for a much wider client base. “It’s opened up a big world for me. I can take this certificate to many other types of agencies and departments. I’m interested in all the corners of life, so I’m especially keen to work with the Police and the UK Border Agency. I’m going to knock on every door!”

“I want to stop smoking”

In October (or Stoptober, as it is known to our Health Trainers!) we wrote a post about helping people to stop smoking. It’s a challenge, but it’s always on the agenda for Health Trainers and POWs.

Health Trainer Susan Bernard says, “Our job is to help people to make healthy lifestyle changes; to get into new and healthier habits. So we help people to plan ahead and get everything in place – mentally, emotionally and physically – for change.

“I want to meet new people”

Some of our volunteers2013 also saw the launch of our volunteer befrienders programme.

Volunteers from all walks of life are matched with a client who needs a bit of extra support; someone referred from other departments within Gateway – POWs, Health Trainers and Lighten Up – or via other routes, like partner organisations or GPs.

By March, eleven volunteers had at least one client of their own and were supporting their new friends in all sorts of ways:

Lorraine has been attending slimming classes with a client who didn’t feel confident going on her own. As well as providing some moral support she’s also helped her to start managing her finances a bit better. Just having someone who’s available to help with a little practical and emotional support can be a big boost.

Tareena helped her client to find alternative housing, as the conditions he was living in were very poor and he was being threatened by his neighbours. Together, they’ve visited Shelter, who found him a new place to live. Now he’s very happy – his new accommodation is warm and clean and he’s able to cook his own meals. This client has many health issues and, without support from people like Tareena, he might not have been able to set the wheels in motion to get the support he needed.

Read more about how volunteering is good for you in Volunteering – good for everyone.

“I want to do more exercise”

A big new year’s resolution for many people is to do more exercise. As well as the physical benefits, exercise is shown to have a beneficial effect on mental health and general wellbeing. So at Gateway, we enjoy finding new and interesting ways for people to get started … and to give people an incentive to carry on.

One of our favourite blog posts from last year came from our guest blogger Sharon, who took advantage of the bike hire scheme we originally initiated in 2012. Read what she had to say in Bike hire scheme – Sharon’s story.

And finally, Health Trainer Keiran took on a new kind of walking group in 2013 – a twenty minute “assisted gentle exercise programme”. In April, we blogged:

Overall, the assisted gentle exercise programme has been a great success. The participants have found benefits not only physically but also socially. All the walkers have spoken of a boost in confidence and happiness levels. The two minute video below shows the group describing what they’ve got out of the six week course – and admiring the views.

Happy New Year from everyone at Gateway. We’re looking forward to a great 2014.

*some names have been changed

Birmingham Budget Cuts – we need your views

Public consultation on the budget cuts for Birmingham include cutting the Pregnancy Outreach Worker (POW) service in 2015. If you have a view on this, please contribute:


You can fill in the online survey here

Or use the public computers at one of the libraries

– Submit comments by text at SMS by texting ‘Budget’ followed by a space and your message to 07786 200 403
– Write to Budget Views, Room 221, Council House, Victoria Square, Birmingham B1 1BB

A first step into a career in care

Gateway has always been about helping people overcome barriers, whether that is to work, to learning or to good health. We have never been interested in quick fixes for long-term issues.  We are interested in looking at issues and problems in a different way and working out how perceived weaknesses can be turned into strengths. Recently, working with Birmingham Community Health Care, we have been able to support people into career opportunities that they wouldn’t have had if it wasn’t for us.

Our role is to provide a bridge.

We know there are lots of people in Birmingham with the skills and resources to work in the NHS, but who currently lack the qualifications and work experience required to apply for jobs.   We also know that the NHS wants to attract a diverse workforce and widen participation; they want to employ the local population and reflect the community they serve.

So the Train To Care programme  is a gateway for people who want a career, offering them the opportunity to get the qualifications and work experience they need in order to apply for NHS jobs.

Turning life experience into employability

Often, people who don’t have formal qualifications or work experience have been busy elsewhere,  bringing up families, or caring for relatives. This experience is so valuable and we know it can be put to great effect in caring roles in the NHS.

The sort of people who’ve already applied for the Train To Care programme are people who have a wealth of relevant life experience, and have a lot to give, but who don’t meet the criteria to get an NHS interview at the moment. They understand being on the receiving end of care and they understand why people sometimes don’t engage with care.

They might also have been out of work for a while and be lacking in confidence, or they might require literacy and numeracy support, so we can help with those skills too.

This is why it’s important for us to offer this kind of stepping stone. There are lots of people who have the skills and resources who just need some nurturing – these are the people who will flourish in the sort of supportive work-based training environment we’re offering.

Trainees will work for Gateway in one of 15 bedded units across Birmingham, carrying out assigned tasks involving direct care for patients within a ward environment. They’ll work to support – and be fully supervised by – a qualified nurse or therapist, caring predominantly for older people with a range of medical and nursing needs. There are currently 20 full time/part time posts.

At the same time, they’ll work towards an NVQ 2 in Health and Social Care, as well as getting further employability support and skills training to become “work-ready” from Gateway.

At the end of the year, trainees will be qualified and confident. They’ll be in a position to apply for NHS  and other roles and potentially continue with a career in health and social care.

The importance of investing in maternal mental health

mother-babyOur staff  support pregnant women with complex social factors  but why are the POWs  needed?  Simply put…our  clients  are vulnerable, but not vulnerable enough to get statutory support.

An NSPCC report from June this year found that:

The wellbeing of more than one in 10 newborn* babies in England could be improved if all new mothers with mental illness had equal access to good services

Mental health problems – including depression, anxiety, post-traumatic stress disorder and schizophrenia – can begin or escalate when a woman is pregnant or in her child’s first year.

They can have a damaging effect on family life, and in the worst cases, impact on babies’ health and welfare.

Evidence shows that the vast majority of these illnesses are preventable and treatable, and with the right support, the negative effects on families can be avoided.

This echoes our findings and the feedback from our Pregnancy Outreach Workers.

So why are so many pregnant women slipping through the cracks? Because they are medically low risk.

In safeguarding terms, a “vulnerable adult” tends to mean an adult who is vulnerable to abuse or exploitation, and much of the advice is directed towards care of the elderly. If a pregnant woman or mother doesn’t meet the criteria for a vulnerable adult – in other words if she is not suffering direct physical or emotional abuse, or neglect – then she doesn’t get support. She is seen as having adequate mental capacity and able to cope alone.

There are services are designed to support the mother but don’t always come through (eg  pregnant women are supposed to see a health visitor but, in our experience, many don’t). A shocking 73% of maternity services do not have a mental health midwife.

This list of risk factors for poor mental health, taken from NHS Scotland’s Early Years website, is typical of the “middle ground” that our more complex clients occupy.

  • experience of poverty and deprivation
  • experience of gender based violence
  • experience of stigma or discrimination
  • living in isolation
  • having been in care
  • alcohol and substance misuse
  • being a teenage mother

Despite all these factors – these pregnant women are not considered vulnerable by definition.

Danni*, one of our more complex clients, already has two children in care, and received Pregnancy Outreach support for her most recent pregnancy. POW manager Michelle explains, “Lack of support in the past means that Danni has continued to lead a chaotic lifestyle and to have more children. This time round, she’s had extended support from a POW, but she still is not engaging with Social Workers. She feels that they are only there to take her children away and judge her. She misses appointments, saying, ‘I feel like a failure’ and ‘what’s the point, you’re taking my kids off me.’

“Like an unfortunate number of women, Danni is ‘vulnerable… but does not meet the criteria of a vulnerable adult,” Michelle continues. “She’s been told by doctors that she’s not clinically depressed, so the support available is limited. If she’s not engaging – missing appointments with her drug worker, for example – no-one chases it up. When anything happens – like recently, when her access to her children was reduced – she’s quick to relapse.”

In fact, most of the safeguarding advice given to support workers for new mothers is based around the child. A mother who has a chaotic lifestyle or a drug dependency is seen not as someone in need of support herself, but as an abuser of a vulnerable child.   We absolutely know that the safety of children is paramount, what we recognise is that it is not only them that need protection and support.

In other words, there is a gap between social services’ concern for the unborn child, and concern for “vulnerable adults”. Many of our clients occupy this space. 213 of the clients we are supporting at the moment have identified mental health issues and 126 are experiencing domestic violence.

Children in care

We’re seeing how unaddressed  maternal mental health issues can lead to more children in care, and there is a cycle attached to this.  We are recognising a missed opportunity to break a vicious cycle.  The lack of support at such a crucial time means that many vulnerable women return to a chaotic lifestyle lost in a gap between services.

In fact, at this vital time, all sorts of support that parents had been receiving – for example, access to a family support worker – is actually withdrawn. Parents on parenting courses  lose their place on the course when they lose care of their child. The implication is that the mother of a child who’s been taken into care is no longer a parent and no longer requires support.

Far too many children are in the Local Authority care and there is a plan to move children into more stable environments through adoption. Surely there must be an equal priority to help pregnant women be fit mothers to take care of their own children? The vast majority want to, and are devastated when this is not possible. A common response is to get pregnant again, and so the cycle starts over.

The POWs are able to create solid, structured mental health support for the mother. They help create the conditions suitable for children to be brought into a family and to strengthen the maternal bond.

This is why I’d like to see the sort of support that Gateway POWs offer – dependable emotional support and practical advice – to become the mainstream.

*names have been changed

Having an impact every day: Lighten Up

This week we’re continuing with our series of Having An Impact posts, giving an insight into how our different services are making a difference – in the words of the people using them.

Having an impact every day: Pregnancy Outreach Workers
Having an impact every day: Health Trainers

This week: the Lighten Up call centre

Lighten Up team at workAs Lighten Up staff member Liz Barber explained last week: “Our job is to take referrals and then contact the person wanting help with losing weight. We then help them choose a suitable provider, make sure they know when and where the meeting is, and send them all the info they need. After the first week we ring them to make sure all’s OK and then we carry on phoning them at regular intervals to check on their progress.”

The Lighten Up call centre doesn’t deliver the weight loss sessions; these are done by a number of providers. In fact, the call centre staff rarely meet the people they support, as their job is done via the telephone. What the call centre does is to make sure the process works and that the person using the service gets as much out of it as possible.

As Lisa Cruice, the team’s manager says: “We like to call what we do ‘wrap-around support.’ Our focus is to keep each person on track – so if there are problems, we sort them out, and if the person is struggling with motivation, we give them encouragement.”

So, as you’ll see, the mixture of attending the weight loss sessions and receiving regular calls from the Lighten Up call centre work hand in hand to provide a complete service.

Here’s a selection of the responses taken directly from the Podnosh Impact Assessment App, in the last ten days. As ever, the question is “how have we helped you today?”


Jane gave a happiness rating of 100% and said:

It’s nice someone is thinking about you.

Graham told us that Lighten Up gave him the kickstart he needed:

I am now into the swing of things with Slimming World and finding Slimming World more helpful. But don’t get me wrong, if it wasn’t for you in the first place I wouldn’t have had the incentive to do it anyway.

Joyce, who’s retired, wants to lose weight to help with her overall health:

Now I know that I am being sent my referral voucher and that I can start on Thursday. It’s much better than just being sent somewhere by your GP. It is good there is a freephone number to call and a team to support you.

Michelle has struggled with her weight for a while but is now with Rosemary Conley. We can see from the app that she benefits from chatting with the Lighten Up staff about her achievements during every call. This week, she said:

The call has helped me feel good about losing a stone.

Vanessa chose to take up the Health Trainers service, but she still gets support from Lighten Up:

It’s nice for you guys to keep in contact to see how I’m getting on and its nice to know you are interested how my weight loss is going.

John used the call to psyche himself up for a challenge that evening:

I’ve got a office do tonight at a chinese restaurant so I have to measure my portions. Being on a flexible plan leaves me 49 “floating points” a week so I can use some of them tonight. Your call will help me prime myself and keep to the challenge.

For Anne, the answer to “how have we helped you today” was simple:

By making me want to go to the class.

Allison is with Weight Watchers but appreciates the extra support:

Well its nice to be remembered and not just given the vouchers and left to get on with it yourself… so yes, its been helpful.

Judy is losing weight so that she can have an operation:

It was absolutely wonderful. Thanks for phoning and checking up on me.


In an average 10 days the team will sign up 212 new clients and they will make 2080 calls. Last year, the team supported their clients to lose a total of 1945 stone. So you see – it works!