BME Health Forum Quarterly Meeting Notes [DOWNLOAD NOTES HERE or see below]

Date & Time: Tuesday 22^nd March 2018, 10.30-13.30

Venue: Paddington Arts (Pyramid Room) 32 Woodfield Road, W9 3NW

Attendees:

Eddie Chan: Chinese National Healthy Living Centre

Inez Guerrero - Midaye Somali Development Network

Kabung Lomodong - FORWARD

Maryam Yaslam - Al Hasaniya Moroccan Women's Centre

Owen Thomas - Working with Men

Marie Tameze - French African Welfare Association

Phayza Fudlalla - Abbey Community Centre & Association

Vienoos Hassan - Wings of Hope Community Association

Edem Ntumy - NAZ project/ SASH (Support and Advice on Sexual Health

Faith Ndirangu - Healthier Life 4 You/ Healthier Divas

Alda Cela - People Arise Now

Nafsika Thalassis - BME Health Forum

Vivien Davidhazy - BME Health Forum

Bethany Golding - NHS Hammersmith & Fulham CCG

Henry Leak - NHS West London CCG

Eddie Chan, Chair of the BME Health Forum, welcomed all to the meeting and Introductions were made.

New format for Quarterly meetings:

Nafsika Thalassis introduced the new format for BME Health Forum Quarterly meetings. Attendees are now all by invitation only and are all from BME community organisations. The agenda is now set by the Clinical Commissioning Groups (CCGs) for us to raise issues particularly for BME communities

Item 1: Henry Leak from West London CCG on Integrated Care – My Care My Way programme.

My Care My Way is offered to over 65s at the GP practice who are most at risk with their health condition. We look at people who have 2 or more health conditions or 1 health condition but are not managing it well. We provide them with case managers (who will either be a nurse or a social worker) who work closely with both the GP and the patient to make sure they understand their care and make sure they get all the support they need.

For those not so unwell we offer a health and care assistant – like a care navigator but more skilled in that they can take blood and also have an understanding of what the third sector offers.

We make sure patients are connected in to the community and their health condition (LTC).

We have two hubs – St Charles Centre Integrated Care Hub and Violet Melchett Integrated Care Hub)

We invite GPs to refer their most complex patients with multiple needs.

The Hubs are key as they house multi-disciplinary teams under one roof made up of health, mental health and social care professionals along with case managers.

As a patient you have your own Multi-disciplinary team who are housed under one roof and work together to deliver the best care for you.

The feedback has been that patients feel more supported – have less anxiety and that they generally understand more about what’s going on with them and make better use of the support network available to them.

We support people to better understand what’s going on with them and get them linked in to local voluntary sector services that they could benefit from. In West London we produced a directory of 3^rd sector services.

More information on My Care My Way (MCMW): http://mycaremyway.co.uk/

Please send any feedback to Henry Leak  - henryleak@nhs.net

Item 2: Updates from representatives

Chinese National Healthy Living Centre: WAES is putting out a Health & Wellbeing small grant that we are applying for.

There has also been a recent report on the harmful effects of gambling. A significant section of the Chinese population are affected by gambling problems and we have just started talking to Casinos about starting a Forum to address this.

SASH (Support and Advice On Sexual Health)/ Naz Project: SASH is a Sexual Health Promotion organisation working with people across H&F. K&C and Westminster – Edem is the BAME and Faith coordinator.

Working with Men: Gender organisation working with marginalised and disenfranchised communities - mainly BME who are 13 – 25 years. At the moment they are working in parts of Westminster and K&C. We deliver outreach, we work with young dads – mainly one to one but we are working on getting men to work together in groups. We are currently running three groups for dads. We are recruiting men for these groups for Lisson Grove area and also South Westminster.

Question: Do you cover Hammersmith & Fulham at all?

Answer: We just finished a project around mental health for men that was across the Tri-borough but that has ended now so we have withdrawn from Hammersmith and Fulham for the moment.

Question: Have you linked up with Community Champions?

Amswer: Yes we have with some of them in South Westminster.

 

PAN (People Arise Now) – We work with ex-offenders. At the moment we are running a movie and discussion night on Fridays in Fulham.

The Abbey Community Association -  We run lots of activities for children and families. We run a Community Champions programme. We have just started a new Healthy Minds Hub with many activities available. We have an employment programme for BME women and a monthly BME Carers group.

BME Health Forum – We are a second tier organisation working with BME organisations facilitating engagement with the NHS. We have two new projects – one is about community organisations referring people in to the My Care My Way project. The second is a mental health version of MCMY.

FORWARD – We work with communities affected by FGM (African and Middle Eastern communities) We offer one to one support service and work in a holistic way linking people we see in to other services they may benefit from. We run a monthly coffee morning where we invite other services to speak to the attendees. We try to link in isolated women to the community. We also work with young people in schools and we train women to be community champions in their local area.

Midaye – We work with local BME communities in West London, Kensington & Chelsea and Hammersmith & Fulham. We offer education and outreach, befriending, sewing classes, walking and exercise sessions. We run a diabetes mentoring programme. We also have an FGM project where we send a health advocate to the FGM clinics to form a bridge for the community into mental health and other health services.

Al-Hasaniya Moroccan Women’s Centre – We support the Arabic speaking community predominantly in North Kensington and mainly women but we do have some services for men (over 55’s elderly project). One of our recent projects is the Inspire Well Women Project which provides holistic support for women.

Wings of Hope Community Association -We run Health awareness workshops and also have Zumba for Women sessions.

FAWA (French African Welfare Association) -  We work across London. We have a new activity starting in April for older men in African community – we will offer hot meals and get them out and meeting other people. Our organisation is based at Canalside house.

 

Item 3: Overview of engagement work done and planned on integrated care outcomes framework (Bethany Golding – H&F CCG)

The NHS is facing challenges with rising cost of healthcare, more old people with long term conditions –  We have the financial challenge of healthcare costing more without having extra funding.

We want to work with people transparently – to work together.

Integrated Care - Moving forward we want to make sure everybody gets better more joined up care and the community and voluntary sector have a big part to play. All three CCGs have to think about how to work together with VCOs

With Integrated Care we want to make sure every NHS provider is working with voluntary and community sector and local residents towards the same goal. Everyone involved in a person’s care needs to understand the whole picture.

We would like to put the following questions to you:

1. What does it mean to have a good quality of life?
2. What does ‘good care’ mean to you?
3. After reflecting on ‘good quality of life’ and ‘good care’, what do you think the NHS should be doing differently?
4. What would help to build positive relationships between local people and the health services?
5. What do you think would make the NHS work more efficiently?

Feedback and questions regarding overview of integrated care strategy (Henry Leak) and overview for engagement work done and planned on integrated care outcomes framework.

PF (The Abbey Centre)I am concerned about accessibility for BME people, those who are house bound, and those with mental health issues in to the integrated care system and the services it offers.

EC (Chinese National Healthy Living Centre)CNHLC have been working with My Care My Way by delivering befriending services but have found that the payment per referral is too little and we (CNHLC) end up subsidising it ourselves in order to deliver it so will have to stop doing it. Being adequately paid for delivering services is important to us – all costs to organisation should be taken into consideration.

MT (French African Welfare association)In the consultation process it is very important to reach out to the people themselves – not just to rely on organisation representatives’ feedback.

[Nafsika mentioned that focus groups were being organised in order to do this but there was some discussion around the fact that there ought to be an open opportunity for anyone who wants to contribute to attend.]

NT (BME Health Forum) poor housing conditions is a huge factor whether people feel they have a good quality of life or not

PF (The Abbey Centre) poverty is an issue for quality of life

MT (French African Welfare Association) a good referral from a GP to a community organisation should be as important as prescribing medicine.

OT (Working With Men)Health and the NHS is very low priority for the young men we work with – it is important to consider that for this group their focus is primarily about generating wealth – it is when this is not working for them that it causes more stress and perhaps other health issues. These men are not connected to health services, education around sexual health, children’s dietary requirements etc. Specific guided information geared to these men is needed.

IG (Midaye) women with young children are particularly isolated and can have no notion of early child development needs e.g. the importance of play– children are often left while mothers are doing their cleaning and cooking.

OT (Working with Men) We need to educate parents about how to support their children developmentally

PF (The Abbey Centre) We need to educate parents about green spaces to take their children

IG (Midaye) A lot of people we work with do not know how to access a lot of services that should be available to them

EN (NAZ project/ SASH)Fear of being denied services puts off many from BME communities about asking for things.

NT (BME Health Forum) There used to be much more provision of English classes – the voluntary sector would be crucial in getting people more immersed in British society. It would be more than just offering English lessons which is not enough – it would be helping people with the English and support them with accessing the services.

PF (The Abbey Centre) more and more services require people to do things online which is not accessible to our vulnerable community members including ; older people, housebound, people who are mentally ill and BME communities.

IG (Midaye) Filling in forms for people is a help many people come to us for and it can take up to 4 hours per person – it is a lot of pressure for us and people wait a long time.

Comment: there is a lot of stress around the transition to Universal credit and understanding how it will affect people.

OT (Working with Men) We need to get people integrated and feeling part of society

EC (Chinese National Healthy Living Centre) People want a good life but they also want a good death – having the right to end your own life in order to go with dignity and without suffering is an issue.

KL (FORWARD) Following up with patients about the services they have been referred to would be important - at the moment there is no central link.

EN (NAZ project/ SASH) When talking about sharing patient information/ records between services can you make sure that patients have control over what will be shared? This would be important to many, especially around use of sexual health services. Patients should have the choice to consent or not.

 

Item 4: Emotional Wellbeing Campaign

All three CCGs fund Community Champions Projects which deliver 2 campaigns a year. All Community Champions projects conducted base line health surveys and something that came up high on all of them was emotional wellbeing and barriers, particularly for BAME communities, and the taboos around emotional health and not acknowledging issues. In London older Irish women and young black men are also identified with significant barriers.

We are running a campaign from April to August around Emotional wellbeing which has been co-produced with the community

We are working to break down stigma –

• What is the cause?
• Why is there lower access?
• Why are there poorer outcomes?

We are also working with LGBTQ community.

We have an idea now of what the barriers are for BME communities, but do you agree and is there anything to add?

Across the three boroughs we have put together a list of all the NHS services you can refer people to that we will give to Community Champions and to VCOs. We also want to create a CVS directory of culturally sensitive services outside of the NHS.

 

Feedback and Questions regarding Emotional Wellbeing campaign -How can we reach BAME residents? Are you already providing support we should be linking in with? What resources and additional information might be needed:

EN (NAZ project/ SASH) Barrier of suspicion of health care professionals e.g if they say something they won’t get medications/ care.

NT (BME Health Forum) Also suspicion of medications they are being given.

PF (The Abbey Centre) There is a lack of belief that counselling therapy will help them – a feeling that just talking about things is useless.

NT (BME Health Forum) Further to this, CBT is often what is prescribed, and this is not appropriate for many BME communities – a lot of reading and writing is involved and is task based.

OT (Working with Men) BME people are often over prescribed medication and under prescribed talking therapies. But sometimes people feel that talking therapies are just about getting people to accept their circumstances which they don’t want to do.

NT (BME Health Forum) For many people living in poverty, their poor mental health is caused by practical problems. This was the idea of out Emotional Wellbeing project of it offering emotional support alongside immediate practical help because if some of these practical problems can be solved, this helps people’s emotional wellbeing considerably.

EN (NAZ project/ SASH) When you talk about cultural barriers you need to be specific about what you mean exactly by culture.

PF (The Abbey Centre) In my experience of referring people to CBT services people say that they dislike to fill out the questionnaires every time they go.

EN (NAZ project) Can you not find alternative ways than filling out endless questionnaires to get the information you need from the clients?  At SASH we now use a different approach.

How do we reach BAMA residents?

PF (The Abbey Centre)Linking in with Mosques, schools and nurseries

PF (The Abbey Centre)Supplementary schools

NT (BME Health Forum) Advocacy – taking people to appointments, calling up to make appointments for people

What additional resources and information might be needed?

• More funding
• Getting therapists to sit in voluntary organisations to offer counselling in people’s mother tongue – but more than just co-locating the therapists, actually having the therapist part of the management structure of the BME organisation
• Seeing as young people are not in so many services – could there be early action plans for young people – reaching out to people who are not yet sick.

 

Item 4: Equality Objectives Overview

All the CCGS have to plan their work against a set of equality objectives and these are refreshed every 4 years and every year we are meant to go out to make sure it is al still relevant to community groups.

We talk about the 9 protected characteristics:

• age
• disability
• gender reassignment
• marriage or civil partnership (in employment only)
• pregnancy and maternity
• race
• religion or belief
• sex
• sexual orientation

We are currently doing a refresh of our equality objectives across the 8 boroughs. We will form a document outlining what progress  has been made and what are our plans. This goes to NHS England and we are then monitored on how well we have achieved them. We will be disseminating our previous Equality Objectives

 

What should our Equality Objectives be – discussion

Nafsika: Something about access issues for BAME communities into mental health services.

Question: The consultation around Equality Objectives – how long has it been going on?

Answer: It started at the beginning of February and finishes at the ned of March. We have going with a community outreach approach by going ourselves to specific groups. We are also checking the objectives every year so if you feel they are wring you can give input for them to be changed.

Comment: It might also be good if as well as your outreach sessions to specific groups if you also organised an open feedback event that anyone can come to.