The new year will see us launching a new service for people in Solihull: the Lighten Up For Life weight management group.
Lighten Up for Life has been designed as an extension of the Solihull Lighten Up service (SLU), which we’ve been running for a while. SLU supports people in a number of ways, but a very popular option is a weight management group, so we’ve used our in-house specialists – and over a decade of experience – to design a weight management group with a difference.
The free 12 week programme is funded by Solihull Metropolitan Borough Council and sessions will run at two venues (to begin with) in Chelmsley Wood.
The main difference between Lighten Up For Life and other groups is that this is intended to be a distinct 12 week course, rather than a group that people will continue to go to indefinitely. That’s because we believe weight loss should be a sustained, behavioural lifestyle change. By the end of 12 weeks, we hope the people who attend Lighten Up For Life won’t only have lost weight, but will have made the changes required to keep the weight off. We don’t want the people we work with to be attending weight management groups forever – we want to give them the tools they need to make the changes themselves. For life.
Over the last ten years, Gateway has helped thousands of people to lose weight and keep it off, through services like Health Trainers. The Lighten Up For Life team includes para-professional Health Promoters who have been helping people to make sustained lifestyle changes for many years, as well as an experienced Dietitian, and a Behaviour Change Adviser who is a trainee health psychologist.
And, unlike some other weight management groups, Lighten Up For Life isn’t just about diet. The 12 sessions will include physical activities, ways to manage stress, tips about “food and mood”, and the type of social peer support that we know from experience really helps everyone in a group.
We’re really looking forward to delivering the Lighten Up For Life course and we’re delighted that so many people have already signed up for the first sessions in January. If you’d like to join them, call 0121 456 7820 and ask for Lighten Up For Life to find out if you are eligible.
Shazia has been a POW since the start of the service in 2007. At the time, she wasn’t sure what she wanted to do – she’d done some teacher training but knew it wasn’t for her. However, as part of teacher training she’d met someone involved in the health sector, and felt immediately that she would be more suited to this sort of work.
Soon afterwards, she saw an advert for the new Pregnancy Outreach Workers Service and liked the idea of it. “I liked the fact that there would be no routine and I would be doing something different every day, and that I’d be in charge of my own caseloads. I always knew I wanted to help people and that’s exactly what I would be doing.”
Shazia puts her ability to engage with people down to her sense of humour. “I’ll make fun of myself if I have to. Helping clients to see the humour in situations breaks down barriers and brings people closer together.”
Shazia’s most memorable clients are those who have had issues with substance misuse. “When I started, my knowledge of drugs wasn’t great – I knew a bit about it but not much – but over the years I’ve learned a lot from my clients. Now, I understand the phrases people use, and the way users think.”
She continued, “the thing about addiction is: there’s no point in patronising someone or telling them they shouldn’t do what they’re doing. They know this already. They feel a terrible amount of guilt. They deserve to be treated nicely.”
She went on, “the pull of addiction is really, really strong. If the only people you know are dealers or addicts themselves, and they all have your number and know where you live, that’s a hard environment to get away from. Most of the addicts I’ve met started using in response to abuse or trauma from a young age – things they’ve never had any real support for – so the problems go very deep.”
Shaz recently bumped into someone she supported six years ago. As they chatted, the woman thanked her, saying, “you were the one who treated me like I mattered, and didn’t look down on me”.
Shazia says, “This person’s journey was special to me because I was the one who communicated with her the most, explaining what was happening and often being the person who had to give her bad news. She had a social worker, who was very good, but she didn’t trust her… So it was me who was her birthing partner, staying three nights in the hospital with her. And then it was me who explained to her that, because she hadn’t had four clean drug tests, it was unlikely her baby would be going home with her.”
When support ends, Shazia says it’s important to close cases properly by ending contact and making sure that clients are self-reliant. “It’s not fair on them if they continue to rely on me afterwards,” she says.
(Shazia went on maternity leave last month. When she returns next year, it will be to a new role within Birmingham’s new Early Years Health and Wellbeing service.)
Jacque came to Gateway at the very start of the POW Service in 2007. For her, it was the ideal job.
“I have a degree in Family Work and before I joined POWS I was working with families as an outreach worker and social therapist. Working one to one with families is ideal for me.
“I love helping people face to face, helping them to find balance and meeting their needs. Sometimes people just need someone to listen to them, and even just a fifteen minute chat can have a big impact. This kind of social support is vital.
“One of the great things about POWS is that we are from the communities we support, so we know what’s out there and can engage at a community level. The women we work with trust us, because there’s a mutual understanding. We can have a real heart-to-heart … it’s mom to mom.
“Over the years the POWs have supported thousands of women between us. The original remit for the service was to support ‘marginalised’ women – those who have experienced domestic abuse; women with mental health issues; families with no recourse to public funds – and over the years the needs have become more acute.
“The women we’re supporting now are more vulnerable than ever. They include refugees and people who have been hit really, really hard by the recession, so we are dealing with a lot of homelessness, and language barriers.
“Although on paper we do a lot of the same things that other support workers do, the difference is that we are more available; more accessible than most. We will come out to see people wherever they need us to, whether that’s at home, at a Children’s Centre or at the shops, and they can call us at any time.
“It’s our job to make sure baby is born healthy, and to reduce inequality. And the way we do that is to make sure mom has support from as early a stage as possible. If she’s smoking or drinking, or if she isn’t eating properly, perhaps because she doesn’t have the finances to support herself – then of course the child will be born into inequality.
“Some of the happiest times with POWS have been seeing people’s excitement at a new house, or seeing women breastfeed happily when they never thought they’d be able to.”
Jahanara has been with Gateway on and off for many years. Like many of our POWs, she originally joined as a Community Family support worker, but as a speaker of different Punjabi dialects, including Mirpuri, she’s also worked as a Gateway Interpreter.
As a POW, Jahanara works with a mix of women, but over the last couple of years has seen more and more women with mental health problems.
Recently she supported a client who has suffered severe depression and mental health issues after being raped. She had never told anyone about it – not even her husband – and it was only when she became pregnant with her husband that she finally started talking about what had happened.
“She’s in such poor health that she hasn’t really been able to look after herself,” says Jahanara. “But it’s my job to make sure that she will be able to look after her baby when it arrives. We have spent a long time talking and her husband now understands that he needs to really look after her at the moment.”
Sometimes it will take a while for women to admit they need help. On one visit to a new client, the pregnant woman told Jahanara everything was fine – but Jahanara noticed that her other children were going barefoot and wearing ill-fitting clothes. So, on the next visit, she took along some items from Gateway’s baby bank, including children’s clothes, baby clothes, toiletries and nappies. “She couldn’t believe it,” says Jahanara. “She said, ‘I only get £90 a week and it goes so quickly. You can’t believe how much you’ve helped me.’ It gave me peace in my heart.”
Often, women will have a number of support workers, but don’t feel like anyone is there to support them, themselves. “Sometimes women just need someone to make them smile, or to pop to the shops with them,” says Jahanara, “and provide a bit of moral support in everyday life. Most support workers are there for the child, but we are there for mum, giving her someone to rely on and a number to call in times of need.”
Sophia has been here since the start of the service in 2006. She says, “it’s completely changed in that time!
“Over the last decade – and the last couple of years especially – it’s gone from simple signposting and accompanying women to appointments, to supporting women with issues around safeguarding and substance misuse, and helping them through court reports and procedures.”
Sophia says she’s learned a lot as a POW, both on the job and from her colleagues. “We’re a good team,” she says. “It’s important for us to be able to offload onto each other, bounce ideas around, and support each other through difficult cases.”
Sophia explains how important it is for POWs to meet women as early as possible during their pregnancy. “POWS is a preventative service. Often, if we meet women in the first few weeks of pregnancy, we can start helping them to begin the routines and habits that will lead to a healthy pregnancy. We can sort out a lot of issues before they get to the point where the woman or her unborn child go into safeguarding.”
Sophia is keen to point out that POWS are there for mum, when everyone else is there to support the child, and that they can prevent safeguarding issues. “The whole reason POWS were brought in was to empower women. If we can support them to make their own healthy choices from the beginning, then we can prevent a lot of issues later on down the line. In many cases we can help to stop babies being removed and going into care.”
Many of Sophia’s clients are women with a number of complex issues. “One woman who always stays in my mind already had a teenage child, and she’d had another baby years ago who’d died. When I met her she was pregnant with her third child, but she was not in a good way at all – she was drinking heavily, smoking cannabis and more. She’d been referred to drug workers and social services, but she needed more help during her pregnancy so she came to us.
“I helped her to focus, really. By taking her out of her environment a bit, and helping her to make sure that her money went onto the things she would need for her baby rather than drugs, I supported her to start new, healthier routines.
“For many women, the only support network they have is an unhealthy one, so we can provide a different outlet – we’re there for her to talk to at the end of the phone, we can meet up with her at home or in the community, and we can support her with all the admin that having a baby brings – filling in forms, shopping for essentials and getting to appointments on time.”
Shaista’s been here for nine years so she’s a relative newbie!
“POWS used to work out of Children’s Centres, which was a bit isolating, so coming together to work out of the Gateway office a few years ago was the best thing. Being able to work as a team, sharing advice and supporting each other is important for us.
“I’ve worked across Birmingham, with all types of new mums, including teenagers and older mums, and in lots of different communities, from Washwood Heath to Handsworth.
“That’s what I love about the job: we’re out in the community, and anything can happen. But that’s also why POWS are good for pregnant women – because we can go to them.
“It’s all very well making an appointment for someone to visit a Children’s Centre, but it’s not always practical to expect a pregnant woman to travel, especially if they have other young children too. If they’re new to the area they may not be able to remember where to go, or how to get there on public transport, and if finances are an issue, then even bus fares can be prohibitive.
“We are also really accessible. We are there from early on in the pregnancy, because early intervention can be vital. The more that services are cut, the more vulnerable women need someone to help them prepare, and to navigate through what is often a very confusing and admin-heavy time.
“Clients have our phone number and they can call us any time. We can visit families in the evenings if necessary, and we can use our own transport to pick people up and take them to appointments. It’s this sort of flexibility that really sets us apart from other health professionals and helps us to build a more genuine, useful relationship with the women we work with. We’re not turning up in a suit with an official-looking badge, we’re just popping over to give them a bit of support.
“One of the things that has really helped us recently is the ability to use more modern technology in our roles. We all have tablets that we take to each appointment and that means we can help people to fill in forms, bid on council properties, and make appointments there and then. This can be really important for people who don’t have internet access at home, have limited phone credit, or find it hard to talk on the phone, perhaps due to language barriers.”
This week, we thought we’d share some more personal stories, both from the Health Trainers themselves and the people they’ve supported.
Beckie is moving over to work for Gateway’s Pre-Diabetes team, but here she reflects on her year as a Health Trainer and tells us about one of her most memorable clients during that time.
Ralph came to the Health Trainers from the Lighten Up service. Here, he tells us what he has found most satisfying about being a Health Trainer. Sometimes, the successes aren’t as obvious as you think!
Contrary to popular belief, the Health Trainers service wasn’t just about weight loss or physical activity (although of course they helped people with that too!) Many people reported improved mental health and wellbeing, reduced their alcohol intake, or became less socially isolated thanks to their Health Trainer.
Wayne (pictured above at our Health and Wellbeing Day in July) told us how one of his clients came in for help with her weight management, but went on to make many other changes.
“Once she’d made the decision to lose some weight, it felt easier for her to make other changes in her life too,” he says. “One of those things was smoking. She knew she had wanted to stop smoking for a while – especially after one of her grandchildren made a comment about it, saying ‘nanny, you don’t smell very nice’, so the next time she came to see me, she asked about smoking cessation services and I was able to refer her straight away to a stop smoking clinic. A lot of people think it’s really difficult to stop smoking without putting on weight, but because she’d made the decision to change, and made the changes in tandem, she found it a lot easier than she thought.”
Health Trainer Margaret (left) told us about one of her clients, who was referred for weight loss, but whose issues went a bit deeper than that. “She rarely left the house,” says Margaret, “so she wasn’t doing any physical activity at all. She also had a diagnosed Obsessive Compulsive Disorder which meant that she had a lot of discomfort around eating. She hated certain foods because of her phobia of crumbs and dirt, and didn’t eat any fruit or vegetables.
“So I supported her by taking things really steady and helping her to mentally prepare for the changes to meals. First we substituted just one item of food at a time in each meal for a piece of fruit or veg. Then we started getting her out of the house, for just two or three minutes a day. And she really worked hard. Every time I met her she was going out for longer and longer periods of time and eating more and more healthy foods.
“By the end of the support, she had already lost a stone and a half, and was walking down the road to meet me in different locations. I’m so proud of her! And it’s so rewarding for me, too. I have really loved this job.”
As you can see, the service means a lot to staff and their clients. We hope that, in a future without Health Trainers, people will continue to get the support they need.
It’s a sad time for Gateway, as funding from Birmingham Public Health comes to an end for one of our longest-running services.
The popular Health Trainers service, offering one-to-one support and advice to people who want to make lifestyle changes, has been decommissioned and will finish at the end of September.
All our Health Trainers are now working hard to finalise arrangements with their remaining clients and get everyone to a place where they feel they have achieved at least some of their goals.
Although it’s a sad time for us, it’s also bittersweet, as we reflect upon the Health Trainers’ many successes and achievements. So we thought this would be a good opportunity to have a look back at the service and share some of the stories and statistics with you.
The Health Trainers service was started in 2008. By the time the funding ends, we will have worked with more than 18,000 South Birmingham residents, with more than 90% completing their support.
Over the last two years, the service has changed very slightly. Rather than focusing our support in the most deprived areas of Birmingham, we now focus on people with a level of vulnerability. This can include recent offenders, people with substance misuse, people who have experienced domestic abuse, or mental ill health, and people who are in temporary accommodation. More than a third of the 2000 people we work with every year are in this group.
When a Health Trainer starts working with someone new, they help them to come up with a set of achievable goals to work towards. These often include losing weight and becoming more physically active, but they also include stopping smoking, or even becoming more confident and socially active.
Over the last decade, Gateway’s Health Trainers helped people to achieve, or part-achieve, the goals they set themselves in 84% of cases. For example:
Physical activity: 91% of the people we worked with needed to increase their levels of physical activity, and 85% did
Nutrition: Of those who were eating less than the recommended level of fruit and veg, 52% of those classed as “low” and 60% of those classed as “very low” resolved the risk
Alcohol: 45% of those who had a risk relating to drinking more than the recommended level of alcohol resolved that risk
Mental health: More than two-thirds saw an improvement in their mental wellbeing, according to WEMWBS measurements at the beginning and end of support
Dr. Asfia Aftab is a GP Partner at Vicarage Road Surgery, one of the GP surgeries that Gateway Health Trainers worked with. When told about the end of the service, she said, “I am sad to hear this news. As you know, we had a great experience with Health Trainer services for our patients in Kings Heath and say they were a very valuable part of the primary care services we provided. We had a lot of great anecdotal feedback from patients.”
As Josh explains, below, Health Trainers is a “whole person” service and one of the biggest benefits of the service has been the ability to offer people time. Time to build up a rapport, learn as much as possible about a person, and really talk things through.
Josh came to Gateway after completing a degree in Psychology; first as a volunteer, and then as a Health Trainer. He has used the skills and knowledge gained as part of his degree to back up his work with Gateway, helping people to make significant lifestyle and behavioural changes.
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.
Could your organisation benefit from Gateway Health Trainers’ expertise?
The Health Trainers service can now be tailored to the needs of a specific group or organisation, and commissioned directly. As well as traditional one-to-one support, Health Trainers now design and lead flexible wellbeing programmes for groups in a range of settings. If you are looking for creative ways to motivate your workforce or client base, a Health Trainer could be just the ticket.
After all, Health Trainers aren’t just about physical exercise and healthy eating; they offer preventative health advice and encouragement that changes people’s lives.
As well as weight management advice, Health Trainers help people to learn how to budget and how to cook. They help people who smoke, or are at risk of diabetes or high blood pressure, to reduce their risk in the long term. They help people to become more confident and more socially active, as well as offering practical help with things like housing, benefits, and finances.
Over 40% of the people we worked with last year have both physical and mental health needs. We understand healthy living goes hand in hand with good mental health, so our Health Trainers know what to do and who to involve to reach that balance.
We also know there are strong links between good health and wellbeing, and employment. Over the last decade we’ve supported many people back into work by helping them to reduce their anxiety and build their resilience. For those already in work, support from a Health Trainer can help to build confidence, lower sickness rates and raise morale.
Could this kind of support help your organisation too?
Over the last year, Gateway Health Trainers have worked not just alongside GPs in their surgeries, but with an increasing number of local organisations including Jobcentres, Cerebral Palsy Midlands, the Signing Tree and Better Pathways. Health Trainers’ tried and tested methods can be tailored to add value to all kinds of other services. Give us a ring on 0121 456 7820 to find out more.
Case Study: Better Pathways
Better Pathways (formerly BITA Pathways) is a mental health charity in Birmingham which specialises in offering training and work opportunities for adults with mental health problems. Gateway Health Trainer Wayne (pictured) got in touch with Michael Summers, a Recovery and Employment Adviser, to create a six-week Health Trainer package for service users at Better Pathways, supplementing the great work they already do around mental health recovery and employability.
The first thing Wayne did with the ten people who were referred into the sessions was to get everyone to start a food diary.
“It’s one of the easiest things you can do to kick-start a healthy lifestyle change, and yet it’s one of the most eye-opening,” explained Wayne. “It helps us to start to see patterns, and from there you can start making really simple changes.”
Mohammed’s diary showed that he rarely ate fresh food, but ate microwave meals twice a day. Together, he and Wayne looked at the food labels of some of his regular meals and Wayne pointed out the high levels of salt he was consuming. Mohammed started replacing some of the ready-meals with fresh fruit and veg, and managed to cut his intake to just two microwave meals a week. It’s a simple change, but it’s likely to drastically reduce his risk of having a stroke or a heart attack.
Dale was eating a lot of snacks throughout the day – and his food diary helped him to notice just how many! Thanks to the food diary and the weekly sessions with Wayne, he found it a lot easier than he thought he would to stop buying them, and put temptation out of his way. Not only is he losing weight as a result, but he’s saving so much money, he’s decided to save up for a bike!
As well as healthy eating advice, which included some fun, hands-on cookery sessions, Wayne offered one-to-one advice for everyone who came on the course. He also helped Better Pathways to set up a walking group for service users, which now meets every Friday for a sociable half-hour walk round the park – another simple lifestyle change that impacts mental wellbeing as well as physical health.
The positive social element of the Health Trainer support was a nice surprise for many of the participants – who started arriving earlier and earlier each week just to have a natter and a cup of tea, and continue to walk together regularly. But the biggest change was weight loss, with all ten clients losing weight as a direct result of the course. As a group, they lost a total of 5 stone 3 pounds (33kg)!
Michael, a Recovery and Employment Adviser at Better Pathways, says, “we believe that healthy living goes hand in hand with healthy mental health, so having the service with us was a huge benefit to our clients. All of them reported benefits such as weight loss, healthy eating, and knowing how to cook.”
You can hear more from Michael in the video below.
Wayne says, “it’s been really rewarding to see people make such big changes in just six weeks. I’m really proud of everyone I’ve worked with at Better Pathways. Not only have people lost weight – and they’ve lost a lot of weight! – they’ve gained confidence and made new friends. It just shows, no matter where you are in life and what your abilities are, a lot can happen if you have the right support.”
If you would like to talk about working with Gateway to deliver a Health Trainer service at your organisation or workplace, please contact Jemma Abbott on 0121 456 7820.
A note – and a message for GPs
Our funding from Birmingham Public Health comes to an end in September, when the Health Trainers service will be decommissioned. We’re continuing to support everyone who’s already been referred into the service, but after the end of September we will no longer be running the service in the same way.
The numbers show that Health Trainers has been a popular and successful service. By the time the funding ends, we will have worked with more than 18,000 South Birmingham residents, 85% of whom were referred by their GP or another member of practice staff. Health Trainers have assisted people to achieve or part-achieve the goals they set themselves in 84% of cases.
We’d like to express our gratitude to GPs for the way they’ve worked with us and supported our Health Trainers over the years. Many GPs hosted a Health Trainer in their surgeries and our Health Trainers tell us they really appreciate the way the GP Practices made them feel part of the team. Thank you for making them feel so welcome and valued.
We’re very keen to continue providing Health Trainer support to surgeries, as well as to other agencies and organisations, which is why we’ve come up with a cost-effective, flexible package for GPs. If you’re a GP or Practice Manager, please contact us to find out more about how we can continue our partnership.