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Health Trainers having a real impact

Most people who use the Health Trainer service want to lose weight – but their stories are very different. That’s why the support we offer has to be different for every person.

One of the ways we make sure that we tailor our services to each person is by gathering information on our new Impact Assessment App. Rather than writing up a report after an appointment, the App allows us to record the client directly, during the visit, in their words. It records text, video, audio and images.
This means that each time we see a client, we can record how they’re actually feeling – it’s a direct record of a person’s wellbeing. We even ask people to give us a “happiness score” out of 100 during every visit.

And the App allows us to record their journey from beginning to end. After a few appointments, we can sit down with a client and look back with them to see how far they’ve come.

So here are a few examples of the variety of help that the Health Trainers give – in the words of their clients.


Eighteen year old Thomas came into the service in late Nov 2012 with a BMI of 50.

Four months later he said:

This is my 5th appointment with my health trainer today. So far I have lost 2 stone 10 pounds. I feel really good about my weight loss; as a young man I was embarrassed about my weight, and I’m not now. I wished I had met my health trainer last year. How I’ve lost the weight is by eating breakfast and lunch and an evening meal every day, and eating fruit and vegetables. The correct amount is crucial. I am looking forward to meeting people now, I go shopping, and I’m enjoying life more. Thank you for everything. You have been great.


Aston, aged 52, was referred by his GP at Karis Medical Centre at the beginning of March. He needed support with healthy eating as he eats very little during the day but then eats a lot in the evening, which is bad for him as a diabetic. One of the first things Joy his health trainer asked him to do was keep a food diary for a couple of weeks.

Completing the food diaries has helped me to see where I can start to make changes. I’ve decided to make a start with eating breakfast and looking at the menu options you gave me.


Nyachin is a 17 year old student who lives in Edgbaston. She wanted to lose weight so she would feel more confident and be able to wear trendy clothes. She began working with her Health Trainer just before Christmas. She’s now just had her fourth appointment and says:

Your advice has helped to keep me motivated and to think about what I am eating. You have given me more information and support to help me continue with the changes I have been making.

Her happiness score has increased from 65% to 100% in three months.


Fifty eight year old Derek was referred into the service in October 2012. At the time, he said:

Over the years my weight has kept going up and up. I was buying larger tops, now I’m wearing size XXL. I’m at my heaviest ever at 29 stone. Wayne [the Health Trainer] is advising me on healthy eating, portion sizes and doing moderate exercise. I feel really crap at the moment – Wayne you’ve got your work cut out as I’m hard to motivate!

In March 2013 he said,

I’m a driving instructor with major weight problems; my car seat was pushed that far back no one could sit in the back. After six months of being with my health trainer I feel so much better. My car seat has moved forward and my pupils are asking me my secret to losing weight! My health trainer has changed my life. I’ve still a long way to go but I’m doing it. I’ve lost weight before but put it all back on, and more besides. I now eat three meals, have fruit every day, drink water and eat no rubbish. Cakes, crisps, McDonalds have all gone! I have lost four stone so far.


When 35 year old Rhiannon from Ladywood started working with her Health Trainer in January, she said:

I’ve tried many times to lose weight, so I’m really glad you can support me because I know I can’t do it on my own.

Two months on, she said:

I’ve lost over 2 stones with your help and I’m really happy. You made me feel good about the two stone I have lost so far – and to concentrate on this and not the 2lbs I’ve gained.


Clare, from Longbridge, is 25 and came into the Health Trainer service with her husband.

In February, Clare said:

I have no confidence at all.

Three months later, her Health Trainer took this video:

Pregnancy Outreach Workers Handing Over

POWs can support women all the way through their pregnancy and then for a short time post natally (usually a maximum of 8 weeks). In total the support can last for almost a year. This gives the POW the time they need to tackle the woman’s issues, but equally it gives them the opportunity to forge a useful and trusting relationship.  

However they always have an eye on when their support will end – and much of what they do is to prepare the woman for this.  Ideally she will be on a more stable footing and well able to be independent.  For some women the journey is longer so there will still need to be a support network in place that adequately meets her needs.  The aim to to ensure there is a seamless transition and that she doesn’t get lost in the system.

Michelle POW Programme Manager explains; “Ideally handover is something that is thought about before baby comes along.  We like to ensure that every woman has at least one professional to turn to, should they need them. Frequently the handover is to a Family Support Worker so what we’ll try and do is arrange a visit to the local Children’s Centre while mum is still pregnant.  Not only do they get to meet their Family Support Worker and begin to establish a relationship but they see what’s on offer and what they can tap into, so classes, groups etc.”

Michelle continues: “Sometimes mums-to-be, particularly those pregnant with their first baby, may worry about where to get support if they should need it once the POW is no longer around.  This shows them that it’s there.  It’s one less thing to worry about.  It also means that they get familiar with the facilities before baby comes along, which is always a busy time, and it won’t all be new to them.”

Natasha’s coming to the end of her support from Rachael, her POW.  She’s made real progress and it’s hoped that in a few months she’ll be ready to apply for her own house so she and her baby can live independently.  For now, though, Rachael feels Natasha still needs some extra help – which is why she’s introducing her to what her local Children’s Centre can offer – and Natasha’s already applied to do their Positive Parenting course.

Some of the women we support are going to need more help than others.  In many cases the POW has been able to solve the problems the woman was referred to us with, but in some complex cases this isn’t possible.  In this situation it’s about working in partnership with other professionals and ensuring that everyone knows the part they have to play.

Miriam, one of our POWs, has concerns about one of the women she’s supporting: “She had her baby six weeks ago but due to some recent changes both she and I feel she needs some specialist help.  So I’m going to initiate a CAF (Common Assessment Framework).  I’m just filling out the paperwork to get things underway because my aim is to make sure the initial meeting happens before my support ends. I’d like to see who’ll be responsible for doing what and make sure someone takes over the role I’ve been doing which has been sort of co-ordinating things”

Michelle adds: “It depends on the woman.  We take a lead from her and how well she’s coping.  What is set is that handover must happen. There are things we do as part of it that are standard, like making sure mum knows how to register the birth, that she’s getting the benefits she’s entitled to and that immunisations are booked in, but what support remains is a unique thing; it’s tailored to the individual.”

The smoking challenge

ashtrayHelping our clients to give up smoking is an important part of the work we do here at Gateway, but it can be a bit of a challenge.

Of course we, as professionals, know what the risks are for smokers – but sometimes clients just don’t want to make it a priority. Or perhaps the client tells us they do want to address it, but it’s one of a long list of things. It’s quite a skill to support clients in tackling a whole range of issues AND keep smoking cessation on the agenda.

So how do we do it? We tend to find the holistic approach is beneficial for all of our clients. Rather than adding “stop smoking” to a person’s already long “to do” list, we help them to deal with all of the issues they have in a logical order. By helping someone to begin making positive changes in other areas of their life, we often find that they decide to tackle smoking as part of a new routine.

Health Trainer Susan says, “persuading someone to get out of a routine is difficult; it’s scary for them. But once the changes start happening, we see a knock-on effect.”

Sean, another Health Trainer, agrees. “If someone starts exercising, for example, we’ll often find that other positive lifestyle changes come from that, even without much further intervention. They start eating more healthily. They’ll gain confidence. Giving up smoking is one of the things that we continue to talk about as part of that chain reaction.”

Our Health Trainers frequently find that those people who don’t choose smoking as their first priority can be convinced to come back to it. What happens is that they first need to see they can make big changes to their life. So, for example, someone who’s been supported to lose weight sees for themselves what they can achieve with a bit of encouragement. Then, they can decide to tackle something else – maybe something that they felt was out of reach, like smoking.

The Health Trainer is key to this as they’ve already been there in the background helping and supporting them, so they’re trusted to do the same thing again.

For the Pregnancy Outreach Workers, the balancing act can be particularly difficult. Of course, time is of the essence, as the earlier in the pregnancy the woman can stop smoking, the better. However when a woman has a range of issues, some often complex, there can be a lot to tackle in a short time. Team this with the fact that pregnancy is already an emotional and vulnerable time, and women can feel a bit bombarded with do’s and don’ts. We know from experience that this is when behaviour change is far less likely to happen, so it’s vital to deal with the issues with consideration.

“We have to make sure to assess a client’s whole environment before tackling things like smoking,” says POW Sophia. “It’s important to get to know the client and build up a relationship with them – to really understand the bigger picture – before we can suggest it. There are usually lots of other problems that need to be dealt with and giving up smoking is often the last thing they want to do.

“For many clients, smoking is the only link they have to ‘life before baby’ and they see it as a stress relief – a way out. So if we’re going to persuade them to give that up, we have to pick our moment very carefully. It’s tricky, but we always find a way.”

Volunteering – good for everyone

We’re only a couple of months into our latest volunteers programme, but already it’s clear to see that it’s good for everyone involved. Each of the volunteer befrienders is matched with a client (someone who needs that bit of extra support) and, as you’ll see from the examples below, they’re getting the help they need.

Also, though, the volunteers themselves are benefiting – as, not only does volunteering make you feel good, it’s now proven to improve your health! A recently-published study has found that people who volunteer enjoy healthier hearts. That’s right – doing good is good for you!

Making a difference – the story so far…

So how does the volunteers programme work?

Clients are referred from other departments within Gateway – POWs, Health Trainers and Lighten Up – and via other routes, like partner organisations or GPs.  Then Chelsea Gaffey, the administrator for EAST (Employment Access, Skills and Training), carefully matches volunteers with clients based on practical considerations like where they live and their availability, as well as interests and relevant experience.

“Some people are volunteering as part of their university course and using it as their placement, so if they have other skills to offer we try to take these into account too,” says Chelsea. “Some clients have specific needs, so we look for volunteers that might have dealt with similar issues previously.”

“We’re really happy with how it’s going so far,” Chelsea continues. “Our first group of volunteers are settling in really well – and we’re preparing to interview the next batch in the coming week.”

Practical and emotional support

Eleven volunteers already have at least one client of their own and are supporting them in all sorts of ways.

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

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

One of our partners is the Thomas Pocklington Trust, who specialises in providing housing and support for people with sight loss. Social isolation and lack of interaction can be major problems for people with sight loss, so our befrienders have again been able to help. Volunteers Lorraine, Hannah, and Stephenhave all supported people with visual impairment over the last few weeks. The help they’ve been able to give has been varied; accompanying their clients to the shops or to medical appointments, going for walks and even helping with IT problems.

There are still a few places available, so if you’re thinking that you’d like to give this type of volunteering a try, why not get in touch?

Gateway’s volunteers programme is funded by the Big Lottery Fund.

Breastfeeding 20% more likely with Gateway POWs

In the last quarter of 2012, 65 babies were born to clients of our Pregnancy Outreach Workers team, and 55 of those women initiated breastfeeding.

That’s 85%, compared to an average of 65% in the wider community*.

In December alone there were 17 births and 16 of the women initiated breastfeeding – a whopping 93%.

Increasing the rate of breastfeeding is something that’s important at both a national and local level, so we’re delighted to be doing our bit to reach the city’s targets.

Most clients want to breastfeed – they know it’s the natural thing to do and the benefits it brings – but sometimes they need just that extra bit of help. That’s why all of our POWs are trained in breastfeeding support as part of Unicef’s Baby Friendly Initiative.

Before the baby arrives, POWs give their clients lots of information, including leaflets and DVDs from the World Health Organisation and Unicef. Often, POWs will watch the DVD with the client so that they can explain or interpret it, talk about it and answer questions. We also run group sessions where POWs can demonstrate different breastfeeding techniques using dolls.

Sophia and Khadijah run a session at Springfield Children’s Centre. “It’s a six week course, where we show the DVD and give out handouts, as well as giving demonstrations of things like how to help baby latch on,” says Sophia. “We answer questions and discuss worries so that the mums are as prepared as possible. Then, for up to eight weeks postnatally, we visit mum and baby to give some extra support when they need it most.”

In this video of a typical breastfeeding group session run by the POWs, Colette uses a doll to show some different techniques for breastfeeding:

Another POW, Jacqui, says, “At the time of the birth, breastfeeding support is vital. We find that if the mother doesn’t get enough help and encouragement straight away, in the hospital, she’s more likely to start bottle feeding. That’s where POWs can really make a difference.”

Jahanara’s client had her baby on Sunday. “I was her birthing partner,” she explains. “Before the baby was born, the mum had told me that she wanted to breastfeed; this is her second child and she’d already told me how difficult she found it when she bottle fed her first baby. So I knew it’s what she wanted – but, after giving birth, she was so tired, she just didn’t want to do it. She wanted to give the baby a bottle. So I gently reminded her of everything she’d talked about before, and encouraged her to try again. Now she’s very happy to be breastfeeding.”

*published average breastfeeding rates for 2012 in the wards we cover. Source: Birmingham Public Health Health Inequalities Action Plan 2012.

Gateway staff climb Kilimanjaro… without even taking a day off

February is National Heart Month. So four staff at Gateway are taking part in a British Heart Foundation challenge – to climb the equivalent of Mount Kilimanjaro… at work!

Maxine, Justine, Jamie and I are taking the “stair climb challenge”. Our target is 2578 flights of stairs – the equivalent of walking up Mt Kilimanjaro – between us.

It sounds dramatic but, after some nifty calculations from Maxine, we’ve broken the total down to an average of 33 flights of stairs each a day. At that rate, we can “reach the summit” within 25 days (five weeks of five working days).

Here’s a little video that shows the intrepid climbers as they begin their latest ascent.

We decided to give the stair climb challenge a go after reading about it on the BHF “active at work” website. We’ve been promoting to the people we work with for a while now, so we thought it only right that we give it a try ourselves. As the site says, “Employees who are physically active at work enjoy it more. […] They’ll have better concentration, be more mentally alert, and have greater rapport with colleagues.”

We’ve all found it fairly easy to fit in some extra flights of stairs as part of our working day. Maxine says, “It’s actually quite easy to fit the stair climb into your daily routine. And when you’re sitting at a desk all day, it’s nice to have an excuse for a quick break.”

For Jamie, this is the latest part of a long term weight loss plan. He’s massively improved his health since starting at Gateway over 18 months ago. And at the end of the first week, he’s ahead by some way. “I’m doing a mini workout every lunchtime,” he says. “I walk up three floors, three times. It all adds up.”

All of us are already starting to see the benefits of a little extra exercise every day. Justine says, “for the first couple of days I was out of breath after coming upstairs to work in the morning, but I’m already coping better. If I can feel like this after just a few days, I hope that five weeks of it could really make a difference. By the end of the challenge, I’d love to have buns of steel!”

If you’d like to give the stair climb challenge a go yourself, have a look at the British Heart Foundation’s Active At Work website.

First steps for the new twenty minute walking group

Yesterday saw the first outing of our 20 minute walking group, a six week “assisted gentle exercise” programme in partnership with Shenley Green Surgery.

As we mentioned in our blog post about the main Shenley Green walking group a few weeks ago, the idea of the 20 minute walk is to provide some gentle group exercise for those who, for one reason or another, can’t manage a full hour.

The new group started their first session with a chat about exercise and the benefits of physical activity, then the six walkers did a 20 minute circuit of the surgery. They were led by Health Trainer Keiran, who has been working closely with the surgery to set up the group.

“We had a very varied group on yesterday’s walk, most of whom I already knew through my other Health Training work. It’s good to be able to offer an opportunity like this to people,” Keiran says. “The group enjoyed the walk, and look forward to the next five weeks, some of which will be led by other Health Trainers and will include presentations from other health professionals.”

Participants in the “assisted gentle exercise” programme tend to be referred by their GP. Most people who take part will be recovering from illness – perhaps from an operation, a fall, or a cardiac episode – or they will be awaiting treatment. At this point, doing something too strenuous would be a bad idea, but a gentle walk can be very beneficial.

The video below shows the group enjoying their first session – despite the rather hilly terrain!

As the NHS Choices website explains, regular walking has been shown to reduce the risk of chronic illnesses, such as heart disease, type 2 diabetes, asthma, stroke and some cancers. Group activities like this are also beneficial for mental health – as participant Jenny says in the video, a walking group is a great way to get some fresh air and meet other people.

We hope that, over time, the gentle exercise from these regular 20 minute sessions will allow people to build up their stamina and, eventually, we’d love to see the 20 minute walkers join the main walking group.

Linda’s a Lighten Up champion!

Gateway took over running the Lighten Up service 18 months ago and in that time we’ve seen hundreds of clients lose thousands of pounds in weight.  The most successful to date has been Linda Bartlett.

Over her 12 months with the service, Linda reduced her BMI from 43.4 to 26.68 and lost an amazing eight stone – and, thanks to the kick start from Lighten Up, has continued to keep up the good work since then.

So how did she do it?

Linda had managed to lose some weight on her own, but was finding it hard work. So when she heard she could go to a slimming group for free for 12 weeks, she decided to give it a go. She says, “I thought ‘if it doesn’t work, I won’t have lost out on anything'”.

In the first 12 weeks, she lost two stone. With continued support from the Lighten Up service for the following 12 months, she lost a further six stone.

Crucially, Linda lost weight in a regular, consistent way. Her average weight loss in the first six months was just over two pounds a week – which is a very healthy rate and gives her the best chance of keeping the weight off.

Linda’s Key Stats

Day 1: 19 stone / BMI 43.42
At 12 month maintenance call: 11.10 stone / BMI 26.68

Since leaving the Lighten Up programme in June 2012, Linda’s lost a further stone and is now at the weight she wants to be. Altogether, counting the weight lost before, during and after her time with Lighten Up, she’s managed to lose a whopping 11 stone. As she says herself, that’s “a whole person!”

Linda has continued to maintain a healthy lifestyle and, in this video, Linda explains how the continued support she received, and the lifestyle changes she’s made, have helped her to keep the weight off.

Lighten Up is a free service. It’s open to anyone aged 16+ with a BMI of 30 or over who lives in Birmingham or is registered with a Birmingham GP. On average, clients who complete the programme reduce their weight by 5% and – more importantly – keep the weight off.

To find out more, speak to your GP, or contact Gateway on 0121 456 7820 and ask for Lighten Up.

Pop Up Talent Generator: Volunteer Facilitators wanted

Pop-Up-Talent-logo-smGateway are looking to recruit four volunteer Pop Up Talent Generator Facilitators as part of the Pop Up Talent programme running in Birmingham.

The purpose of the role is to support 12 young people to carry out a 12 week social action project that is driven by the young people themselves, by hosting weekly team meetings and facilitating activity. Young people should be encouraged to lead themselves as much as possible, with support and encouragement from the facilitator, Pop Up Talent staff, and mentors sources from the community.

To see if you fit the bill more information on the role can be found by reading through the Pop Up Talent Generator Facilitators Specification.

If you have any questions please feel free to email Lee Marsham on for more information on next steps and for an application form.


POWs preventing Pre Natal Infections

Pre Natal Infection is one of the major causes of infant mortality.  Our Pregnancy Outreach Worker Service (POWs) works hard to reduce infant mortality here in Birmingham, so today, the first day of  Pre Natal Infection Prevention month seems the ideal time to explain what we do to help.

If women miss their ante natal appointments they and their babies are at more significant risk.  We see that part of our role is to get this message across but then it’s about taking practical steps to make sure they get there.  Many of the women we work with have missed appointments, in fact this is one of the reasons midwives refer people to us as they know we can be relied upon to tackle this issue.  We understand why what appears to be a routine thing can be a problem for some women.  Recognising the issues helps us put in place practical steps as Shazia one of our POWs explains:

Over the past 6 months we have supported 150 of the women we work with to attend their ante natal appointments, whether that be by helping them get them booked in, ringing them the day before to remind them,  explaining in advance what they can expect,  or accompanying them to give them some morale support (even  giving them a lift if they’re stuck for transport).