Gatekeepers (Presentation Slides)

Gatekeepers

voicesofstoke.org.uk expertcitizens.org.uk

Contents • Partnership • Tips for health • Health of homeless people • Gatekeepers report and findings • Lived experience testimony • Impact • Acknowledgements voicesofstoke.org.uk expertcitizens.org.uk

Working in partnership • All organisations involved have similar aims & philosophies • Have a remit/commissioned to influence service change/design • Tradition of bottom up design, ensuring the input of service users • Service Design built around experiences voicesofstoke.org.uk expertcitizens.org.uk

Developing outcomes • More than a research project in that this requires outputs to be applied • Publication of paper is merely part of the journey • Expertise in the field – “lived experience” • Staff Experiences

• Knowledge of the broader sector • Project Management with clear goals from outset • Ability to access and negotiate with health and care leadership

voicesofstoke.org.uk expertcitizens.org.uk

voicesofstoke.org.uk expertcitizens.org.uk

Top tips for health 1.

2.

3.

4.

Don’t be poor Don’t live in a deprived area Don’t be disabled Don’t work in a stressful, low paid, manual job 5. Don’t live in damp, low quality housing or be homeless

voicesofstoke.org.uk expertcitizens.org.uk

Top tips for health 6. Be able to afford social activities and holidays 7. Don’t be a lone parent 8. Claim all the benefits to which you are entitled 9. Be able to afford and own a car 10. Use education to improve your socio economic position

voicesofstoke.org.uk expertcitizens.org.uk

HEALTH OF THE HOMELESS

voicesofstoke.org.uk expertcitizens.org.uk

“Homeless people are more likely to die young, with an average age of death of 47 years old and even lower for homeless women at 43.”

Crisis & University of Sheffield (2012), “Homelessness Kills”, page 4.

voicesofstoke.org.uk expertcitizens.org.uk

Homeless people aged 16 to 24 are twice as likely to die as their housed peers.

Crisis & University of Sheffield (2012), “Homelessness Kills�

voicesofstoke.org.uk expertcitizens.org.uk

Homeless people aged 35 to 44 are between five and six times more likely to die as their housed peers.

Crisis & University of Sheffield (2012), “Homelessness Kills�

voicesofstoke.org.uk expertcitizens.org.uk

Cause of death GENERAL POPULATION

HOMELESS PEOPLE

Source: Crisis and University of Sheffield (2012), “Homelessness Kills”, page 7.

voicesofstoke.org.uk expertcitizens.org.uk

Hospital interactions

voicesofstoke.org.uk expertcitizens.org.uk

voicesofstoke.org.uk expertcitizens.org.uk

NHS England guidance A patient residing in the practice area does not need identification • Specific examples cited in the guidance include • People that are street homeless or in unstable accommodation • People fleeing domestic violence https://www.england.nhs.uk/commissioning/wpcontent/uploads/sites/12/2015/11/pat-reg-sop-pmc-gp.pdf Gateway Reference 04448, November 2015.

voicesofstoke.org.uk expertcitizens.org.uk

Situation we tested • Anecdotal information that registration was a problem • Support workers and others in the sector • Signposting was directed at a specialist practice or walk-in centres • Limited choice for homeless people

voicesofstoke.org.uk expertcitizens.org.uk

What we did • Expert Citizens conducted a mystery shop • 47 practices across Stoke-on-Trent contacted • Scenario presented was registration of a homeless person with no ID • No other details were given • Also considered case studies and testimony from stakeholders voicesofstoke.org.uk expertcitizens.org.uk

The results 48% 26%

26%

voicesofstoke.org.uk expertcitizens.org.uk

TESTIMONY voicesofstoke.org.uk expertcitizens.org.uk

IMPACT

voicesofstoke.org.uk expertcitizens.org.uk

What£s happening • CCG and Public Health have responded positively and are taking action • Group met twice • • • •

Director of Public Health Clinical Director of the CCG Portfolio Holder CCG Commissioning

voicesofstoke.org.uk expertcitizens.org.uk

Key actions • CCG written to all GPs reminding them of the NHS England guidance • Assurances • Key staff will receive training • Involvement of people with lived experience • Incorporation of this customer group in to equality delivery system • Action on hospital discharge

voicesofstoke.org.uk expertcitizens.org.uk

Hard Edges in Stoke Impact on use of services for 22 customers 12-month prior vs. 12-months since

voicesofstoke.org.uk expertcitizens.org.uk

Acknowledgments • Authors • Paul Astley, Healthwatch Stoke • Ben Wilson, VOICES

• Expert Citizen researchers • • • •

Joanne Cutts Rachele Hine Karen McCall Susan Perry

• Contributors • Jane Morton, Staffordshire University

• Responders • • • • • • •

Cllr Ann James Dr Lesley Mountford Dr John Gilby CCG Commissioning Ruth Smeeth MP BBC Radio Stoke BBC Radio 5 Live voicesofstoke.org.uk expertcitizens.org.uk