Call for evidence - inclusion health

Case Studies

• Homeless Step Down Pathway Case Study 1

  by Teri Milewska, almost 3 years ago

  CASE STUDY 1

  SOCIAL BACKGROUND

  The patient is a Jamaican National who came to the UK in 2002, after fleeing a threat to her life. She does not have any status in the UK, but has been working with Lewisham Refugee and Migrant Network, who submitted a “indefinite leave to remain” application to the Home Office on the 15 July 2022.

  She stayed in Birmingham for several months, with a friend, before moving to London. There she sofa-surfed with friends. Both parents are deceased, but does have siblings and children living in Jamaica and a cousin in London.

  MEDICAL SUMMARY

  ... Continue reading

  CASE STUDY 1

  SOCIAL BACKGROUND

  The patient is a Jamaican National who came to the UK in 2002, after fleeing a threat to her life. She does not have any status in the UK, but has been working with Lewisham Refugee and Migrant Network, who submitted a “indefinite leave to remain” application to the Home Office on the 15 July 2022.

  She stayed in Birmingham for several months, with a friend, before moving to London. There she sofa-surfed with friends. Both parents are deceased, but does have siblings and children living in Jamaica and a cousin in London.

  MEDICAL SUMMARY

  TE was admitted to the Mildmay on our homeless pathway on the 29 June 2022 with the following issues.

  End stage renal failure

  Dialysis (3 times a week)

  Type 2 diabetes

  Ischemic heart disease

  Hypertension

  Cataracts

  IMMIGRATION SUMMARY AND SUPPORT

  Before TE was admitted to the Mildmay Mission hospital, she was already working with LRMC (Lewisham Refugee & Migrant Centre) to apply for ILR (indefinite leave to remain), which was submitted on the 15 July 2022, as they believe that she has a strong case for her ILR to be granted. Later, she was referred to Lawstop, only when she was referred to Haringey ASC to request for a Care Act, which Haringey did not fulfil. Lawstop became involved to challenge Haringey ASC. Lawstop are still continuing to work on TE’s case with regards to a Care Act assessment being done.

  In November, Lawstop was seeking information from both the Royal Free and Queen Elizabeth, following advice from the Barrister. The Barrister also ascertained that Tower Hamlets should be the local authority doing the Care Act assessment, which they have now approached to request for them to complete a Care Act Assessment. Lawstop have given Tower Hamlets ASC until the 19/12/22 to provide a substantive response.

  The immigration officer at LRMC (Lewisham Refugee and Migrant Centre) is in the process of preparing a Schedule 10 application to the Home Office for accommodation.

  SOCIAL WORK INVOLVEMENT

  When TE was at QEH, a referral was made to Greenwich ASC for a Care Act assessment to be done on the 14 July 22, but this was never completed, as Greenwich has also questioned whether TE was of ordinary residence in Greenwich, but was not found to be of residence and her case was passed onto Haringey ASC to request for a Care Act assessment, based on her level or care and support needs. However, Haringey ASC could not establish that she was of ordinary residence to Haringey, despite being provided with evidence of her address history. Lawstop then made the decision to challenge Haringey ASC, following letters sent and waiting response.

  HOUSING SUPPORT

  Whilst at the Mildmay, TE has been supported by referring her to a number of agencies/organisations, in support of people with no recourse, just to name a few.

  Emmaus community (not suitable for their service)

  Housing Justice (did not hear back)

  Migrant Help UK (could not assist, as she did not make an asylum claim- the immigration officer at LRMC, did not feel it was a good idea, as this could complicate her case)

  With Migrant Help UK, her file was created on the 30/11/22 and advised that there is normally a 10-day window, depending on when she would be discharged. Called back on the 2/12/22 and they requested for her Home Office reference number, which was given to them, but unfortunately, this was not a PORT reference number, just her ILR application reference and advised that unless she has made an asylum claim, they were unable to assist her.

  Your Place (did not hear back)

  Martha House (only accept those who had been granted ILR within 6 months)

  All people All places (only accept those who have a local connection to Newham)

  SJOG (referrals for those recognised by the Home Office as being trafficked)

  Hackney Winter Shelter (not taking any new referrals)

  TE was also discussed about the possibility of staying with friends and/or family, but this was not an option for her, as she did not have anyone she could stay with.

  A request to Lawstop to ask for them to refer to Hosting Schemes on the 21/10/22

  DISCHARGE PLANNING

  • Schedule 10 application by LRMC in process to send to Home Office to request for accommodation
  • Lawstop has requested for Tower Hamlets local authority to provide substantive response following request for Care Act Assessment by 19/12/22
  • Housing officer to continue to look at other possible available options for accommodation

  CHALLENGES

  • SERVICES STIPULATIONS REGARDING CIRTIERIA NOT SUITABLE FOR
  • LACK OF RESOURCES
  • DELAYED FEEDBACK FROM SERVICES ALREADY INVOLVED
  • CONFLICTING INFORMATION REGARDING ADDRESS HISTORY
  • FUNDING
  • SOCIAL SERVICES NOT ACCEPTING DUTY FOR CARE ACT ASSESSMENT
  • LIMITED ACCOMMODATION OPTIONS

  Case studies written by Sheila James

  Housing Officer

• Homeless Palliative Care in Liverpool

  by Ryan Young, almost 3 years ago
  

  Background - Need and Service Provision

  Brownlow Health is a large city centre GP providing specialist healthcare for people experiencing homelessness. An audit of deaths of people experiencing homelessness was undertaken over a two year period which found that on retrospective review a significant number of patient deaths could be expected and that there was a low level of palliative care support provided.

  In response, Brownlow Health collaborated with Marie Curie Hospice in Liverpool to establish a Homeless Palliative Care Multi-Disciplinary Team. This team:

  • Secured funding for a Palliative Care Nurse to lead on care for people experiencing homelessness and... Continue reading

  Background - Need and Service Provision

  Brownlow Health is a large city centre GP providing specialist healthcare for people experiencing homelessness. An audit of deaths of people experiencing homelessness was undertaken over a two year period which found that on retrospective review a significant number of patient deaths could be expected and that there was a low level of palliative care support provided.

  In response, Brownlow Health collaborated with Marie Curie Hospice in Liverpool to establish a Homeless Palliative Care Multi-Disciplinary Team. This team:

  • Secured funding for a Palliative Care Nurse to lead on care for people experiencing homelessness and people using substances.
  • Established a Homeless-Palliative Care MDT. This team meets once per month and discusses patient management and care.
  • Focused on early identification of people with deteriorating ill-health before they reach the dying phase.
  • Undertook out-reach work to review and manage individuals at the end of their life where they live and in an appropriate setting to them.
  • Provided education to support workers and hostel teams and offered structured reflective practice to teams after death.
  • Created links with hospital based palliative care teams to ensure smooth transition of care into or out of hospital.

  A subsequent audit of deaths was carried out after the team had been active for two years. The following improvements were found:

  • 90% of patients were on the practice palliative register when they died opposed to 31% before.
  • Some level of end of life discussion/advanced care planning happened in 85% of cases increased from 19%.
  • A preferred place of care & death was recorded for 70% of patients an increase from 19%.
  • 90% of patients received a medical palliative care review prior to death, an increase from 13%.

  During our work it was identified that patient's preferred place of care and death was most commonly the hostel where they lived. The team worked hard to support end of life plans for patients to allow them to die in hostels, linking in with allied professionals and homeless/hostel staff. Despite some resistance from other professionals we have managed to utilise syringe drivers in the hostel setting successfully at the end of life, achieving a number of planned deaths in homeless hostels. As far as I am aware we are the only service which has been able to utilise syringe drivers in the hostel setting. Below is a case study of one such patient's experience.

  
  

  Case Study - Mark (name changed)

  Mark, a resident at a hostel in Liverpool had a history of alcohol dependence and heroin and crack misuse. He was managed on a methadone script which was delivered daily to the hostel. Whilst an inpatient he was reviewed by the Homeless Palliative Care Team as he had developed liver failure and was given less than three months to live. At this time, he suffered from encephalopathy and did not have capacity. Brownlow Homeless Team, who knew Mark well, decided that his preferred place of care would be the hostel he had lived at for the last four years. The Homeless Palliative Care Team worked with the hospital and hostel staff to arrange a rapid discharge to the hostel for end-of-life care.

  On discharge there was a marked improvement as Mark regained cognition and capacity and some functional ability. He confirmed at this time that it was indeed his wish to be cared for and to die at the hostel as he regarded this as his home. The team regularly reviewed Mark in the hostel and developed a trusting relationship with him.

  Around six weeks after his discharge Mark developed ascites, jaundice and was sleeping more and more. He developed nausea and vomiting and abdominal pains. The team managed this with oral morphine and metoclopramide (anti-sickness medication). He continued to deteriorate, and a syringe driver was commenced to manage pain, distress, and nausea which provided good symptom control. Concerns were raised by staff and the district nursing team as to the appropriateness of using a syringe driver with controlled drugs in this setting. Through remote and face to face meetings with staff, the team were able to answer questions and ease concerns about the use of a syringe driver in the hostel setting.

  The team arranged for a package of care to support staff with Mark’s personal care.

  Mark died peacefully at the hostel, with staff and friends around him, with dignity, in a setting he regarded as his home.

  The Homeless Palliative Care Team met with the hostel staff after Mark’s death to complete reflective practice, offer emotional and spiritual support and learn from this new experience of providing end of life care in a hostel setting.

  
  

  Feedback:

  Following Mark’s death, the Homeless Palliative Care Team received the following feedback:

  From the District Nursing Team:

  “Just a thank you from the district nursing team to all attached to this email for the care of [Mark] in single men’s hostel.

  Thank you for the compassionate holistic care provided and ensuring Mark’s wishes were met, thank you [Hostel Managers] who advocated for Mark, he felt safe and supported by yourselves.

  Thank you especially [GP] and [Palliative Care Consultant] for the regular reviews, communication with DNs and synergy between Marie Curie, DNs, GP and hostel in this complex situation. Thank you for ensuring his care and comfort”.

  From the Hostel Manager:

  “I would just like to take the opportunity to thank everyone for their contributions towards granting [Mark] his final wishes to have his end of life be at [Hostel]. I am so glad he got to die with dignity and choice. The team have been amazing and I am so proud to be part of it”.

  From the Service Manager:

  “Notwithstanding the central efforts to support [Mark], this is a superb example of services working together, supporting each other to get the best outcome for someone in a difficult situation. The sum is certainly greater than the parts and your involvement has been an inspiration to our team”.

  From Housing Commissioner:

  “It’s really heart-warming to see how you are all working together to provide the best possible support for [Mark] and that the level of support for [Mark] and staff is so high”.

  
  

  Extra Information

  Permissions from partner organisations and from myself and Brownlow Health to share the case study.

  Permission to share logos for Brownlow Health, Marie Curie Liverpool and Whitechapel.

  Services Involved: Brownlow Health (Homeless Team), Marie Curie Liverpool, Whitechapel Centre & SHAP (run 2 Aigburth Drive Hostel, mentioned in case study).

  Tips for success: It is vital for healthcare staff to have regular and open conversations with allied health providers and homeless service providers. Regular contact can alleviate concerns and empower other providers to offer care in the most challenging of scenarios. Early planning is vital and reflective practice and learning is vital to continue to improve. Each case is a new challenge and will be different.

  Next Steps: We are looking to share our experiences on a wider scale and offer support for those wishing to replicate elements of our service. At a local level we are looking to offer specialist advice around managing end of life care for people experiencing homelessness and people who suffer addictions who are not registered at Brownlow to support other services to achieve similar outcomes.

  
  

• Spectrum CIC WY-FI+ Case Study

  by Sharon Whitaker, almost 3 years ago

  Ann, 45 years old

  In 2020 Ann was re-referred to WY-FI+ for support with Homelessness, Addiction, Re-offending, and Mental Ill Health. On the WY-FI+ traffic light she presented red, chaotic, and not engaging with support.

  Background - Ann developed bacterial meningitis as a teenager. This caused a brain injury and she had to rehabilitate, relearning how to walk and talk. Ann began working with a brain injury charity at the start of her journey with WY-FI+.

  Homelessness: Ann was housed in unsecure short-term emergency accommodation following release from prison for an offence of arson which stemmed from unstable mental health... Continue reading

  Ann, 45 years old

  In 2020 Ann was re-referred to WY-FI+ for support with Homelessness, Addiction, Re-offending, and Mental Ill Health. On the WY-FI+ traffic light she presented red, chaotic, and not engaging with support.

  Background - Ann developed bacterial meningitis as a teenager. This caused a brain injury and she had to rehabilitate, relearning how to walk and talk. Ann began working with a brain injury charity at the start of her journey with WY-FI+.

  Homelessness: Ann was housed in unsecure short-term emergency accommodation following release from prison for an offence of arson which stemmed from unstable mental health and frustration of having no contact with her daughter and directly impacted on her prospects of being accommodated by any provider. She was referred to a housing provider with tenancy support whilst in temporary accommodation and engaged well. She then moved into their supported self-contained accommodation.

  Now: Ann continued to work with housing, prioritised bills and engaged with services. In October 2022 she secured a council bungalow to suit her health needs. She was referred for ongoing housing support. Her Navigator liaised with her Housing worker throughout offing joint home visits and support to attend face to face housing support sessions.

  Ann was paying her council tax and debts via Direct Debit however her bank account has been recently closed. She continues to engage with housing support to prioritise her bills, has agreed to Care Link and is prioritising her funds to pay for gas and electric. She is extremely settled in her bungalow and has made positive relationships with her neighbours.

  Addiction: Ann was already registered with local Recovery Services and on an opiate substitute script

  but was only engaging sporadically with her worker and was still using on top.

  Now: Ann’s Navigator supports her to attend appointments, she engages well and has almost stopped using drugs reporting many more drug free days and only using on pay days. She has weekly face to face support sessions with her key worker, has achieved most goals and her urine tests have been negative for opiates. She is working towards reducing her opiate substitute dose. When she previously relapsed, she left herself without funds, now she prioritises bills first stating she has learnt from her actions, feeling very disappointed in herself for her previous behaviour.

  Re-offending: On release from prison, Ann only engaged sporadically with her probation worker.

  Now: The partnership work with WY-FI+, Probation Service and the brain injury charity allowed Ann to complete her probation whilst feeling fully understood and supported by all parties involved. Ann is no longer under the probation service.

  Mental Health: Ann was not in any Mental Health services. Her brain injury makes her very vulnerable, she has experienced all forms of abuse in the past. Due to her drug use the only mental health service she had been able to access was dual diagnosis.

  Now: Ann engages with the brain injury charity and attends weekly groups where Ann speaks with other individuals with similar brain injuries and enjoys craft sessions. Ann has expressed feeling bored and anxious not using drugs but is in a positive frame of mind. She has rehomed a dog that she refers to as her therapy dog.

  This has given Ann a new sense of responsibility and she has chosen to stay home with her pet instead of going out and using substances.

  Ann found positive connections at her local church and was baptised. She attends bible studies and Sunday service weekly giving her more stability in a routine.

  Ann enjoyed participating in a lived experience workshop arranged by a local research project regarding homelessness and health inequalities in Wakefield. She shared her experiences and suggestions for improvement and these were taken forward, she also attended a follow up meeting to share the findings.

  Challenges:

  Ann needs intensive support with regular contact which she received from her brain injury Nurse, but this has reduced to just the weekly group sessions. She engaged well with her supported Housing worker who assisted her with billing queries, however, this support has ended since she moved as she is no longer with the supported housing provider. Ann now has a different housing support worker from another provider as she still struggles to manage her letters and bills and has called her Navigator in crisis at times when unsure about which payments to prioritise.

  Ann was having her opiate substitute delivered whilst in her previous accommodation, due to her vulnerabilities it was safer for her not to attend the chemist. Since moving to her bungalow, the local chemist does not have capacity to delivery her prescription and her previous chemist are unable to deliver to her new address. Ann agreed to safeguard herself by collecting her prescription from another chemist away from Wakefield centre where she is targeted by other drug users. She now has a bus pass and can manage this independently.

  Ann recently fell out of prescribing for opiate substitute, after being targeted by other drug users she was unable to attend her chemist. Her Navigator advocated to get her back into prescribing quickly, she has restarted her prescription and agreed to a reduction.

  Ann was targeted whilst in Wakefield and her bank account was used for money laundering, this was raised as fraud and her account closed. This has been a

  big challenge for Ann as she is now unable to open a high street bank. Her benefits are paid into a PES account as a short-term measure and she has been assessed by adult safeguarding team to identify ways to stay safe and override these fraud markers, which is ongoing.

  Community Safety Outcomes:

  Ann is a very vulnerable person who is no longer at risk of losing her accommodation and does not associate with those who would take advantage of her anymore.

  Ann is now engaging well with all services, paying her debts and is almost drug free. Her Navigator has also supported her with managing her debts and budgeting.

  Ann has engaged with GP appointments, Housing Needs, Probation and local recovery services, and supported to engage in activities to fill her time positively e.g., attending group sessions through the brain injury charity.

  Since Ann completed her probation order she has committed no further crime.

  Her Navigator has supported Ann to register with a Dentist, attend appointments and complete the process to get dentures.

  Ann attends at a weekly food pantry and has formed positive relationships with the staff and volunteers. Through attending church Ann feels she is spending her time with more meaningful activities and caring for her dog has given her a sense of responsibility.

  Ann’s contribution to the local research project was very well received and has increased her confidence. She stated she may attend similar activities in future.

  Insights:

  When WY-FI+ began working with Ann her chaos index score was 39, it is has reduced to 32.

  When WY-FI+ began working with Ann her outcomes star was 29, it has since increased to 45.

  On the WY-FI+ traffic light system Ann now presents as amber, she is much less chaotic, engages well with services and has secure accommodation, however she has relapsed with drug use a few times and is still in need of regular contact to encourage and support her in her aim to be drug free and to manage and prioritise her funds. Regular contact is also required to support her to continue to engage and liaise with all services involved.

  Tips:

  Having a dedicated team, that comes from a trauma informed approach, with a low caseload allows Navigators to work intensively with a client. This approach has proven to have successful outcomes.

  What next:

  Ann’s navigator will support her to open a bank account and continue to encourage her to integrate in the local community.

  Ann said:

  ”I feel like other support workers don’t understand what I am trying to say but my Navigator doesn’t rush me. She helps me by speaking for me when needed and I am so grateful to WY-FI for helping me find my dog and trusting me to take care of her on my own. She is my therapy dog and has saved my life.”

  
  

• Portsmouth Homeless Drug and Alcohol Team

  by Katie Wood, almost 3 years ago

  Homeless, suffering from anxiety resulting from trauma which he endured as a child, James (now aged 47) turned to using substances and drinking alcohol in excess amounts at an early age. He had a difficult relationship with his family and moved around frequently as a child, which resulted in him never feeling that he could call anywhere home. As James grew older he found it difficult to maintain a working life. He experienced overwhelming anxiety in the workplace to the extent that he could no longer work without drinking alcohol to block out his emotions. James wanted to be able... Continue reading

  Homeless, suffering from anxiety resulting from trauma which he endured as a child, James (now aged 47) turned to using substances and drinking alcohol in excess amounts at an early age. He had a difficult relationship with his family and moved around frequently as a child, which resulted in him never feeling that he could call anywhere home. As James grew older he found it difficult to maintain a working life. He experienced overwhelming anxiety in the workplace to the extent that he could no longer work without drinking alcohol to block out his emotions. James wanted to be able to socialise with other people, but found his feelings of anxiety overwhelming and found it extremely difficult to attend groups which aimed to help people address their substance use.

  James’s problems culminated in his becoming street homeless. He first received help from a recovery worker, who supported him in addressing his substance use and accessing housing options. Despite wanting support, he frequently missed his appointments with his worker. However, James slowly came to realise that even if he did not attend his appointment with his recovery worker, she would nevertheless meet him at his temporary accommodation at the same time each week. This consistency and reliability encouraged James to engage more frequently and over time he improved his attendance. He gradually became more motivated to address his alcohol use and felt that he needed some support addressing his anxiety, which was an underlying reason behind his alcohol use.

  James then started working with an assistant psychologist who helped him to challenge underlying beliefs relating to his anxious thoughts and introduced him to some techniques to address his anxiety. He at first struggled with being aware of his thoughts and feelings and how they influenced his behaviour, but over time challenged himself to explore these in more depth.

  James continued engaging with his recovery worker and assistant psychologist and expressed to his recovery worker that he would like to receive a detox and rehabilitation, as he felt ready to make some lasting changes in his life. Although he was willing to engage in support, he felt he could not cut down his alcohol consumption entirely on his own, and felt he needed a fresh start and treatment away from Portsmouth. A few months later, James undertook treatment at a detoxification centre which was followed by a programme of rehabilitation.

  James has now graduated from rehabilitation. He is now leading a very different life and has been engaging in many recovery activities in the community: he is about to start some volunteering, he is attending college with the possibility of progressing to a further course that would give him access to university, he goes to the gym and swimming pool several times a week, he is attending daily Alcoholics Anonymous meetings and has an sponsor.

  James is grateful for the support he received from the Portsmouth Homeless Drug and Alcohol Team. He was supported in his journey from being homeless, suffering with mental illness and being unwilling to make changes to his drinking, to accessing detoxification and rehabilitation, being empowered to begin his new journey in recovery.

• NHS charging

  by Yvonne , almost 3 years ago

  I met my patient in the day centre where I worked, Her visa had expired and she had no recourse to public funds. She was being charged for her medication/treatment upfront for breast cancer. I contacted the breast unit to explain the NHS charging policy re 'necessary and immediate care'. I also contacted the Overseas office who understood the 'necessary and immediate care' policy.

  Despite sending evidence re charging and talking to the person n the breast care unit, they insisted that she should still pay upfront before treatment can be continued.

  This delayed my patient getting treatment

  I met my patient in the day centre where I worked, Her visa had expired and she had no recourse to public funds. She was being charged for her medication/treatment upfront for breast cancer. I contacted the breast unit to explain the NHS charging policy re 'necessary and immediate care'. I also contacted the Overseas office who understood the 'necessary and immediate care' policy.

  Despite sending evidence re charging and talking to the person n the breast care unit, they insisted that she should still pay upfront before treatment can be continued.

  This delayed my patient getting treatment

• The #HealthNow Peer Network - promoting participation for people with experience of homelessness

  by Rachel Brennan, almost 3 years ago

  The #HealthNow Peer Network is an innovative and empowering initiative that has the potential to make a real difference in the lives of people who are often overlooked and marginalized by mainstream healthcare services. The network brings together individuals with lived experience of homelessness who have expertise in tackling homeless health inequality. As a result, the network is uniquely positioned to generate community-led solutions to health inequalities, particularly for those who are marginalized and excluded from mainstream healthcare services.

  One of the key features of the #HealthNow Peer Network is its use of a digital platform that enables members to... Continue reading

  The #HealthNow Peer Network is an innovative and empowering initiative that has the potential to make a real difference in the lives of people who are often overlooked and marginalized by mainstream healthcare services. The network brings together individuals with lived experience of homelessness who have expertise in tackling homeless health inequality. As a result, the network is uniquely positioned to generate community-led solutions to health inequalities, particularly for those who are marginalized and excluded from mainstream healthcare services.

  One of the key features of the #HealthNow Peer Network is its use of a digital platform that enables members to connect and communicate with each other, regardless of their location. This allows people who are isolated or living in remote areas opportunities for inclusion and connection that they might not otherwise have access to. By creating a supportive and inclusive community, the network aims to empower its members to take control of their own health and wellbeing, to connect and collaborate with others who have had similar experiences, and to advocate for change in the healthcare system.

  Areas of involvement

  Previous network meeting topics and involvement activities have been numerous and varied, with topics including:

  • Developing heatwave resources for people experiencing homelessness
  • The Impact of Temporary Accommodation on Health and Homelessness
  • #HealthNow Mental Health research
  • NICE guidelines consultation – Integrated Health and Social Care for People Experiencing Homelessness
  • Amnesty - Health and Homelessness research
  • Encouraging Vaccine Uptake workshop the findings of which were shared with DLUHC
  • “Bridging the Gap” - Access to primary care for people experiencing homelessness
  • Health inequalities in Primary care advisory group
  • GP registration barriers workshop
  • Healthcare access and engagement within services workshop
  • Vaccine Resources workshop
  • #HealthNow Peer Evaluation
  • Campaign roles and volunteering opportunities
  • Training Advisory Group and training development
  • Palliative care training
  • Newcastle University focus group– The Health Impact of the ‘Everyone In’ initiative
  • Palliative Care - research interviews and focus groups
  • Suicide Prevention resource development
  • Dental care for people experiencing homelessness

  Engagement with these topics and in other areas of involvement have been substantial and productive, and has also led to a great deal of positive feedback and further involvement from stakeholders.

  Volunteer experiences and benefit of involvement

  During a peer evaluation in 2022, respondents unanimously expressed a high degree of satisfaction with their involvement, and cited positive benefits for their mental health, social connections and an increased sense of empowerment.

  Current and former volunteers from multiple organisations across the country have forged strong bonds and friendships as a result of their involvement in the network, and the advantage of existing relationships gained by involvement in online meetings has had clear benefits for volunteers when the opportunity for in-person engagement has arisen.

  The network actively promotes all of the principles of the framework.

  We have permission to share this case study, we are happy for it to be shared and can provide Groundswell and #HealthNow logos.

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

  
  

• Peer participation in tackling health inequalities for people experiencing homelessness

  by Rachel Brennan, almost 3 years ago

  This case study will outline how the #HealthNow project is involving people with direct experience of homelessness in developing and delivering solutions to health inequality through local system change. #HealthNow is a UK wide campaign that aims to work towards an inclusive health system where everyone has access to the health care they need; ultimately moving people out of homelessness. #HealthNow is led by Groundswell and delivered in partnership with national charities Crisis and Shelter. As part of the delivery of the #HealthNow project, local #HealthNow alliances have been established in Birmingham, Greater Manchester and Newcastle. Local alliances bring together

  ... Continue reading

  This case study will outline how the #HealthNow project is involving people with direct experience of homelessness in developing and delivering solutions to health inequality through local system change. #HealthNow is a UK wide campaign that aims to work towards an inclusive health system where everyone has access to the health care they need; ultimately moving people out of homelessness. #HealthNow is led by Groundswell and delivered in partnership with national charities Crisis and Shelter. As part of the delivery of the #HealthNow project, local #HealthNow alliances have been established in Birmingham, Greater Manchester and Newcastle. Local alliances bring together stakeholders from homelessness and health organisations who are tasked with developing health inequality action plans. Meaningful participation of people who have direct experience of homelessness is central to the success of the local alliances in understanding the scale and impact of the barriers people face accessing and engaging with healthcare and to coproduce effective solutions to health inequality that will work. This is how we ensured people with direct experience of homelessness were involved with all alliance activities to promote local system change to tackle health inequality: Peer Research: A team of volunteers were recruited and trained in research skills, they worked together with a Research Manager from Groundswell to develop a research tool that would ensure we could evidence health inequalities for people experiencing homelessness in Birmingham, Greater Manchester and Newcastle. Developing the action plan: The Peer Researchers worked with the Research Manager from Groundswell to identify the key priority areas to inform the inequality action plan.Within each area specific barriers and issues were identified, peers met to develop the solutions they felt would work to address the problem. These were presented to stakeholders from health, homelessness and housing and explored to create realistic and effective actions that could be trialled and implemented. Alliance meetings: While peers have been represented at all of the alliance meetings the level of participation of people with experience of homelessness has grown significantly since we held the first meeting in October 2019. Through support from the Local #HealthNow Coordinator the peers set the agenda for the meeting, present on agenda items, hold alliance members to account for actions and continuously raise awareness of inequalities in the health system through their own experiences & the experiences of the people they support through the delivery of Homeless Health Peer Advocacy. This links to framework principles: 1,2,3, 4 We have permission to share this, happy for it to be used and for #HealthNow logo to be used

• An integrated holistic health service for refugees and asylum seekers in Gateshead

  by chark, almost 3 years ago
  This is the description of a joint integrated primary and secondary care service for refugees and asylum seekers in Gateshead, North East England

  This is the description of a joint integrated primary and secondary care service for refugees and asylum seekers in Gateshead, North East England