Recently, we have decided to take a bit of a risk and relaunch a service, despite a lack of external funding. Using our own reserves, we have relaunched Healthy Futures, a programme supporting socially isolated people. In partnership with MyHealthcare, we are now taking referrals from GPs across South Birmingham.
Why? Because we know this service is desperately needed in Birmingham… and we know it works.
We know that Healthy Futures works because we ran a pilot programme in 2016. GPs and surgeries referred people who were socially isolated – for a variety of reasons – and Gateway’s para-professional staff and volunteer befrienders supported them. It was found to be a cost-effective way to reduce the time people spent with their GP (when a social intervention was more appropriate), as well as significantly increasing people’s self-reliance and self-care.
Importantly, we learned a number of things from the pilot, which means we know what works and what doesn’t. This has allowed us to design and relaunch a streamlined version of the service, despite limited resources.
For example, we were surprised at the age of many of the people we worked with in the pilot – we had been expecting to see a lot of elderly people, but in fact 70% of the people we saw were under 65. As well as people who wanted support to manage long term conditions, we saw a lot of alcohol dependency, anxiety and depression, accommodation issues and financial hardship.
It meant that every person we worked with initially needed intensive support from a para-professional Practice Navigator, rather than lower-level support from a Volunteer Befriender.
So, to start with, all staff working on Healthy Futures are para-professional Wellbeing Navigators. We hope that once the programme has been running for a while – depending on future income – we can introduce volunteer befrienders again, to allow people who no longer need intensive help to continue receiving a phased-down, lower level of support.
And, of course, we are continuing to apply for funding, so we’ve designed the new Healthy Futures in a way that will allow us to build capacity quickly and efficiently once we secure outside investment. With a little help, we could be supporting hundreds of socially isolated people across a wider area in no time.
Healthy Futures was designed, and is being relaunched, in partnership with MyHealthcare. To find out more, or to refer patients into the service, GPs and Practice Managers should call 0121 456 7820 and ask for Healthy Futures.
Social isolation is a big issue for people of all ages, but research shows that it’s a particular problem for those who live in cities, older people and people with a long term health condition. That’s why having more opportunities to get together with others for a cuppa and a chat is really important.
A great example of a group supporting those at risk of social isolation is the Patient Health Forum. It’s for anyone in South Birmingham who has a long term health condition, and its members include people with everything from asthma to arthritis, Alzheimers and anxiety.
Although it can be useful for people to talk about their health condition during the meetings (and, in fact, the meetings are funded by South Birmingham CCG in return for feedback about the health services they use), the biggest benefit that the Patient Health Forum brings is the opportunity to meet and talk to others.
Our first session of the year took place a couple of weeks ago in Stirchley, and 31 attendees enjoyed a buffet lunch, a talk from Wayne on the Five Ways to Wellbeing, and entertainment from a Michael Bublé tribute act. Some, like Irene, even had a sing and a dance!
Committee member Pauline Hartley said, “It matters not what health condition people have – but how they can be helped to deal with the isolation, the social problems and the access to services that will help them. Our members constantly ask if the group will stay open because it so important to them and even sometimes is the only place they go to for social interaction.”
Although the Forum had already been running for a number of years, Gateway became involved in 2014 to help facilitate the meetings. Since then, we’ve been supporting the committee with the general running and budgeting of the group, organising the venue, transport and refreshments, bringing in speakers and entertainment, and sharing our knowledge and contacts. And although funding for the group has dipped recently – meaning we’ve had to go from monthly to quarterly sessions – we’ve seen numbers continue to grow. We’re particularly pleased that older people and carers are coming along because, according to research evidence:
In the UK, 17% of older people are in contact with family, friends and neighbours less than once a week, and 11% in contact less than once a month.
Loneliness is common in carers, especially resident carers. Other groups at risk of loneliness include older married women, older people who live with married children, those living in sheltered housing or residential care and older people who emigrated from other countries (especially those who do not speak the language well).
Loneliness seems to be less prevalent in those rural areas where a sense or community still remains than it is in more densely populated urban areas.
Lack of money limits the opportunities for overcoming loneliness: those on lower incomes are more prone to feelings of loneliness than those who are better off.
Membership of the Patient Health Forum is open to anyone who lives in South Birmingham, or is registered with a South Birmingham GP, and lives with a long term health condition. If you’d like to get involved, give us a call on 0121 456 7820 and ask to speak to someone about the Patient Health Forum.
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* 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* 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.
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.
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:
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.
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.
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.
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.
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 (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.
Forming strong partnerships with other local organisations is a very important part of Gateway’s work.
By sharing resources we are able to provide a more cost-effective, joined-up service – both as an individual organisation and as a sector. In an environment where budgets are shrinking, effective partnerships mean less duplication of work, which saves vital resources. It also means less “pushing from pillar to post” for clients, easier access to services and one point of contact to help someone navigate through services.
People rarely have one issue they need support with, so all our services have always worked in partnership with other organisations, either formally or informally. Over the last couple of years, however, partnership work has become even more important to the Health Trainer service as they have started working with broader groups of people, reaching out to communities who might not otherwise be able to access the service.
Health Trainers at The Signing Tree
One partnership that we’ve set up relatively recently is with BID Services, a charity supporting people who are deaf, hard of hearing, visually impaired or have a dual sensory loss. BID Services runs a social enterprise called the Signing Tree, based at the Deaf Cultural Centre in Ladywood – and it’s here we now run a Health Trainer service with interpreters (one provided by Gateway, and the other by BID).
Gateway Health Trainer Richard, pictured, says, “I visit the Signing Tree once a month, where I set up a classroom together with two interpreters. If it wasn’t for them, the communication barrier would definitely be a sticking point – I don’t think many of the people I see at the Signing Tree would contact the Health Trainer service otherwise. The interpreters are brilliant – they actually get involved and help me to provide an informative yet fun session each month. We have 15 clients per session and it’s very popular – in fact last time, I had to turn four people away.”
Bhavana Jamin, Specialist Enablement Co-ordinator at BID, says, “This has been a positive experience for all the deaf people involved. The trainers make the pace of the sessions meet the clients’ needs and by this the clients became confident to participate and engage with the sessions. They gain access to information about their health and wellbeing that they may not be able to access from other areas, so they now have some knowledge of healthy food choices, and the information is presented visually.
“Word of mouth has been used to promote these sessions within the community and I now have a waiting list of people who would also like training in the future. So I look forward to working with Gateway again in the future.”
Strong partnerships allow us to do several things, especially when clients have more complex needs. They enable us to have an up-to-date knowledge of the issues that people in Birmingham are facing, so we can adapt the services we offer and respond to need as quickly and usefully as possible. It means more opportunity to help clients prioritise their needs, and to deal with issues in a way that suits the individual, by taking the services to them.
As well as the Signing Tree, we now also deliver services in partnership with a number of other organisations, including Jobcentres in South Birmingham, and Cerebral Palsy Midlands, based in Harborne.
If you would like to know more about working with Gateway, whether that’s to work with our Health Trainer service, or any other Gateway services, for example the Pregnancy Outreach Workers Service, do contact us – we’d be very pleased to hear from you.
“Social prescribing” (sometimes called “care navigation” or “care co-ordination”) is a bit of a buzz topic at the moment. Although similar approaches have been used for many years, the financial squeeze on clinical services is greater than ever, leading to greater interest in alternative pathways.
Social prescribing refers to the idea of GPs and other primary care professionals referring people to a range of local, non-clinical services, and treating people in a more holistic way; looking at the “whole person” and taking into account social, economic and environmental factors.
But does it work? Our experience running the Pregnancy Outreach Workers Service, Health Trainers and Gateway Healthy Futures, tells us that the answer is a resounding “yes”… but that creating a successful service depends on a number of factors.
Saving time and money… building resilience
Gateway Healthy Futures, a pilot programme that finished at the end of September 2016, was designed specifically to reduce the number of unnecessary GP visits by providing patients with a non-clinical alternative. GPs referred patients who had presented with risks including social isolation, low reported wellbeing, ongoing mental health conditions, alcohol or substance misuse, and financial hardship, and the Healthy Futures Practice Navigators provided them with practical support, reassurance and a point of contact.
It’s an idea that we had been batting around for a couple of years before we had the opportunity to develop it. Eventually, it came to fruition thanks to My Healthcare, a consortium of GPs in South Birmingham. Gateway Healthy Futures was one of a series of projects funded by MyHealthcare with money provided by the Prime Minister’s Challenge Fund.
It’s now five months since the Gateway Healthy Futures service ended, but we’re pleased to see initial reports from its formal evaluation (which was carried out by international development consultancy Mott Macdonald) are very positive. It shows that Gateway Healthy Futures reduced the time people spent with their GP (when a social intervention was more appropriate), and that the people our Practice Navigators worked with significantly increased their self-reliance and self-care during and after the support.
“…GPs are happy with the service because it is reducing the burden of social needs patients on primary care.”
“Feedback from patients … indicates that self-resilience levels have increased due to the scheme. Anecdotally, there is evidence of behaviour change; the scheme has helped some patients to understand that the GP is not always the most appropriate source of support for helping with non-clinical issues.”
The Gateway Healthy Futures service was also found to be cost-effective.
“The use of non-clinical staff members instead of GPs is cheaper by around one third of the cost.”
“… had [Gateway] not intervened, patients would likely have been referred on to social services at a much greater additional cost; the care navigation service is estimated to represent a saving in this scenario of approximately £10 per hour.”
Lessons for the future
One element that was key to the success of Gateway Healthy Futures was being able to work with GPs who engaged with the service. Because we already had a relationship with MyHealthcare (via Health Trainers) and the GPs had been involved with Gateway Healthy Futures from the start, they had confidence that it would work. This benefited everyone involved – including the patients, who trusted their GP’s recommendation and were more likely to engage themselves.
And thanks to experience gained from our other services, in particular from over a decade of running the Pregnancy Outreach Workers Service, we were also able to employ and train the right kind of staff. Our Practice Navigators provided a flexible, understanding and open-minded service, providing “whole person” support.
Rather than falling into the trap of “doing what’s best” for patients, without really consulting with them on a deeper level, Gateway’s services generally let the patient lead the support. We believe that asking someone what their priorities are, believing them, and working with them to build self-confidence and resilience creates a programme of support that is more successful and more sustainable.
When social services become involved to protect an unborn child, who is there for mum?
Gateway Pregnancy Outreach Workers Service (POWS) is a unique service in this respect. Because, while social services and midwives – quite rightly – are focusing on the child, our focus is on mum. As far as we know, we’re the only organisation that can provide this intensive level of support to women during and after pregnancy.
The women POWS work with are referred to the service for many reasons. Many have issues with unsuitable accommodation, financial difficulties, problems with substance misuse, or risky relationships. All are vulnerable. Some have had children removed from them in the past, which means that their current pregnancy will be under increased scrutiny, bringing added pressures to an already difficult situation.
While this scrutiny and focus on the unborn child is necessary, it can often leave mum feeling bereft and unsupported, with her original needs unmet. And if she 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 a parent needs (and that social workers and family courts will approve of) can be virtually impossible.
This is where POWS support is invaluable. Not only does a POW work one-to-one with mum to come up with an action plan, helping her to tackle issues in a methodical way, but she will also liaise with social workers and other services to ensure that they are aware of the changes being made.
In the video below, you can hear from Chloe*, who tells us about the support her POW Shazia gave to her, and how it changed the outcome of her social services intervention.
Shazia says, “Chloe was proactive – she knew the dangers and wanted to change – but she needed emotional and practical support to actually get stuff done. I was able to be there for her throughout the pregnancy, not just at the end of the phone, but with practical advice – signposting her to other services, going with her to appointments, writing letters on her behalf and making sure social services knew she was making progress.”
Just having someone available to talk to is really important, so POWS work together to make sure all their clients get constant access to support. Shazia works part time, so she introduced Chloe to another POW she could contact, and made sure she had the number for the office too. If anything happened and Shazia wasn’t around, someone else would be.
Shazia continues, “There were times when Chloe doubted herself and times when she struggled to understand what she needed to do, but as time went on she started to believe in herself and that’s when she really started to make changes. She was keen to prove herself – even requesting things like additional drug tests – and just generally needing me to do things for her less and less. A nice example is when I rang her to remind her she needed to register the baby’s birth – and she’d already done it!”
As you’ll see from the video, Chloe is still making progress. She’s a lot happier now, and a lot more confident in herself. In fact, we found out this week that she has been given unsupervised access to her other two children on a regular basis.
Even when a mum doesn’t get the outcome she wishes for, and a child is removed, POWS are able to continue supporting her for up to eight weeks. However, it frustrates us that we can only work with her for such a short time. A mother is extremely vulnerable – and likely to fall into old patterns – during this period, so continued practical and emotional support and guidance is absolutely vital at this time.
Finally: the sort of support offered by POWS isn’t just something that would be “nice to have” for hundreds of families – it also saves a surprising amount of money. The approximate cost of taking a child into care for nine months runs into tens of thousands of pounds, but the approximate cost of the combined preventative services accessed by a vulnerable mum over nine months is less than a quarter of that.
Every day, our outreach workers visit clients all over Birmingham who are in need. Could you help us to help them?
Two of our outreach services, Gateway Healthy Futures and the Pregnancy Outreach Workers Service (POWS), work with people who are in the most “at risk” categories – and each week our staff are seeing more people in dire need of basic essentials from our food and baby bank. Could you help us to stock up?
Who we are working with
The Gateway Healthy Futures service provides a one-stop-shop for people with a wide range of social needs. GPs can refer anyone that needs non-medical help, so that includes people who have issues around things like housing, alcohol, finances, benefits, social isolation, and much more. Our Practice Navigators provide reassurance and a point of contact for the people they work with, as well as vital practical support.
One of the people recently referred to us by her GP is Angie*, who’s in her 50s and lives in Kings Norton. One of our Practice Navigators, Lindsey, visited Angie on a Monday morning a few weeks ago – and it’s a good job she did, as you’ll hear in the video:
We don’t normally start asking for donations until we are planning our Christmas Hampers, but we’d like to be able to stock up on more emergency essentials, so that we can offer practical help to people like Angie all year round. (Of course, this will be as well as the help we give them to access all the support they’re entitled to, and signposting them to other agencies for support.)
How can you help?
To help us stock up, we’ve expanded our donations list to include things that our Gateway Healthy Futures clients might need, as well as our POWS clients. If you’re able to donate any of the below items, they would be gratefully accepted at our offices: Floor 5, Chamber of Commerce, 75 Harborne Road, B15 3DH. Alternatively give us a ring on 0121 456 7820 and we can arrange pickup. We’d also love it if you could share this list with your contacts.
Imperishable food (unopened):
Tins – beans, soup, custard, peas, beans, fish (tuna, mackerel, pilchards) etc.
Herbs and spices
Pasta sauces/jars of sauce
Some sweets and chocolate would be nice
Toiletries (unopened) for men and women:
Body lotion/moisturiser/hand cream
Other useful items for men and women:
Packs of underwear, socks (these need to be new)
Woolly hats, gloves, blankets (second hand is fine if clean and in good condition)
Slippers – with backs, not slip-on (these need to be new)
Pregnancy Outreach Workers Service (POWS)
POWS works with pregnant women who have a low medical risk and high social risk, dealing with issues including temporary accommodation, homelessness, substance misuse, domestic abuse, offending, newly arrived communities, poor mental health and safeguarding. So our donations list for POWS clients includes some extras that will be especially helpful to new mums and mums-to-be.
Toiletries (unopened) for POWS clients, including:
Sanitary towels – the larger “maxi pad” type is better for new mums
Baby bath wash
Baby clothes – up to twelve months as we have little space to store them (second hand is fine if clean and in good condition)
Books and toys for mums who may also have older children (second hand is fine if clean and in good condition)
We thought we’d have a bit of a change from our usual fortnightly blog post and rather than a story from one of our services focus on something a bit more pictorial, with photos and comments from people we’re currently working with. Hearing what people think of us and what they’re achieving or the changes they’re making is really important. It’s essential in terms of us making sure we’re providing what people need and getting the level of support right but at the same time the information is often encouraging and thought provoking.
To make gathering this type of information quick and easy our Outreach Staff all have the www.impactassessmentapp.com installed on their phones. At the end of each appointment or visit they use the app to gather a few simple things; a comment in response to the question “How have I helped you today”, a satisfaction rating – done by using a sliding scale and if they’re willing a photo, a bit of audio or even video. We think it’s really important to record the comment as it’s said, sometimes the Outreach Worker will pass the phone to the client so they can type in what they want to say themselves or if not it’s entered exactly as it is said so it remains in the client’s voice.
We thought we’d give you an insight by showing you just a little of who we’ve been working with and what we’ve been doing together over the past few weeks.
“I am happier than I have been in a long time. I love my new flat and have been along to the Children’s Centre where there are lots of groups going on which I’m going to go to.”
“I now have smaller portions, more fruit, more veg and I exercise more. All the talk about healthy options has been noted! “
“By telling me all the things that are available if I need them you’ve helped me realise there are still things available for me to do.”
“I’ve gained knowledge about food but I’ve also made friends.”
“We’ve talked about my birth plan and the things to expect when I deliver. I feel I understand a bit more about labour now.”
“We’ve looked at properties together and we’ve also filled in the Sure Start Grant form.”
“You’ve referred me to a couple of activities I can go to this week. I’m looking forward to going to them, it gets me out of the house, I’m sick of looking at the four walls.”
“You’ve helped me fill in the PIP application and given me a bit more confidence.”
From the information we’ve collected via the app we also know that over the past six months we have provided one to one support to 1424 people and as we gather some basic demographic information we know various things like age and work status. We can see that we’re working with a wide range of people which is important.
In terms of age the largest single group are those aged 50-64 with 420 people falling into this group but then in total 1045 were of working age, 321 people were over 65 and at the other end of the scale 43 were aged 18 or younger.
In terms of work 439 were in either full time or part time employment and 648 were unemployed, then 45 were in full time education and 292 were retired.
Satisfaction – we talked about this at the start and how at the end of each appointment or visit we ask people to rate their satisfaction or happiness by indicating where they feel they are on a sliding scale, which is out of 100. 70% is the average score, so that’s like 7 out of 10, but what we can see is that 57% is the average people are scoring at the start of their support but by the end it’s increased to 77%. This shows that satisfaction increases significantly as time goes on, but then that stands to reason as when people start to see or feel the effect of what they’re doing then their belief and confidence grows in us and the changes we’re making together.
We talk about “evidence-based” services a lot, but for social interventions such as our Pregnancy Outreach Workers Service (POWS) it can be difficult to find proof that the service is successful without resorting to anecdotes and self-reported data.
However, a group of researchers at the University of Birmingham, funded by CLAHRC (Collaboration for Leadership in Applied Research and Care) West Midlands, have recently published their findings from a clinical study into the POW service – and we’re very pleased to note that it shows clear statistical evidence of benefit to the women we support, particularly with regards to their mental health.
The research took the form of a Randomised Controlled Trial (RCT) – the most academically rigorous way of determining whether a cause-effect relation exists between treatment and outcome.
It looked at 1324 women, some of whom received standard maternity care and some of whom were supported by POWS, and compared outcomes such as antenatal attendance, postnatal depression and mother-to-infant bonding.
The study found that mother-to-infant bonding is better when mum has the support of a POW.
It also found that, for women who have two or more social risk factors, the intervention of a Pregnancy Outreach Worker was beneficial in preventing postnatal depression.
The study adds, “this finding is important for women and their families given the known effect of maternal depression on longer term childhood outcomes”. It concludes:
This trial provides evidence that a lay support service targeted to women with two or more social risk factors improves aspects of maternal psychological health relative to controls; such improvements are likely to be of lasting impact due to the known effect of maternal depression and poor attachment on longer term childhood outcomes.
This, together with the relatively low costs of the service, means that consideration should be given by policymakers to introduction of a lay support service.
When the trial was being carried out, we worked with a much wider group of women than we do now. The research showed that our interventions have the biggest impact on women with two more more social risk factors – and it is this group that we now work with exclusively.
Our POWs work hard to offer early help to women who are at risk; to make sure that baby arrives safely, and to support mum to be the best parent she possibly can. This study is incredibly helpful in validating the work our brilliant POWs do, and we’re delighted to see it published.