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Date & Time:Tuesday 5th December 2017, 12.00-15.00

Venue: White City Community Centre, 7 India Way, Shepherd's Bush, W12 7QT

Theme:Tackling Obesity in BME communities

[DOWNLOAD MEETING NOTES HERE]

Eddie Chan, Chair of the BME Health Forum, welcomed all to the meeting and introduced the first item.

Item 1:

Jimmy Rushworth from Healthy Hearts will present their projects for tackling obesity and improving diagnosis of high blood pressure

Today I will focus on 2 core areas of the work we do which is around obesity and blood pressure.

Obesity is when your BMI (body mass index) is over 30 which greatly increases your risk of stroke, CVD (cardio vascular disease) and Diabetes.

20% of the population is obese in UK and a further 33% would be classed as overweight and the problem seems to be getting worse. It is currently worse in the UK than other European countries.

London is in fact doing better than other areas in the UK, however there is massive inequality in London when looking at who is obese and who is not. This inequality exists between men and women, and alsoamongst certain BME groups.

What do we do?

We have been commissioned to deliver free health services

We run a 10 week programme on weight management.

Each session is 1.5 hours and each week focusses on a different topic such as

  • Portion sizes
  • Takeaways week – looking at healthy alternatives
  • Nutrition labelling
  • and more…

The sessions are complimented by physical activity sessions.

The aim is to empower people to look after their own diets.

The physical activity part is a low cardio vascular session which is tailored to the needs of the individual.

The purpose of the course is for people to have lost 5 % of their bodyweight by the end of it.

In this programme 40% manage to lose the weight.


Question: Is their a follow up element to the programme to see if weight loss has been maintained?

Answer: Unfortunately there is no follow up element and we are not able to bring people on to the course who have already done it once before so that we can maximise the reach of the course.

 

2 out 3 of the people who come to see us for the weight management programme are women. However we know that more men in general population are overweight than women so our commissioners asked us what we can do to help men.

Man vs Fat Football

These are football sessions with a weight loss and weighing element. Men are put into teams and weight loss counts as a goal for your team. People who join don’t actually have to play – they can contribute simply by losing weight for the team. It is a fact though that some who start off by not playing go on to do the playing part once they have gained confidence and motivation.

Alongside the game there is one to one support and also peer support with a WhatsApp group.

It is a 14 week programme.

Referrals to Healthy Hearts Programmes:

All those with an increased risk of CVD can access Healthy Hearts programmes.

People can self-refer or be referred through their GP or voluntary organisation.

 

RBKC Blood Pressure Project

This is a community blood pressure and pulse check project

1 out of 10 people are undiagnosed with hypertension. We are trying to reach people who don’t have regular health checks.

We engage people at Healthy Hearts events, via Diabetes Champions, and in libraries.

We want to engage with voluntary organisations to reach those who are not accessing these checks,  for example those with language barriers. We can give temporary loans of blood pressure monitors and offer blood pressure training (though all data collected would have to be returned to Healthy Hearts for follow up by them).

 

Q&A

Question: What is the referral criteria for the Man vs Fat football?

Answer: It is very accessible. You have to be a 16 + man with a BMI of over 27.5

Question: How do people find out their BMI?

Answer: At our call centre we can help people work it out over the phone

Question: What happens when someone who doesn’t speak English tries to call to self refer?

Answer: We do have quite diverse team who have a fair number of languages, however if no one is available to speak in their language we would try to encourage them to first see their GP.

Question: Where do the physical activities sessions take place?

Answer: We use a number of venues – many community centres across the tri-borough. We run 7 or 8 activities across 9 venues in the tri-borough.

 

Item 2:

Zohra Davis from Al-Hasaniya will talk about their services for Arabic speaking women

Al- Hasaniya MoroccanWomen’s’ Centre has been in existence for 33 years delivering services to Moroccan and Arabic speaking women in North Kensington.

‘Al-Hasaniya’ means ‘to do good’.

Al-Hasaniya was founded by a group of Moroccan women in 1985. Many Moroccans came to the UK in the 1970s to work in catering and hotel businesses and North Kensington was a practical place to live for getting in to the West End for work.

Al- Hasaniya was set up due to a realisation that many Moroccan women’s needs were not being met.

In one year Al-Hasaniya will support between 600 – 1000 women.

Angelou Project - Al-Hasaniya is part of the Angelou Project which is a partnership of organisations who support women who are affected by domestic abuse. All Arabic speaking referrals are directed to Al-Hasaniya from the Angelou project.

Elderly Project – This project has been in existence since the beginning of Al-Hasaniya and in fact has one of Al-Hasaniya’s longest remaining clients  - a lady who arrived in the UK in the 1960s and could speak only French and Arabic but while in UK never managed to learn English and ended up with multiple support needs

Mental Health Project-  supports a lot of women who suffer with low confidence – many of whom are women who are unable to have children and find themselves without family and very little confidence in themselves.

Inspire Project – This is delivered in partnership with Midaye. It is a 12 week peer support group that also offers one to one sessions and group physical activity sessions at the Westway sport centre. Because of cultural barriers many of the women can’t access mainstream exercise classes.

New Project – in the wake of the Grenfell disaster Al-Hasaniya now has a Grenfell Support worker who is a qualified clinical psychologist who works with many survivors and not just those who were from the building but also people in the surrounding area who have been and continue to be emotionally affected by what happened.

Language, Communication and Culture:

These [language, communication and culture] are the main issues that Al-Hasaniya are faced with. Al-Hasaniya gives women a voice who are unable to speak out due to language barriers. At Al-Hasaniya we have people who can speak in Moroccan, Egyptian and Yemeni dialects. We also run ESOL classes to build people’s confidence in English. We always encourage people to speak up even when their English is broken.

Confidence: a belief in your ability to rise to the occasion when the pressure is on. Confidence is an emotion which is why it wavers at times.

Education is empowering – we want to arm women with new skills.

Trust is something we value greatly in our organisation – people will never come forward if they do not trust us.

Q&A

Question: Can you tell us about your involvement with Go Golborne?

Answer: Yes we took part in Go Golborne getting families and children to be involved in healthy initiatives. We organised a Sugar Smart March which involved around 30 children who got t-shirts and handed out fruit to the passing public on the Golborne Road.

 

Question: How are your services funded?

Answer: Our Mental Health and Domestic abuse projects are funded by the council and the Inspire project is funded by Public Health. We also have an Emotional wellbeing project that is funded by the BME Health Forum.

 

Item 3:

Deka Salat from Hear Women will talk about their work to keep their community healthy

 

Hear Women work with East African women for the last 10 years in North Kensington. We were previously known as the GargarFoudation but we changed our name to Hear Women.

 

We aim to be a bridge between service users and service providers and advocate for services users’ wellbeing and their families.

We work with mainly with East and North African women and children but all other communities are welcome to use our services.

We are also an NGO and do work in Africa.

Our work includes:

  • Healthy talks
  • Physical exercise
  • Gender based violence support
  • FGM support
  • Financial advice
  • Leadership and advocacy programme

Whatever programmes we run in the UK we also run in Africa.

Healthy Talks

These talks are supported by West London CCG. Many service users have barriers that prevent them accessing services around them. For the Healthy Talks we have invited representatives from the CCGs, Mind, Healthwatch to speak about their programmes, how to access them and to have a dialogue about how to improve services to be more accessible.

Cook and Talk - this is a mental health and wellbeing programme. The idea for the programme came from the women using the service – a grassroots up service design with the benefit being that the women have taken ownership of the programme and help make sure of its success.

In the programme we invite psychologists to support the women and at the same time we cook. Cooking has a way of easing tensions.

The programme has been very successful.

Active Mothers Group–this is a group of mothers who came together and wanted to do exercise for themselves. The programme was initially funded by the BME Health Forum but after it ended the women kept it going. It is now finded again by the London Sports Trust and they do Zumba and Stretch classes at the Stowe Centre.

Grenfell survivors programme – this was a successful programme delivered in the Al Manaar centre. We ran cook and talk sessions and provided childcare for the children with outings.

Right now we are working with 15 families directly affected by the Grenfell tragedy

 

Item 4:

Emily Ingrams and Jillian Pitt from Mytime Active will talk about their programme to tackle childhood obesity and the training they offer to the voluntary sector

MyTime Active are commissioned by tri-borough councils to deliver MEND programmes for 0 – 18 year olds.

MEND stands for Mind, Exercise, Nutrition, Do it.

We have a multi-disciplinary team including physical activity leaders who can also offer post-natal courses.

We work with Community Champions.

We want children to be empowered and their families as well.

We work with schools, the community and families.

Programmes:

MEND Mums                                       

  • Post-natal programme for new mums (baby up to 2 years)
  • Energy boosting workouts and great nutrition tips to help establish healthy habits for life

One to Ones

  • Parents with children aged 0-4 years
  • Tailored advice from a Dietitian on a range of nutritional topics, working with a Physical Activity Specialist to help with fitness

MEND Mini

  • Children aged 2-4 years and parents/carers
  • Healthy family habits, portion sizes, reading food labels, reducing screen time

MEND 5-7 & 7-13

  • Children aged 5-13 years who are above a healthy weight (85th centile) and their parents/carers
  • Learning to read food labels, interactive supermarket tour, goal setting

MEND TEENS

  • Young people aged 13-18 years who are above a healthy weight

 

REFERRALS:

Referrals can be made by phone but where convenient we also have referral forms that can be returned to us.

We have found that if people are referred by a GP or a community organisation, they are more likely to attend.

 

Workforce training

Free service, led by experts to empower frontline staff to help improve the health and wellbeing of their communities. It is a train the trainer course.

Part of our commission is that we aim to train over 1000 staff who work with children in the tri-borough per year.

We have had 88% satisfaction for the training so far.

Training Modules:

Healthy Eating:

  • Obesity: The whole picture and raising the issue of weight
  • Nutritional Guidelines
  • Cooking on a Budget
  • Cooking in the Curriculum (schools INSET sessions)

 

Physical Activity:

  • Active Health
  • Delivering Physical Activity to Children
  • Active Playtimes
  • Physical Activity in the Early Years
  • MEND in Schools

Who attends?

  • Teachers
  • Community Champions
  • School Nurses
  • PE staff
  • Midday Supervisors
  • Early Years Educators
  • Youth Workers
  • Maternity Champions  and a whole lot more……

 

We work closely with the Go Golborne project.

Those who attend the training get a CPD accredited certificate. All content of the course goes through a rigorous  process to keep up to date with changing guidelines and content is signed off by public health department.

Q&A

Question: How many days/ how long is the course?

Answer: Each module is 1 – 2 hours long and there are 9 modules.

Comment: Nafsika said that the BME Health Forum are trying to arrange a set of training sessions with MyTime Active for community groups to attend together. She asked anyone who is interested to contact her directly. There needs to be at least 8 representatives per training session. Currently 3 organisations have expressed interest.

 

Item 5:

Stephanie Linden from Pohwer will talk about the Independent Health Complaints Advocacy service

Pohwer is a charity that has provided advocacy services for over 25 years nationally and for the Tri-borough for 10 years.

It is an independent complaints service and community advocacy service that specialises in providing professional advocates.

There are lots of different kinds of advocacy services out there and it can be difficult for individuals to know which service they need to ask for – we try and help people understand the different services.

Pohweris one of the advocacy services in the tri-borough and offer the following types of advocacy services:

  • Independent Health Complaints Advocacy
  • Health and Community Advocacy
  • Independent Mental Health Advocacy (IMHA)
  • Independent Care and Support Advocacy (ICSA)

Independent Health Complaints Advocacy

We support people to go through the complaints procedure of any health service.

People can refer themselves through a helpline (also possible to refer via email and website).

People can refer on behalf of a client

We work with people mainly over the phone and we provide a self help package with a hard copy that is sent home

This is free service and independent from the NHS. However we do work in partnership with PALS. If we feel that something can be dealt with quickly we will try and do it working with PALS but if more complex will go through independent complaints advocacy service.

Although most of our work is over the phone we do also provide face to face meetings in the community if required.

 

How Advocacy works:

 

We do not work on behalf of the patient – instead we make sure the patient is in the driver seat

Rules of advocacy:

  • We will only do what we have agreed with the client
  • We will not tell clients what is best for them
  • We will ask clients how they would like to be helped
  • We will find out how best to communicate with an individual

 

Independent Mental Health Advocacy (IMHA)

IMHA is a free, confidential and independent service.

Helping individuals to speak up for and have their wishes heard and to

be aware of their rights under the Mental Health Act.

 

POhWER IMCA (Independant Mental Capacity Act) advocacy

There is a legal duty for an IMCA to be instructed

where:

- there is a decision to be made regarding either serious medical treatment (SMT) or change of accommodation, or proposed or granted deprivation of liberty

AND

- the person has been deemed not to have time and issue specific capacity to make that decision

AND

- the person has no close family or friends who are appropriate or practical to consult, or temporarily unavailable suitable person act as Relevant Person’s Representative as 39C IMCA

 

IMCAs can also be instructed for Safeguarding Adults protective measures, accommodation reviews under Care Review, or support person or representative to understand deprivation of liberty processes as 39D IMCA

 

Safeguarding is a major element in our work. We often pick up on clients who are vulnerable and at risk and we will work with the council to get them support.

We can help people at any stage, from writing a letter or going with them to a meeting – or after being dissatisfied with a resolution we can help people with the final stage of putting grievance to an ombudsman.

We focus on outcomes – we make sure that clients know what they want to achieve as a result of a complaint.

Usually people want to be taken seriously, want assurance that what happened to them won’t happen to someone else. However if people are looking for compensation we refer them to legal services.

Q&A

Question: How are you linked up with Healthwatch CWL?

Answer: We are linked up with them and we do talk about trends that we uncover.

Question: Do you link in at all with the CCGs?

Answer: No, but we do want to link in more with GPs so it would be good for us to to.

Question: You mentioned that you don’t do Independent Mental Health advocacy in the Tri-borough - Can Advocacy Project offer this?

Answer: Yes they do. In some boroughs we offer all our advocacy services such as in Hillingdon – but not in tri-borough.

 

Item 6:

Hannah Hanfy (H&F CCG Primary Care Team), Central London CCG and West London CCGwill present ‘Improving GP services (including 24 hour blood pressure monitoring, ECGs & wound dressings)’

We are here to talk about GP (Primary Care) Services and Out of hospital services.

What is Hammersmith and Fulham CCG?

  • We plan and buy (commission) health services for the people living in Hammersmith and Fulham.
  • We are led by GPs and are made up of 30 GP practices.
  • We have a patient population of 190,000.

We work to improve patient care, reduce health inequalities, and raise quality and standards in a way which is efficient and financially sustainable.

We want to get an understanding of how local people are experiencing services now.

Out of hospital services were commissioned in 2015 when we moved many services from hospitals to GP settings – we want to know how it has been.

Services include ECG, lung tests, Warferin monitoring, care planning – is this working?,pessary fitting.

We have been engaging with different community groups such as at LGBT Forum, Homeless and now BME Health Forum to gather views across all communities.

We would like to send out questionnaires to your groups and ask you to return them by the end of the consultation period.

These questionnaires are only for Hammersmith and Fulham residents.

We want to find out what specific communities (LGBT, BME, Homeless etc) are feeling about their experiences.

 

Central London Clinical Commissioning Group

Central London CCG are at a differentpoint in the process than Hammersmith and Fulham. They undertook their review of services from January to June 2017. One of the main points that came out of this review was that there was a big difference between people’s experiences depending on which area you were living in so we are changing the way we offer services. We have created GP Networks where by if a service is not available at your GP you will be able access it another GP surgery within the network.

The next piece of work for Central London CCG is about making the Whole Systems Integrated Care model a reality as it has not been delivered yet.

We will be paying for outcomes and we want to find out from you what you think outcomes for patients should be.

We want to ask the following questions:

  1. What health & wellbeing outcomes are most important to you?
  2. How do you want services to be delivered?

We would like to come out to you so if you have an event happening where we could come and have this discussion please let us know.

 

West London Clinical Commissioning Group

 

Alex Silverstein from West London CCG reported that they are continuing with the same services, but they are looking at how they can create better outcomes for the services. West London CCG works in partnership with the GP federation (all 43 GP surgeries are part of the GP federation working together to ensure there is equity of access and satisfaction with services).

Question: What is a GP Federation?

Answer: The GP Federation is a membership organisation comprising of all 43 GP practices to work as a team to coordinate services offered.

Question: How are you ensuring that your engagement is twoway?

Answer: We want to ask you to invite us to your meetings. We can send you our material and we can tailor our presentations for specific communities.

Further comment: The CCGs have a newsletter that includes patient views and comments that we can forward for you to distribute.