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Gerry Dickson Groundswell
- 1. Homeless Health Peer Advocacy Life on the Front Line
- 2. What’s the Problem? “I guess as well the longer you’re on the streets the more you feel separated from health professionals. You don’t want to go to them. They’re part of the system and you’re so far away from that.” – Peer Advocate “You don’t know where you are from day to day, where you are from moment to moment, really.” – HHPA Client “… the language and communication barriers, not understanding what the doctors are saying. People don’t have the confidence to even ask to see someone.” – Peer Advocate “…you put a lot of it down to just being on the streets, the cold and the drinking and drugs, so you don’t think about it, and you don’t want to know.” – Peer Advocate
- 3. Solution: Homeless Health Peer Advocacy “… people think that if he can do it anyone can do it.” – Peer Advocate
- 4. 4 One-to-One Support "As a Peer you can share your experience and show there is a solution, then clients can find their own confidence and begin advocating for themselves.“
- 5. Hostels and day centres Regular presence Informal chats about health and wellbeing Bring in healthcare providers Facilitated ‘coffee morning’ sessions Mobile testing “We create a safe non-judgemental environment where people feel safe to discuss anything that is on their mind.” Health In-Reach
- 6. Why Peers? 6 “Well a lot of the Advocates have been there and done it. So they understand us a little bit better, and you can talk to them on a level and you can be honest with them.” – HHPA client “I’ve been in the system all my life, it takes a lot for me to trust people, but straight away from the word go he explained that he’s had his troubles in the past and that really broke the ice, I felt quite comfortable.” – HHPA Client
- 7. 7 HHPA supports people experiencing homelessness to improved health It Works! Young Foundation Evaluation: Key Findings “If it weren’t for you guys [Groundswell] coming and taking the time out and getting myself sorted out, I reckon I would have been dead now. That’s how much it made an impact in my life.” – HHPA Client - Increased attendance at scheduled appointments; reduction in DNA rates to that of the general population - Decreased reliance on secondary and unplanned care; 42% reduction in secondary care use - Increased knowledge, confidence and motivation to manage health and engage with healthcare - Increasingly independent healthcare related behaviours. “It’s made me more confident in myself and I’m dealing with things now that I never would have dealt with. If no one was there with me I wouldn’t have dealt with it. So in the long run it’s going to help. It really is.” – Client
- 8. Case Study 8
Editor's Notes
- Introduce yourself and tell them what you do at Groundswell (I know that’s a bit fluid at the moment – maybe ‘set up health promotion in-reach sessions’ is a good bet ; )
- Can you talk a bit about the barriers and why people don’t access mainstream healthcare. You don’t have to read out the quotes they are just there to back up what you’re saying. I guess the main point we’re making is that the NHS is meant to be the safety net – why are the people we’re working with falling through?
- Could you say a wee bit about how you started as a volunteer in the second intake of volunteers when we were only working in two boroughs and now you are a staff member and we’re working across so you’ve been part of the team as the work expands and develops
- Explain what we do
- Explain what we do
- Talk a bit about why it needs to be peers
- The headline finding of this evaluation are that Groundswell’s HHPA programme supports people experiencing homelessness to have improved health. Excitingly it works on a number of levels to help people overcome the barriers they face and to engage more proactively with their health management. Importantly, as you can see the benefits are not just seen at one point in the patient journey. So we see both increased attendance at scheduled appointments, and a commensurate decrease in reliance on secondary and unplanned care. What we see is that the Peer Advocates are helping clients to increase their knowledge, confidence and motivation – they feel that it is possible to take control of their health, and to improve their health. For many clients, this is a long hard journey changing habits and patterns which have been ingrained over years, and building up self-confidence from the lowest of levels. It is by no means an overnight transformation but each and every client makes significant progress to being more independent and proactive in managing their health. All of this, of course, has cost saving implications for the NHS and potentially wider cost reductions based on improved health and reduced access to healthcare services.
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