Post on 03-Jun-2018
8/12/2019 SW Health and Wellbeing Network Presentations
1/48
By Phayza Fudlalla
Health and Wellbeing Programme
Manager
7thMay 2014
5/27/2014SW Health and Wellbeing Network meeting 1
8/12/2019 SW Health and Wellbeing Network Presentations
2/48
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
5/27/2014SW Health and Wellbeing Network meeting 2
8/12/2019 SW Health and Wellbeing Network Presentations
3/48
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 .
5/27/2014SW Health and Wellbeing Network meeting 3
8/12/2019 SW Health and Wellbeing Network Presentations
4/48
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
5/27/2014SW Health and Wellbeing Network meeting 4
8/12/2019 SW Health and Wellbeing Network Presentations
5/48
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.
5/27/2014SW Health and Wellbeing Network meeting 5
8/12/2019 SW Health and Wellbeing Network Presentations
6/48
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
5/27/2014SW Health and Wellbeing Network meeting 6
8/12/2019 SW Health and Wellbeing Network Presentations
7/48
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
5/27/2014SW Health and Wellbeing Network meeting 7
8/12/2019 SW Health and Wellbeing Network Presentations
8/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
9/48
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
5/27/2014SW Health and Wellbeing Network meeting 9
8/12/2019 SW Health and Wellbeing Network Presentations
10/48
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
5/27/2014SW Health and Wellbeing Network meeting 10
8/12/2019 SW Health and Wellbeing Network Presentations
11/48
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
5/27/2014SW Health and Wellbeing Network meeting 11
8/12/2019 SW Health and Wellbeing Network Presentations
12/48
8/12/2019 SW Health and Wellbeing Network Presentations
13/48
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
5/27/2014SW Health and Wellbeing Network meeting 13
8/12/2019 SW Health and Wellbeing Network Presentations
14/48
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
5/27/2014SW Health and Wellbeing Network meeting 14
8/12/2019 SW Health and Wellbeing Network Presentations
15/48
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.
5/27/2014SW Health and Wellbeing Network meeting 15
8/12/2019 SW Health and Wellbeing Network Presentations
16/485/27/2014SW Health and Wellbeing Network meeting 16
8/12/2019 SW Health and Wellbeing Network Presentations
17/48
Emergencyor Not?
8/12/2019 SW Health and Wellbeing Network Presentations
18/48
UNSCHEDULED CARE INSIGHT
PROJECT
A Report by the
BME Health Forum
Commissioned by the NHS Central
London CCG
8/12/2019 SW Health and Wellbeing Network Presentations
19/48
Who was involved
BME Health Forum
Midaye
Healthier life 4 You
Abbey Community Centre
Marylebone Bangladesh Society
Westminster Mind
Volunteers and participants
CLCCG
8/12/2019 SW Health and Wellbeing Network Presentations
20/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
21/48
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)
8/12/2019 SW Health and Wellbeing Network Presentations
22/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
23/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
24/48
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
39% went 3 to 4 times
10% went 5 to 6 times
6% went 7 to 8 times
Over a period of 2 years 85% of the adultparticipants had accessed A & E services
8/12/2019 SW Health and Wellbeing Network Presentations
25/48
8/12/2019 SW Health and Wellbeing Network Presentations
26/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
27/48
Why patient didnt attempt to see GP
before A&E?
8/12/2019 SW Health and Wellbeing Network Presentations
28/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
29/48
8/12/2019 SW Health and Wellbeing Network Presentations
30/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
31/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
32/48
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:
8/12/2019 SW Health and Wellbeing Network Presentations
33/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
34/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
35/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
36/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
37/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
38/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
39/48
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.
8/12/2019 SW Health and Wellbeing Network Presentations
40/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
41/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
42/48
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.)
8/12/2019 SW Health and Wellbeing Network Presentations
43/48
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 !
8/12/2019 SW Health and Wellbeing Network Presentations
44/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
45/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
46/48
8/12/2019 SW Health and Wellbeing Network Presentations
47/48
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
8/12/2019 SW Health and Wellbeing Network Presentations
48/48
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
Info@kmewo.com
http://www.kmewo.com/mailto:Info@kmewo.commailto:Info@kmewo.comhttp://www.kmewo.com/