GP practice overcomes barriers to patient engagement

A GP practice providing health and social care to homeless people, asylum seekers and refugees across the Bradford district has developed unique ways of engaging with patients to help them improve their health and wellbeing.

Bevan Healthcare, which is a social enterprise based in Bradford city centre, has developed different and tailored approaches to engaging with people who access their services.

NHS Bradford City Clinical Commissioning Group (CCG) will learn first-hand about how the practice engages with seldom heard communities at its governing body meeting on Wednesday (9 Sept).

Many of Bevan’s patients find it hard to engage with mainstream primary care, but engagement with the practice is beneficial in a range of ways and enables them to gain skills, knowledge and confidence, while also raising their aspirations.

The practice offers a full range of GP services to its patients as part of a wider holistic service which supports people to find stable accommodation, get into education, training and employment – and move onto mainstream healthcare.

A local improvement scheme (LIS) was set up by the CCG to financially support practices to develop strong engagement mechanisms and involve patients in practice and CCG activity.

Elizabeth Fewkes, Bevan Healthcare’s practice engagement lead, funded through the LIS, said: “Engaging our service users can sometimes be challenging - they often have lifestyles which are stressful and chaotic, and do not see health as a priority. They may have communication difficulties – for example, language or literacy problems, all which contribute to a sense of disempowerment.

“We are grateful to those who are able to be part of our patient participation groups (PPGs) and have done a lot of work to ensure that these groups are truly reflective of our practice population. Regular contact with participants has been crucial in keeping rapport, building trust and building their confidence in the fact that they have a lot to offer.”

Patients’ views have helped the practice shape a healthcare programme that provides the best level of care for the diverse and challenging needs of homeless people, asylum seekers and refugees.

It has two active PPGs which meet regularly to provide opinion and advice about services:

  • Experts by Experience: the group mainly represents people who have been homeless. It was put together to advise, support and make recommendations for Bevan’s outreach services, but now aims to offer a service user perspective on all aspects of homeless and asylum healthcare provision

  • Practice health champions: their focus is supporting the health and wellbeing of the practice community through community engagement and delivery of activities to support health priorities, including self-care and long-term conditions.


 

Max Mclean, lay member for patient and public involvement at Bradford City CCG, said: “Bevan Healthcare provides a unique service to some of the most socially excluded groups of people in Bradford. It’s a one-stop-shop for not only health and social care, but also getting people back on their feet and into housing, training and employment.

“The practice has been equally committed to involving its patients in how services are developed and run – so they feel a sense of ownership in the practice and empowered to improve their health, wellbeing and overall quality of life. It proves that people’s background and circumstances are no barrier to real and meaningful patient engagement.”

As well as core GP services, the practice is also pioneering a range of new projects, funded by Bradford City and Bradford Districts CCGs, and public health. These innovative services are already delivering excellent results by reducing patients’ hospital admissions and A&E use, and scoring highly in terms of patient satisfaction. They include:

  • The Bradford Bevan Pathway: the practice has teamed up with Pathway, a health charity, to create a new team to work with homeless people, vulnerable migrants and people from other excluded groups who get admitted to hospital.

  • Street Medicine Team: this team offers care at homeless drop-ins, soup kitchens and hostels.

  • Intermediate care facility: Horton Housing Association won funding to provide 14 self-contained units for homeless people to be discharged from hospital, with Bevan as a partner providing primary care to patients. This offers a health and social care facility for convalescence, support and rehabilitation


Bradford City CCG’s governing body is holding its meeting in public at Seminar Room 2, Life Centre, Wapping Road, Bradford BD3 0EQ, on Wednesday 9 September at 2.30pm. The agenda and associated papers are available on the CCG website www.bradfordcityccg.nhs.uk/

If you would like to tell the CCG about your experiences please contact: engage@bradford.nhs.uk   Local people can also become members of their practice patient participation group or get in touch with Healthwatch Bradford and District at www.healthwatchbradford.co.uk