Frances Schofield on ‘using insight to create actions for change’

“Now we have highlighted people’s experiences it is more important that we act to create change.”

First published March 2021, written Frances Schofield, #HealthNow Coordinator, Crisis Birmingham.

Today, 19th March 2021, Groundswell and Crisis Skylight Birmingham are launching our peer research report ‘understanding homeless health inequality in Birmingham’. This research is part of the #HealthNow campaign led by Groundswell, delivered in partnership with Crisis in Birmingham on a local level.

Back in the early days of the pandemic, we assembled a team of volunteer Peer Researchers with experience of homelessness to investigate homeless health inequalities in Birmingham. Right from the beginning the team united around a singular goal: to improve access to healthcare for people experiencing homelessness in our city. We wanted to understand barriers to accessing treatment when someone is experiencing homelessness, so we could use this knowledge to inform and influence system change that ultimately improves people’s health and saves lives.

Throughout November 2020, #HealthNow Peer Researchers carried out 64 interviews with people experiencing homelessness across the Birmingham. As the research progressed, peers reflected on how interviewees’ stories mirrored their personal experiences – it didn’t take long to see patterns emerging. Issues such as poor communication, access barriers, experiences of stigma and discrimination and lack of knowledge of feedback mechanisms impacted people’s engagement with all health services. Other barriers were specific to individual services. I invite you to read the full report of our findings and pay particular attention to the excerpts from individual interviews: it is important we listen to people’s stories in their own words.

Now we have highlighted people’s experiences it is more important that we act to create change. Last week we convened a meeting of our local Birmingham #HealthNow alliance to draw up an action plan addressing the issues identified in our research. We brought together #HealthNow Peer Researchers and representatives from Birmingham and Solihull CCG, local NHS Trusts, Birmingham City Council, HealthWatch Birmingham and local homelessness and substance misuse services. Birmingham’s Director of Public Health, Dr Justin Varney, opened the meeting, inviting us to challenge ourselves to seek fundamental change.

“The action planning session was brilliant as it has enabled an attainable, practical and joined up approach to moving forward in tackling these inequalities”

Latifah Stone, Healthwatch Birmingham (Partnership Officer)

“I was surprised and encouraged to see how wide the representation was and excited to see the level of enthusiasm from many sectors to agree priorities and press the agenda locally. I think connections will be a big part of this and learning from good practice elsewhere including in Bristol where Connected Care is working well.”

Dr Jonathan Bown, GP Partner, Cape Hill Medical Centre and Homeless Health Xchange

We left the meeting with a plan of coproduced concrete, tangible actions that system leaders can take to improve services for people experiencing homelessness, as well as commitments to hold each other to account. For example:

  • we will explore and develop training on good practice when supporting patients who are experiencing homelessness
  • we will pilot GP and paramedic in-reach to hostels
  • #HealthNow volunteers will support our local homeless primary care team to set up a patient participation group

Some of this work is already underway. #HealthNow volunteers have begun delivering training to trainee nursing associates at University Hospitals Birmingham NHS Foundation Trust. But there is still more to do. Our #HealthNow alliance will meet every two months to review our action plan and track progress. In the words of one #HealthNow Peer Researcher, “This is just the beginning”; and they’re exactly right, this is what #HealthNow is all about – using insight to create actions for change.