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Brighton and Hove Common Ambition: Case Study

Brighton and Hove Common Ambition: Case Study

Patient voice for those experiencing homelessness in Brighton and Hove has never been fully established. The experiences and insights of these patients have been difficult to gather and health inclusion services have very little co-production woven into their delivery model.


Brighton and Hove Common Ambition brings together people with lived experience of homelessness, frontline providers and commissioners through co-production within homeless health services. This is in order to improve systems, services and outcomes for people experiencing homelessness in Brighton & Hove. It is a three year project and it is in its final year.


This is a partnership project that is funded by the Health Foundation, the project partners are Arch Healthcare (NHS), Justlife (third sector), the University of Brighton (academic and evaluation partner), The Brighton and Hove City Council Health Department and NHS Sussex.


The Common Ambition Steering Group design and deliver the project. This group is made up of people with lived experience of homelessness and members from Arch Healthcare, Justlife and University of Brighton. The Steering group first came together in June 2021 and the work it has carried out covers the following areas: developing effective co-production practices; system review; service design; training; advocacy and campaigning. The co-production sub projects carried out by this group include:


Developing effective co-production practices

  • Developing a group approach to trauma informed working

System review

  • Mapping Brighton and Hove’s homeless healthcare system and identifying the challenges and barriers within the system.

  • Mapping the Brighton and Hove housing pathway, identifying challenges and co-designing solutions

Service Design

  • An initial service design sprint focussing on finding solutions to difficulties accessing services and co-designed a prototype called ‘Route to Roof’

  • Inputted into the development of Arch Health CIC move-on and outreach services

Training


  • Co-designed a training course for medical students

  • Co-produced events to share learnings

  • We are currently working to co-produce a co-production training workshop


Advocacy and campaigning

  • Forming Media and Communications group to co-produce project communications

  • Co-producing a social media campaign for World Homeless Day 2022

  • Co-produced a project website: Home - Brighton & Hove Common Ambition (bhcommonambition.org)

  • Developed manifesto points for local MPs before the May local elections


There have been serval key impacts noted by group members participating in the project including:

  • Growing in confidence and skills building

  • Developing a voice for this community and feeling heard

  • Moving on to college or volunteering roles


There have also been key impacts on Arch Health CIC, project partners and wider city stakeholders including:

  • Lived experience involvement in designing healthcare services

  • System maps that can be used by the whole city

  • Effective co-production practices that can be shared and adopted by services in the city

  • Effective design of process to ensure lived experience participation in medical student training


Testimonies, learning, experience and co-produced processes from people with lived experience of homelessness can be found in blogs written by group members on the project’s website: Latest News - Brighton & Hove Common Ambition (bhcommonambition.org)


Key learning from the project so far includes:


  • An important learning to share is that co-production in homeless healthcare takes time and resources to build trust and a safe environment to ensure effective co-production.

  • Co-designing and delivering the project plan and specific deliverables and outputs has meant that detailed goals, outputs and timelines could not be predetermined. There was a level of uncertainty in methods and processes, these had to be co-designed as the project evolved.

  • In order to effectively co-produce it is important to ensure there is a level of understanding of the system and services, this was developed by mapping the system collaboratively.

  • It is impossible to take up the challenge to work with people with lived experience to improve health services and outcomes, without addressing the system as a whole. Feedback from across the system, featuring in almost every conversation, states that the system is inaccessible, confusing, disjointed and there is a distinct lack of good communication and housing.

    What’s next?:

The project is funded via the Health Foundation until March 2024. The project team is exploring opportunities to enable this project to continue past this time. The project is looking to revisit medical student training in order to establish a mandatory element. It will also explore mental health services in the city and how co-production can support improvement here. The big hope for the project is that it will be able to advocate and co-design a homeless health hub where all services can sit under one roof and people experiencing homelessness have a central place to access care and support.



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