Category: Hard to Reach

People who may have significant barriers to accessing services, reluctance to use them.

Healthy Futures Practice Navigator at work

What’s the future for Healthy Futures?

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

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

How Healthy Futures works

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

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

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

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

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

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

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

Judith* is in her 50s and unemployed:

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

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

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

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

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

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

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

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

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

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

A country in crisis?

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

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

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

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

Watch the video

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

*names have been changed

holding hands

Loneliness is bad for your health

Tracey Crouch MP
Tracey Crouch MP, Minister for Civil Society and “Minister for Loneliness”.

Did you know that being lonely is actually harmful to physical health?

Studies show that a lack of social relationships is a big health risk1. Researchers have found that it can be as big a mortality risk as smoking fifteen cigarettes a day!

Now, the government has decided that loneliness is a problem worth tackling. In January, Theresa May appointed Tracey Crouch to lead cross-government work on loneliness, to “shine a light on the issue” and “bring an end to the acceptance of loneliness for good”. And in April, this was followed up by the launch of the “Building Connections Fund”, aimed at supporting programmes that “bring people together”.

There’s no doubt that, in this age of austerity, the Minister for Loneliness has a big job on her hands. But we’re very glad that it has become a national talking point.

What are the risk factors for loneliness?

A recent report by the Office for National Statistics gives some food for thought. It identified three profiles of people at particular risk from loneliness:

  • Widowed older homeowners living alone with long-term health conditions.
  • Unmarried, middle-agers with long-term health conditions.
  • Younger renters with little trust and sense of belonging to their area.

Reducing social isolation in Birmingham

At Gateway we support people who fit all three of these profiles, as well as many of the other identifiers mentioned in the report, such as people with financial hardship, and people who don’t feel a connection to their neighbourhood.

Despite a lack of external funding, we are continuing to run the Healthy Futures service, which supports socially isolated people in Birmingham. GPs can refer anyone that needs non-medical help into the service, so that includes people who have issues around housing, alcohol, finances, benefits, and much more. Our Healthy Futures navigators offer a range of one-to-one help, whether that’s a cup of tea and a friendly chat to get through the day, or more complex support that requires a range of specialist help.

And for people with long term health conditions, we help to run a local Patients Health Forum. This group was set up to allow service users to give feedback on local health systems, but over the years it has also grown into quite a social club. So as well as helping with the practicalities, we make sure to really push the social side of things, making sure events are organised regularly and include food, entertainment, and plenty of time for people to chat. Most of the people who go to the Patient Health Forum fit one of the first two profiles mentioned above, and many of the forum members (or, sometimes, their carers) tell us that it provides them with vital social support.

Earlier this month, the Patient Health Forum took place in Stirchley, where we celebrated the 70th Anniversary of the NHS with entertainment from guest singer Reza, who got everyone moving.

At the first International Social Prescribing Research Conference, in June, Key Speaker Dr William Bird explained how loneliness leads to chronic stress which, via its effects on the endocrine and immune systems, enhances risk of long term conditions. He was keen to promote the concept of supporting people to find “greater value” – that is, not just telling them to do standard physical activity, but working with them to find their purpose.

And this is how we work at Gateway, because we can see that it gets results. In the case of Healthy Futures, as we explained in our own poster presentation at the conference:
Healthy Futures did not fall into the trap of “doing what’s best” for patients; generally the patients led the support. Gateway believes 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 sustainable.

Connecting people

It’s one thing to find people to say hello to, but it’s quite another to feel “plugged in” – to feel part of something; to feel that you’re useful and that your contribution matters. Having things in common is a great starting point. That’s why we’re keen to make sure that all the services we deliver that involve groups of people – for example Solihull Lighten Up, Peer Educators and the Maternity Voices Partnership – work well as social groups, and we encourage people to stay in touch using WhatsApp or Facebook groups, too.

We’ve known for a long time that social isolation has a big impact on health and we’re very glad this is starting to be addressed at a national level. For our part, we will continue to help people to build stronger bonds with others through a range of tailored support.

References

1Stats taken from the following studies:

  • House JS, Landis KR, Umberson D (1988) Social relationships and health. Science 241: 540–545
  • Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk: A Meta-analytic Review. PLoS Med 7(7): e1000316
  • Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D (2015) Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 10(2):227-37

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 about the Patient Health Forum.

Making voices heard: the Maternity Voices Partnership

Since Gateway began in 2006, our tag line has been “Changing Lives, Changing Services”.

To change services, we have to play an influencing and sometimes challenging role, sharing evidence of the need for change. That’s why we have always seen it as part of our responsibility to gather views from service users, ensuring that what they say is heard by decision-makers and other people of influence.

And that’s why we’re delighted to announce that Gateway will be providing Birmingham and Solihull’s Maternity Voices Partnership.

A Maternity Voices Partnership (MVP) is a team of people who work together to review and contribute to the development of their Local Maternity System (LMS). Gateway will be bringing together regular panels of service users (people with experience of maternity services, and their families) and service delivery representatives (like commissioners, midwives and doctors) to ensure that a wide range of voices are heard.

Why Gateway? Well, having run the Pregnancy Outreach Workers Service (POWS) for over a decade, we’re ideally placed to deliver – if you’ll excuse the pun – the Maternity Voices work. We know that there is often a lack of awareness of services in the places where those services are needed the most, so we’re particularly keen to be part of a national programme that wants to build better relationships with hard-to-reach communities, and hear from as many service users, from as many different backgrounds, as possible.

Through POWS, we have already established strong connections within those communities that are known to have a poor take-up of services. We also have strong connections with midwives, Children’s Centres, Social Services, housing providers and other third sector organisations who work with pregnant women – particularly in areas of multiple deprivation. Gateway’s staff are often from these communities themselves, and are experienced in working with and encouraging people who don’t typically come forward.

Gateway’s role will be to form the MVP, finding the right people to be part of it, ensure the quarterly meetings cover topics that are of relevance to service users. Then, we’ll provide the Partnership’s feedback to the LMS Board.

We will soon be advertising for service users to get involved, we’ll be providing training to prepare them for the first meeting in July. If you have recent experience of Birmingham and Solihull’s maternity services, and you’re interested in finding out more, please contact our MVP Co-ordinator Sharon Bartlett at s.bartlett@gatewayfs.org.

This MVP will be part of the new Birmingham and Solihull United Maternity and Newborn Partnership (BUMP), which has been set up as a result of the National Maternity Review (Better Births). We’re very much looking forward to being part of project BUMP, giving as many people as possible a voice, and bringing the ambitions of the National Maternity Review to life.

(The photos on this page were all taken by, or of, our Pregnancy Outreach Workers.)

Taking a risk to invest in people’s Healthy Futures

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.

“The care navigation service is estimated to represent a saving in this scenario of approximately £10 per hour”: read how the pilot of Healthy Futures saved time for GPs and money for the NHS, according to official reports.

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.

“Diane was lonely, anxious and at risk”: read how the Healthy Futures pilot programme helped Diane

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.

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

Grant will help over 100 people improve their wellbeing

Thanks to a Discovery Grant from the Santander Foundation, we will be able to develop and deliver a new course this year – one that will help over 100 people in Birmingham to improve their mental health.

The course is designed around the “Five Ways to Wellbeing“, an evidence-based government strategy that sets out five simple actions a person can take to improve their wellbeing. The grant will allow us not only to develop the content for a five-session course, but to trial its delivery in eight venues around the city.

Mental wellbeing is a vital part of living well. This course is one that we have wanted to pilot for a while, so we’re really pleased to have been chosen to receive a grant that will help us to do this. The grant will help not only with research and development costs, but with practical costs too: things like training materials, room hire and the cost of a facilitator in each venue.

We’re already talking to a number of other local organisations about delivering the course to a range of people. As well as our community sector partners, we’re also speaking to employers because we feel this course could be really valuable in terms of encouraging healthier workforces. One place we’re looking to work is within the NHS; we think this could be a good way for the NHS to support the commitment made in its Five Year Forward View ‘to ensure the NHS as an employer sets a national example in the support it offers its own staff to stay healthy’.

The Gateway Five Ways to Wellbeing course

The course we’re developing will encourage participants to take part in activities based on the Five Ways to Wellbeing.

Like all of Gateway’s work, the content of each session will flexible, allowing participants to lead, and identifying and building on the strengths they already have.

The “five ways” are all simple suggestions – small steps that it will be easy to take – and based around self-awareness. By becoming more mindful of your own wellbeing, you can build confidence and resilience, and so reduce health risks.

“Be active” encourages physical activity because, put simply, exercise makes you feel better! The course will allow each group to tailor this step to their own mobility and fitness levels – so it could be anything from a ten minute stretch, or a walk in the park, to a bike ride or regular swim. As on our Pre-Diabetes courses, we’ll be encouraging people to decide as a group what activities they’d like to do – then we’ll help them to do it.

“Connect” will encourage participants to engage with the people around them. We’ll be looking at relationships and how to build them, whether that’s friends, family or neighbours. Gateway’s own staff and staff at the partner organisations will be able to direct people to activities in the area where they can meet likeminded people, and we’ll also be encouraging the people in the group to connect with each other to take part in future activities, if they want to.

“Give” is another way to create connections. After all, doing something for someone else is really rewarding, and it can be something as small as a smile! We’ll be looking at the ways in which people are already giving (whether they realise it or not) and how making some time to treat yourself can make it easier to do things for others. If people want to give more back to their communities, we may be able to put people in touch with volunteering opportunities, too.

“Keep learning” is all about challenging yourself to learn something new, or reconnecting with an old hobby or interest. Whether people want to learn to cook, learn a practical skill, or take on a new responsibility at home or work, we’ll be there to support them. We’ll be encouraging people to share their own skills and experiences with the others in the group and we’ll also be looking at other local activities and groups where people can try something new.

“Take notice” is probably the most important step for the people we will be working with. Becoming more aware of the world around you, and giving yourself time to reflect, is vital to your mental wellbeing. We’ll be encouraging people to take a little more notice of the little things, and to take time out for themselves, each day. So many of us complete our daily routines without taking much notice of nature or the changing seasons, but taking some time to reflect on the smallest experiences each day can help you to appreciate what matters to you.

We’re really pleased to have been chosen to receive a Santander Foundation Discovery Grant. Even the smallest funding awards – this one is £5000 – can make a huge difference to our work. We are looking forward to delivering this pilot course to at least 100 people, and hope that it will open the doors to allow us to support many more.

Could we deliver the Five Ways To Wellbeing course at your workplace? For more information, contact Michelle Smitten on 0121 456 7820.

Health Trainer group at the Signing Tree

Positive partnerships: strength in numbers!

Forming strong partnerships with other local organisations is a very important part of Gateway’s work.

By sharing resources we are able to provide a more cost-effective, joined-up service – both as an individual organisation and as a sector. In an environment where budgets are shrinking, effective partnerships mean less duplication of work, which saves vital resources. It also means less “pushing from pillar to post” for clients, easier access to services and one point of contact to help someone navigate through services.

People rarely have one issue they need support with, so all our services have always worked in partnership with other organisations, either formally or informally. Over the last couple of years, however, partnership work has become even more important to the Health Trainer service as they have started working with broader groups of people, reaching out to communities who might not otherwise be able to access the service.

Health Trainers at The Signing Tree

One partnership that we’ve set up relatively recently is with BID Services, a charity supporting people who are deaf, hard of hearing, visually impaired or have a dual sensory loss. BID Services runs a social enterprise called the Signing Tree, based at the Deaf Cultural Centre in Ladywood – and it’s here we now run a Health Trainer service with interpreters (one provided by Gateway, and the other by BID).

Gateway Health Trainer Richard, pictured, says, “I visit the Signing Tree once a month, where I set up a classroom together with two interpreters. If it wasn’t for them, the communication barrier would definitely be a sticking point – I don’t think many of the people I see at the Signing Tree would contact the Health Trainer service otherwise. The interpreters are brilliant – they actually get involved and help me to provide an informative yet fun session each month. We have 15 clients per session and it’s very popular – in fact last time, I had to turn four people away.”

Bhavana Jamin, Specialist Enablement Co-ordinator at BID, says, “This has been a positive experience for all the deaf people involved. The trainers make the pace of the sessions meet the clients’ needs and by this the clients became confident to participate and engage with the sessions. They gain access to information about their health and wellbeing that they may not be able to access from other areas, so they now have some knowledge of healthy food choices, and the information is presented visually.

“Word of mouth has been used to promote these sessions within the community and I now have a waiting list of people who would also like training in the future. So I look forward to working with Gateway again in the future.”

Strong partnerships allow us to do several things, especially when clients have more complex needs. They enable us to have an up-to-date knowledge of the issues that people in Birmingham are facing, so we can adapt the services we offer and respond to need as quickly and usefully as possible. It means more opportunity to help clients prioritise their needs, and to deal with issues in a way that suits the individual, by taking the services to them.

As well as the Signing Tree, we now also deliver services in partnership with a number of other organisations, including Jobcentres in South Birmingham, and Cerebral Palsy Midlands, based in Harborne.

If you would like to know more about working with Gateway, whether that’s to work with our Health Trainer service, or any other Gateway services, for example the Pregnancy Outreach Workers Service, do contact us – we’d be very pleased to hear from you.

Stocking up on emergency supplies

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.
Rice
Flour
Herbs and spices
Lentils
Pasta
Pasta sauces/jars of sauce
Biscuits
Some sweets and chocolate would be nice

Toiletries (unopened) for men and women:
Toilet rolls
Toothpaste/toothbrushes
Shampoo/soap/shower gel
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
Newborn nappies
Baby wipes
Cotton wool
Baby bath wash
Baby lotion
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’ve also updated our Amazon wishlist, where you can buy items and choose to have them sent directly to our office.

Thank you very much.

Social support for GP patients

As Gateway Healthy Futures is in month 10 of its pilot period, we want to show you the range of support the service offers, by letting you hear two patients’ stories, in their own words.

mini_docGateway Healthy Futures is a GP-referred service, supporting patients with a broad range of social needs. GPs can refer anyone that needs non-medical help, and they’ll get one-to-one support from an experienced para-professional.

What sort of social needs?

From the discussions that took place before we started, we had made a few assumptions about the support that people would need. We had expected to see mostly older people, and for their issues to centre on long term conditions or isolation. We also expected that the level of support provided would vary, from a fairly light touch to working with people more intensively. But we quickly found that the cases being referred to us are a lot more complex than this.

Rather than the frail, elderly demographic that we were expecting, around 70% of the people GPs refer to us are under 65 – and all have needed intensive support from a para-professional Practice Navigator, rather than lower-level support from a Volunteer Befriender.

The most common issues GPs refer patients to us with are related to mental health (for example low reported wellbeing). Social isolation is a big issue, but this isn’t usually related to age – the reasons are many and varied. As well as people who want support to manage long term conditions, we are seeing a lot of alcohol dependency, anxiety and depression, accommodation issues and financial hardship.

How do we help?

The model we use is flexible and so it works for everyone, young and old. The Practice Navigators work one-to-one with patients to come up with a credible action plan, based not just on the needs highlighted by their GP, but on the patient’s own lifestyle and the pace that suits them. We help people to start living more independently almost immediately, and the network Gateway has built up over the years means that we can signpost people to a huge range of other services for help going forward.

Gateway Healthy Futures was designed, and is being piloted, in partnership with MyHealthcare. To find out more, or to refer patients into the service, GPs and Practice Managers should call 0121 456 7820 and ask for Gateway Healthy Futures.

Meet Arlene, Aisha and Brandon

ArleneArlene Lawrence (pictured) is a Practice Navigator with Gateway Healthy Futures. She joined the team from a background in childcare and family work and has been supporting a number of patients with very different needs.

Each patient gets around ten sessions of support, depending on their needs, and these sessions are patient-driven. Practice Navigators work closely with their clients to come up with an action plan based on their own priorities, which is often hugely helpful in itself as it forces people to focus.

Two of Arlene’s clients, Aisha and Brandon, have recorded some audio so you can hear their stories in their own words.

Aisha’s story

Aisha is in her 30s. She suffers from anxiety and depression and is dependent on alcohol, which has led to her leaving work and missing rent payments. Aisha’s immediate concern was that her landlord was taking her to court over unpaid rent, but she and Arlene have also talked through what she wants and needs in the longer term.

They’ve only been working together for a few weeks but Arlene has already accompanied Aisha to housing meetings, and to the court hearing. She’s referred Aisha to a recovery agency, a counselling organisation and a Health Trainer and – thanks to Arlene’s ongoing support – Aisha has been making the appointments. In the clip Aisha explains the difference the support has made and positive impact Gateway Healthy Futures has had on her life.

Arlene says, “it’s hard because I’m here in a professional capacity, but I do give out a lot of hugs! A lot of people just haven’t had any level of support before, so you have to work together to create the boundaries. Working with Aisha to create an action plan has been beneficial because she knows there’s a cut-off date and she’s had to decide exactly what she wants out of this support and her future. She’s already made a lot of positive changes.”

Brandon’s story

Brandon is 20 and has a learning disability, with related anxiety and depression. He has been living at home but because his family life is quite chaotic, he wants to start living independently. However, until he was referred to Gateway Healthy Futures, he didn’t know where to begin.

Arlene has worked with Brandon to come up with an action plan based on his immediate needs – in this case, applying for the PIP payments he was entitled to – and what he would like to do in the future. He indicated that he wasn’t sure whether he wanted to go to college or straight into work, so Arlene accompanied him to a college for people with learning difficulties to find out more about completing his GCSEs, and helped him to prepare for job interviews by helping him to find clothes and bus fare. In the audio clip, they’re on their way to Rathbone’s – an organisation that Brandon hadn’t been aware of before he met Arlene – who have helped him to find a flat with supported living.

Arlene says, “working with Brandon makes me feel quite positive about young people! The flat where he’ll be living, down the road from his mum’s, is perfect. He’ll have company from his housemates, and six hours of support a week, with cookery lessons and sports activities available to him. He’s finding out what he wants out of life and he’s on track to get a warehouse job or something similar. It’s looking good for him now.”

Gateway Healthy Futures: making a difference

The Gateway Healthy Futures service helps patients who need social support, and we’re keen to take more referrals from GPs to show the benefits of this pilot work.

What is Gateway Healthy Futures?

Gateway Healthy Futures is here to support people with a broad range of social needs. GPs can refer anyone that needs non-medical help, so that includes people who have issues around housing, alcohol, finances, benefits, social isolation, and much more.

Our Practice Navigators support people from the age of 18 upwards, working alongside other services and organisations across the city to provide patients with one-to-one tailored support.

Whether someone just needs a cup of tea and a friendly chat to get through the day, or whether they have complex needs that will require a range of specialist help, Gateway Healthy Futures provides a one-stop-shop into which GPs can refer patients for a range of support.

As part of the Gateway family, our Practice Navigators are skilled para-professionals with a huge network at their fingertips – so if they can’t help, they will know someone who can.

Gateway Healthy Futures was designed, and is being piloted, in partnership with MyHealthcare. To find out more, or to refer patients into the service, GPs and Practice Managers should call 0121 456 7820 and ask for Gateway Healthy Futures.

Read on to find out how the service helped Diane who, without the support of a Practice Navigator, might otherwise have fallen through the net.

Diane’s story

Diane’s GP referred her into the Gateway Healthy Futures service in October last year and she was assigned to Judith, a Practice Navigator.

DianeAt their first meeting Judith and Diane discussed how Diane’s ill health and learning difficulties have knock-on effects for her everyday life. For example, cooking is hard work: she can’t stand for long, finds it hard to grip a knife, and sometimes forgets when things are in the oven.

She finds using the telephone really stressful and struggles with reading due to her dyslexia, so she finds it difficult to manage her paperwork, including bills. She told Judith she was concerned about money, and would like more people to talk to.

The little things

Diane was anxious, lonely and at risk, but it was clear that some help with the little things could set her on the road to a happier, more independent lifestyle.

One of the first things Judith did was to phone the DWP on Diane’s behalf to begin the process of claiming for PIP (Personal Independence Payments; the successor to Disability Living Allowance) in order to help ease Diane’s financial pressures. Diane had also heard about a class she wanted to attend, so they worked out which buses she could take to get there. And they talked about ways in which she could save money, perhaps by changing energy suppliers.

Judith helped Diane set up a filing system, and phoned banks and utility companies to set up new arrangements. She helped her to fill in the application forms for PIP, and then to understand the many letters she received relating to the application.

Financial hardship

We often find that it takes some time before the people we work with feel able to be completely honest about financial hardship and, indeed, it was a couple of months before Judith found out just how little Diane was living on. She was going days without food and had stopped going out because she couldn’t afford bus fare. PIP money would give her a lifeline.

However, after being assessed in December, Diane’s PIP application was declined.

Judith was able to give Diane emergency help over Christmas by giving her bus money from our Hardship Fund, and food parcels from our food bank, including a Christmas hamper, but it was obvious that she would need a longer term solution. With Diane’s need for it increasing all the time, Judith stepped up the pressure to approve the PIP payment.

She got in touch with other services in Birmingham for advice, and wrote a letter to the DWP asking them to reconsider Diane’s circumstances, giving them some extra information that hadn’t come to light as part of the application process and assessment. However, the application was refused a second and third time.

A positive outcome

Finally, Diane’s appeal for PIP went to court.

With the help of an adviser from Freshwinds, Judith and Diane gathered as much evidence as they could to support Diane’s appeal. In May, some four months after Judith’s first phonecall to the DWP, Diane attended a tribunal, accompanied by Judith, and was awarded a “daily living” payment at the standard rate.

Diane’s support from Judith has now ended, but she will still see a Gateway Befriender every now and again to carry on with some phased-down support. Thanks to Judith pushing for a positive outcome, she can now afford food and bus fare, so she’s started going regularly to classes and clubs, where she meets people for coffee and the occasional dance. Her paperwork still causes her some anxiety, but she is much more organised and feels much more able to cope with everyday life.