Assertive outreach makes a big difference
Seemingly small early interventions are having a big impact already as demonstrated by these case studies.
Case Study: Building trust and relationships
A CHW called a resident to book an appointment, however he was reluctant to book but eventually was persuaded to meet the CHW in an open green space in the estate behind his house. During their meeting the resident informed the CHW that he is a victim of torture and war crimes. He had been wrongfully imprisoned for 8 years in the country which he fled from to seek asylum in the UK, where he now lived in a studio flat, feeling trapped and isolated. Social exclusion and past trauma led to him being suicidal, which the CHW was able to elicit.
The CHW got the GP on board who was able to help the resident and prevent harm coming to the resident. Dr Neogi reflects: “One of them [CHW] brought to me a patient who was suicidal, who hadn’t presented to us, so obviously we then dealt with that patient, and got them the care they need. I would have never known. This person could have been a statistic. So it does have huge value”. The CHW is regularly calling the resident on a weekly basis, which is appreciated, and the CHW feels he is becoming more amenable to accepting therapy and seeing the potential for things to get better.
Case Study: Personalised screening advice
One of the CHW's discovered early on in the pilot that some Muslim women declined cervical screening because in the countries they came from this service needs to be paid for. There was also a belief that married women did not need to worry about cervical cancer. Being Muslim herself the CHW was able to speak to the resident and clarify that cervical screening is free, important and relevant for all women regardless of marital status and get her to have the cervical screening done.
“We are definitely getting more appointments for smears, and I’m sure this is all Asma’s work, from people of different ethnic minorities, which never used to happen. They were the hard core patients, it was difficult to get them in. Actual hard numbers we don’t yet have but I think we will see that.”
Dr Neogi, GP at Pimlico Health at the Marven.
Sustainability and scaling
When applied health and care research is most effective it improves service delivery by making it more efficient. Research conducted alongside newly implemented practices give a platform to generate further evidence on the impact. The cyclical process of continual improvement is demonstrated by the pilot of Community Healthcare Worker (CHW) model.
As the pilot continues it will produce more data as it intensifies the integration with existing services. A final report due mid next year (2022) will provide insights into the opportunities and challenges of spreading and scaling the model in other parts of the UK.
Dr Cornelia Junghans, GP in Westminster and Implementation Lead for the pilot, said:
“Although the pilot is only in its early stages of implementation, we are already seeing some significant impact on residents’ health and wellbeing and signs of scaling into other localities. Other boroughs in NW London are already planning to adopt this assertive, proactive outreach approach and two regions (Bridgewater, and Calderdale) have already commissioned it for their residents. It is also being supported by the National Association of Primary Care, who is promoting it into localities across the country looking for novel, cost-effective approaches to health and social care.”
At a time when health services are stretched by demand, and Primary Care in particular is put under extra pressure the need for new ways of working is significant. The need to build capacity through innovative preventive public health and social care model, implemented and reviewed with high quality research methods, has never been more important. The CHW pilot in Northwest London is doing just that.
Discover more about the Community Health Worker model
Hear more about the development and implementation of the community health worker model and lessons learned for other areas around the UK interested to develop similar services in this webinar:
Building Back Primary Care & PH Webinar #5: Community Health Worker model