Specialist Health Visitor for Vulnerable Families in Temporary Accommodation in Hounslow

Background

Health visitors are registered nurses or midwives who have additional specialist training in public health. They work with families from pregnancy to starting school. They are in a unique position as the ‘eyes and ears’ of the community, with contacts carried out in the family home.

During the Covid 19 pandemic, the number of asylum seeker families staying in temporary accommodation in hotels in Hounslow increased. This increase was recognised by members of the health visiting team and created an unmet health need.

We took steps to improve access to healthcare for these vulnerable families and this culminated in the creation of a Specialist Health Visitor role for Vulnerable Families in Temporary Accommodation in the Hounslow health visiting team in November 2022.

The increase in asylum seekers and the increase in health needs related to this community inspired us to create this role. We felt that it was more beneficial for the families to have one person they could build a relationship with and trust rather than having different health visitors.

We also had a vision of having a lead person who would advocate for the families and influence decision making while working with other partners.

The number of asylum seekers living in hotels in Hounslow fluctuates, but currently there are circa 100 mothers/expectant mothers and 200 children aged under 5 housed in seven hotels. The families come from countries such as Albania, Afghanistan, Iran, Iraq and Syria and face a life of uncertainty. Parents and children have experienced trauma in their home countries and on their journeys to England and mental health support is a priority.

Improving access to our service

Telephone language interpreters are used for face-to-face contacts when needed and information leaflets are provided in the home language of the family.

Text messaging and communication via email is preferred by clients rather than telephone calls as they are able to use technology to translate communications. This population rely on hotel wifi as they frequently do not have credit on their phones. The specialist health visitor has therefore adjusted her methods of communicating with this group accordingly.

The specialist health visitor spends days and half days at the hotels thus increasing visibility and access to the health visiting service.

Meeting the needs of individual service users

This role adds value by collaborating across disciplines and stakeholder groups to meet healthcare needs. On the occasion of a planned closure of one the hotels, the specialist health visitor wrote supporting letters for two of the most vulnerable families living there. The letters outlined the reasons why the families needed to be re-housed in the local area so they could continue to access vital health and wellbeing services.

The post-holder works collaboratively with hotels and other services such as midwifery, dietitians, and primary health care to suggest improvements to the food provided at the hotels.

The specialist health visitor has met with local MPs and councillors to share her concerns for this vulnerable population. She has also liaised with senior colleagues in primary care, Hounslow Borough Council and safeguarding. In addition, relationships have been built with the hotel staff supporting the families and local charities and voluntary organisations. All with the same aim – to support the health and wellbeing of this vulnerable group who can find it difficult to navigate systems and who do not always have a voice.

Outcomes

• Keeping children free from harm – this new role has enabled focused attention on the health needs of this vulnerable group
• Ensuring that children live in safe and appropriate accommodation - the specialist health visitor identified security concerns at one of the hotels. The concerns were shared with the relevant safeguarding teams and the company that manages the hotels on behalf of the Home Office. As a result of sharing this information, security was increased the next day and within two weeks all the service users were moved to alternative accommodation.
• Early identification of health needs and prompt referral to services - the residents at the same hotel had not registered with local GPs and their health needs were not being met. Within 24 hours a team of welfare officers were at the site assisting the families to access the care they needed.
• Funding for free vitamins for this cohort has been secured.

Feedback

Feedback from one of the charities working at the hotel since the creation of this specialist service:

“Since health visiting created a specialist role for this community there has been a dramatic change. I have seen a marked difference in how supported families are feeling.

For example:

- I am able to signpost or refer families to the post holder and give them her name, which I can see immediately reduces the anxiety for the family.

- The post holder has worked tirelessly to advocate for the families including meeting with the hotel staff to campaign for better food, and she has secured funding from the local public health team to ensure pregnant women and small children get the vitamins they need.

- Families supported by the post holder feel more able to trust in local services and are therefore more likely to access local community groups.”

The role has helped to keep vulnerable children in Hounslow safe from harm, health needs have been identified and referrals made to relevant services.

Next steps

We would like to apply for funding to expand the team to broaden the skill mix and improve access and health outcomes for these vulnerable children.