sw health and wellbeing network presentations

8/12/2019 SW Health and Wellbeing Network Presentations

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By Phayza Fudlalla

Health and Wellbeing Programme

Manager

7thMay 2014

5/27/2014SW Health and Wellbeing Network meeting 1


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Need for project established by surveys &

consultation:

English non-speakers vulnerable to isolation

Support for mental wellbeing highest need of BME

communities

BME volunteers need tailored support & training

Voluntary organisations key providers of emotional

support for BME communities



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To support the BME people (mainly Arabic and

Bangladeshi community)

Living in Westminster, K&C and H&F

Experiencing challenging personal circumstances

Experiencing symptoms of stress, anxiety or

depression,

but are not accessing mental health services at

present .



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To train bilingual volunteers to:

provide need assessments, emotional support &

advocacy to clients,

make appropriate referrals to other services

including the mental health services

record case work by writing case notes.

To support BME Community organisations:

work with vulnerable clients

enable them to demonstrate the impact of their

mental wellbeing work



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The programme ran 2012/14.

Funded by CCG via the BME Health Forum

Ten bilingual volunteers trained by the BME

Health Forum

The volunteers training included:

basic counselling & advocacy skills

First aid mental health training course.



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To recruit participants: Flyers sent to ACAL members, local partner organisations &

stakeholders to recruit.

Word of mouth by volunteers in the local community.

Volunteers taking flyers to local schools, Children Centres,

mosques, supplementary schools, friends and relatives.

Referrals received from local organisations



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Each service user received

3-6 one-to-one sessions.

active listening, emotional support and/or advocacy,

signposting and/or escorting to other service providers



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Ethnicity Age group Service Users by

BoroughGender

Arab 90 18-24 4 Westminster 105 Female

112Bangladeshi 16 25-49 86 K& C 9 Male 8

British 4 50-74 30 H& F 4Pakistani 1 Over 75 0 Brent 2Somali 1

Spanish 1Black

African

2Afghani 2Scottish 1French 1

Mixed Race 2120 120 120 1205/27/2014SW Health and Wellbeing Network meeting 8


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120 service users supported

440 one-to one sessions provided

Referrals made to ;

IAPT

Third Age counselling

Gordon hospital

Refugees Therapy Centre

Marylebone Family Centre

Westminster Council Admission Office

GPs



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Befriend a Family Westminster Home Start

Expert Patient Programme

Job Centre Plus

Westminster Age UK Carers Networks

Praxis Community Projects

Westminster Muslim Welfare Trust

Westminster and Hammersmith & Fulham CAB



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Rain Trust Cardinal Hume Centre

Social Services

White City Community Centre

Domestic Violence Intervention Project

Westminster Housing Options

The Abbey Centre Health and WellbeingProgramme( carers group, after schoolgroup, physical activities, Diabetes

mentoring scheme, Community Interpretingtraining course)

Open Age IT , ESOL and Chatter and Nattergroup



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Homelessness

Caring role Loneliness

Benefit cap & movement from Westminster

Impacts of imprisonment of family member

Impacts of Divorce e.g. family break up andstigma

Immigrations issues

Bereavement



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Project evaluation is currently underway

but initial findings: I am feeling much better after have

received counselling

The project helped me to move to a bigger

accommodation The project helped me to get my income

support and accommodation

Two volunteer have secured part-time paid

employment



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Mrs X is an Arabic women, mid 40s.

Single mother with 4 children. Suffering from depression for some time

Lacks social support and networks, feels isolated

Language barriers complicates dealing with mostissues.

Her teenage son is involved in gang and drugsissues.

Police have arrested son on more than oneoccasion.

Volunteer supported her over five one-to one

sessions. She was referred to Abbey Centre physical

activities sessions and to Third Age Counselling

.I found the support given by Abbey Centrevolunteer and TAC was very helpful- I feel muchbetter now- thank you.



16/485/27/2014SW Health and Wellbeing Network meeting 16


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Emergencyor Not?


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UNSCHEDULED CARE INSIGHT

PROJECT

A Report by the

BME Health Forum

Commissioned by the NHS Central

London CCG


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Who was involved

BME Health Forum

Midaye

Healthier life 4 You

Abbey Community Centre

Marylebone Bangladesh Society

Westminster Mind

Volunteers and participants

CLCCG


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Methodology The Forum recruited, via an open recruitment

process 5 community organisations that workwith clients from deprived communities in thearea covered by NHS Central London CCG todeliver the project.

A questionnaire was produced by the Forum, the5 community organisations (staff and volunteers)and the commissioners.

Volunteers nominated by the communityorganisations were trained to interviewparticipants.

In total 131 interviews (of 76 questions) were

conducted.


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Selection criteria used to recruit participants:

All the participants had to be registered with a GPwithin the NHS Central London CCG OR

Live within the NHS Central London CCG catchmentarea and not registered with a GP at all

Additionally, the participants had to meet at leastone of the following criteria:

Patients with long term conditions (LTC) such asdiabetes, heart disease etc

Parents of children with LTC (e.g. asthma etc)

Adults without long term conditions who are frequentusers of A&E (e.g. 3 times in the last 2 years)

Parents of children without long term conditions whoare frequent users of A&E (e.g. 3 times in the last 2

years)


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Demography 68% were fluent in English and 32% not

fluent in English 30% had used an interpreter

81% were female

73% had LTCs 50% had children under 18, while 19% had

children under 18 years old with LTCs

83% were unemployed and of those who

were employed, half were in part-time work 87% of the participants were from the BME

communities.


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A & E Attendance 2012/13

38.4% of the population in Westminster isBME

48.6% of the sum total of all A & Eattendances was BME

Individual groups of categorised BMEcommunities do not represent high A&Eusage compared to the different whitecategories except for

the category Any other ethnic group. TheAny other ethnic group constitutes 11.1% ofthe local population and yet has 26%attending A&E


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Key Findings

There was a fairly high number of visits

for self to A&E over a period of 2 years

44% went 1 to 2 times




Over a period of 2 years 85% of the adultparticipants had accessed A & E services


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Key Findings When asked about their visits to A&E within the last

two years and how quickly they felt they needed tobe seen, 88% responded that they needed to beseen within 4 hours while no respondents felt theycould have waited longer than 12 hours

Just over 50% of the participants were able to seethe GP within 12 hours.

When asked why they went to A&E without trying togo to the GP first, 67% replied because they wouldnot be seen quickly enough, rather than becausethe issue could not be dealt with at a GP practice


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Why patient didnt attempt to see GP

before A&E?


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Key Findings 57% felt that A&E offers a better service than their

GP practice.

When asked why Not gone to GP first, here are

some of the reasons


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Key Findings

82% said they were happy or very happywith their regular GP

75% thought their regular GP was a goodor very good listener

21% were unsatisfied very unsatisfied by

the way they were treated by receptionstaff at their GP surgery


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Key FindingsRespondents were asked what changes would

make them go to a GP rather than A&E

59% selected same day appointments

41% better facilities, equipment and tests

17% more faith in the GPs expertise 16% a better relationship with the GP

Respondents suggested GP surgeries opened inthe evenings and on weekendsthere seemed

little awareness of the other urgent care services A better systems for booking urgent appointments

that did not rely on a brief time slot to call and hadgreater capacity.


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Recommendations for Primary

Care

Those who feel that they need urgent care

want to be seen quickly and have little

awareness of other options besides A&E

when their GP practice is closed.

The most significant reason for attending

A&E rather than a GP practice was the

speed with which people could be seen. To rectify this it is recommended:


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A guarantee to patients that when theyhave an urgent need they can be seen

by a GP in a GP surgery, Urgent CareCentre, Walk-in Centre or Out Of Hoursservice within 4 hours.

Pilot drop in clinics that are open late in

the evening (e.g. until midnight)

Raise awareness on the availability ofOut Of Hours services through direct

conversations with patients as this groupof patients do not access informationthough mainstream publicity such as GPpractice websites.


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Ensure every GP practice has an effective andconsistent appointments system for seeingurgent cases, particularly children and older

people within 4 hours during their openinghours.

Work with health professionals about when it issuitable to advise patients to go to A&E. Manypatients reported that they were advised to go to

A&E by GPs but also by other staff such aspharmacists or receptionists

In line with the CLCCGs Better Care, Closer toHome strategy bring certain aspects of the

experience of A&E that people value to primarycare. Patients reported that at A&E they felt thatthey were seen by experts, had tests done andfelt more involved in their care


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Where practical investigations should take place inprimary care rather than in the hospitals.

Inform patients more about GPs Special Interests. If

possible refer patients to other GPs who have aparticular expertise.

Every effort should be made to involve patients in theircare so that they do not feel more involved in their careat A&E than at their GP practice.

Ensure patients know how to change their GP practiceif not happy with their GP

wherever possible that patients with language needshave easy access to an interpreter

Provide workshops for GPs and Practice staff on whatlocal community organisations are providing that cansupport patients.


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GP reception staff should be trained in workingwith a diverse community and particularly inworking with people whose first language is

not English and/or people who suffer fromanxiety or mental distress

Research should be carried out with patientswho attend A&E repeatedly to find out why

they do so and what would make themdecrease the repeated use of A&E

Improve referrals to community organisationsand to community run health programmes as

these may be able to support patients to staywell and to understand how to access NHSservices appropriately.


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Recommendations for changes in

A&E and Urgent CareWhen patients visit A&E inappropriately their experience

should be as similar as possible to attending a GPpractice. For example:

Patients could be told that they cannot be seen at A&Eand have an appointment booked for them with a GP

where they can be seen with 4 hours. Patients could be seen by a GP at A&E who would

follow the same processes as a GP based in thecommunity (same access to tests etc).

Ensure that when a patient goes to A&E the staff have

access to the patients records to ensure that nounnecessary tests are done or repeated to avoid givingpatients the impression that an examination at A&E ismore thorough.

R d ti f Ch i


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Recommendations for Changes in

Community Provision

Community organisations could be involved indelivering a community education programme thatraises awareness within different BME communitiesabout when to utilise which NHS services and what thedifferent services provide

Make some provision for community health advocacywhich could support patients who have unresolvedissues with their primary care in order to ensure theyare able to access appropriate primary care and do notattend A&E as a default

Provide a structured health education programmetargeting people who do not speak English that cansupport people to manage their long term conditionsand teach them how to best manage appointmentswith their GP, book double appointments if needed,and make complaints.


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Recommendation for changes in

the collection of Ethnicity data

NHS Trusts delivering A&E and urgent

care services for the population of

Westminster have a contractual obligation

to collect ethnicity data. This needs to bedone to a higher standard in order to

identify who the 26% attending A&E are in

order to target the community educationprogramme towards these groups.


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Kurdish and Middle Eastern Women Organisation

KMEWOis a women's rights organisationstrives to Empower Middle Eastern and North

African women living in the UK through Support ,Campaigning and Education !

Founded in 1999

Registered Charity Company LTD


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About KMEWO

KMEWO objectives :

Short & Long term support to women.

Campaign and lobby for positive changes in policy andlegislation .

Sharing knowledge and expertise with professionals , peers

and service providers.

Empowering women through Education and Training


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KMEWO Services: Crisis interventions to women and girls at risk of HBV , FM or FGM

( Telephone helpline and drop in advice)

Advice, information, case work , Para counselling and referral and sign posting to specialistservices

( appointments)

Provides Educational courses, workshops and Volunteering and Work placement opportunitiesto women

(LFL Project)

Initiate / support Campaigns and lobbies for positive changes in policy and legislation

advocating BME and Refugee womens rights( FGM project, CHBVF, VAW-WAV)

Held seminars , conferences and raising awareness workshops for service providers on specificissues related to Middle Eastern and North African women

(8thMarch , 25thNov. , HTP before schools events , and etc.)


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FGM Project :

To organise and deliver TENworkshops to :

- Raise awareness of FGM and its different types- Discuss cultural and religious barriers to eliminate FGM

- Inform about health consequences of FGM

- Provide awareness of policy and legislation in the UK .

Focus on KURDISH and ARABIC speaking communities

30% of the work should be with MEN !


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According to Stop FGM campaign by WADI

organisation in Iraqi Kurdistan : FGM is practiced

within Middle East in :Yemen, Oman, the UnitedArab Emirates, Bahrain, the Kurdish regions of

Iraq and Iran, India, Malaysia and Indonesia.

Source : http://www.stopfgmkurdistan.org/html/english/fgm_study.htm


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The prevalence of FGM in Iraqi Kurdistan:

most girls in northern Iraq are likely to have

undergone FGM. In some areas, the FGM rate is

virtually 100%. The average rate is at 72.7%.

http://www.stopfgmkurdistan.org/study_fgm_iraqi_kurdistan_en.pdf


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FGM within Iraqi Kurdish community in the UK:

Class differences

City and rural area differences

Religious believes / statues of local religious clerics

Educational background

Tribal and family issues

Generation gaps between women ( higher statues of mothers in law , grandmothers and outspoken women)

The role of local womens organisations


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Kurdish and Middle Eastern Women

Organisation

Office Numbers :

020 7263 1027 10.00 am- 5.00 pm ( Mon- Fri)

020 7708 0057 10.00 am -5.00 pm ( Thu & Fri)

07748851125 Any time

Languages spoken

: English , Kurdish Sorani & Krmanji

Arabic , Turkish and Farsiwww.kmewo.com

[email protected]
http://www.kmewo.com/mailto:[email protected]:[email protected]://www.kmewo.com/

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