Reaching Out. with Suffolk MVA Health Outreach! In this issue. Page 2. Page 3. Page 4. Page 5. Pages 6&7. July 2013

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1 Suffolk Marginalised and Vulnerable Adults Outreach Services Health Outreach provided by NHS North Essex Partnership with Suffolk MVA Health Outreach! Providing health services for marginalised and vulnerable people in Suffolk. July 2013 Newsletter for GPs, pharmacists and other health professionals, social care and the public about Suffolk MVA Health Outreach NHS which is run by North Essex Partnership NHS Foundation Trust. In this issue Page 2 Who we are & What we do Page 3 Our Performance Page 4 Page 5 Introducing... Pages 6&7 Meet the Team

2 Who we are & What we do We re already treating 1000 people from the most marginalised parts of society, people who do not know their way round the health system or have fallen out of mainstream services and whose health outcomes are a cause for concern. Health Outreach (HO) is expanding and will provide expert help to vulnerable people and provide assistance to GPs across Suffolk. In 2011 it was reported that life expectancy for homeless women in Ipswich was 43 and for men it was 47 women do suffer more on the streets, especially when drugs and alcohol are involved. Our job is to treat those who need immediate help and to help them into the health service, finding them a GP and helping them with social care advice. So we provide health services to people who do not already have a GP or if they do, might need more assistance like: Homeless people Refugees and Asylum Seekers Migrant workers Ex-offenders Gypsies and Travellers care, health checks, and sexual advice, drug and alcohol services, needle exchange and prescribing. We also take up the safeguarding role. On Sunday evening (19 January) I went with a colleague to the soup kitchen in Tower Road in Ipswich. We had to dig our ambulance (which we use as a mobile clinic) out of the snow.we helped the church group who give out soup and clothes (thanks to our volunteer knitters for the hats and scarves by the way!). We re available to provide training and expert advice. We work with GPs on complex cases, people who may be on the Violent Patient Register or who have found problems with local services. We have even been contacted by GPs and hospitals who are looking for a vulnerable patient and we ve gone out to and find them! (and we usually do!) Black and Minority Ethnic Communities This bulletin is to let you know We provide a first response to immediate need like wound have concerns about patients who may now be more vulnerable and in some cases we go out and find them! more about us and most importantly, what we do and how we can work with you. A drian Kirkby is the County Manager. A Molecular Biologist by profession and his job is to run the county-wide service. Up to now it has mainly been based in Ipswich and the service enjoys a good relationship with local GPs. We were able to provide some brief intervention work including a young man who was suicidal (and we saw him the following day at our drop-in clinic) but we also do wound care, foot care (especially trench foot), dental and inoculations. We saw about 30 or so people on that cold night in Ipswich and I have to say it was a great atmosphere the mood was good and the rough sleepers were really watching Our key goal is to stabilise someone and integrate or re-integrate them into the local primary care system. With these kinds of clients, trust is very important we help people into primary care but we also help GPs who out for each other in the challenging weather conditions so it s good to help them into better healthcare. We currently run 15 drop in clinics per week from our base in St Helens Street and from the Community resource centre as well as providing medical services at the soup kitchen on a wednesday and sunday evening like loose the needle exchange; we have two GPSIs who will see people too often with some food and drink (we have a food store too). We help with dental care and new community service will be running from our Ipswich base from March. The Terrence Higgins Trust provide a coincidental HIV testing service from St Helens Street as well. Our promise to GPs is to work with you when you need it; work with you to give marginalised and vulnerable patients the health care they require; work with you on any challenges, or for training or advice. Take us up on it! Our Performance August September October November December Patients at the Health Outreach reception 2 Service Users registered with the MVA Service new Service Users registered New Service Users registered with No Fixed Abode Service Users registered identified as At Risk Service Users discharged

3 Health Outreach is different from teams in many conventional ways. the It maximises strengths of individuals who find their lives marginalised for a host of reasons; and opens opportunity. Our skilled team works pragmatically with GP s and all aspects of Primary, Secondary and allied Health care provisions and alongside Social Care, Voluntary and Charitable services. Each day is rarely dull - the diversity and complexity of the needs of our clients means every scenario is different. From Needle Exchange to immediate wound care, liaison with drug and alcohol services and safeguarding referrals, hospital admissions, advocacy, support, home visits, street walks, food parcels and so much more, it is impossible to predict what we will be doing next! That s what makes Health Outreach uniques and innovitive. The teams meet individual need in order to put that person back on their road to recovery and provide them with the access and the tools to do so. K at Saunders came to Health Outreach in 2003 as a student of Nursing & Social Work. She qualified in 2005 and despite going into Statutory Social Care Services (Child Protection) Kat has regularly gravitated back to Health Outreach. Being dual qualified is really rewarding. It gives me the opportunity to work alongside both the nursing staff to meet the health needs of our marginalised clients, and safeguarding - identifying our most vulnerable clients (children and adults) and keeping them safe. I love the work we do, particularly face Kat Saunders at a networking event in Stowmarket to face outreach like going to the soup kitchen and our street based engagement work. This work gives us a unique insight into the most private aspects of marganalised and vulnerable people s lives and gives us an opportunity to deliver a service and make changes where other agencies 4 struggle. Introducing... Dr. Williamson Dr Williamson qualified back in 1986 and is dual trained, being both a GP and a Public Health doctor. Though semiretired he works at Health Outreach/MVA and runs two morning clinics at St Helen s Street, Ipswich. MVA operates five days week so there is another GP or Nurse Practitioners as needed. Dr Williamson s particular expertise is with Asylum Seekers and Refugees. He teaches a Mental Health module to final year Medical Students, and also trains first year students with a local practice. I m 8 to 10 years into this now and I have a great practical interest in this area of health for patients and communities. I d strongly advise GPs to make sure they use a proper translator or interpreter He explains how the system works. The Border Agency (UKBA) locates Asylum seekers with housing providers who refer them to us. We see all new arrivals for health screening (all you would expect including BCG/TB, blood borne virus screening, as well as routine vaccinations). From there we will make sure that people get registered with a local GP. When I see people I will spend some time on mental health and it s something I d really recommend GPs to consider too. We do have more time than GPs in our clinic so I can explore the issues. We go through the background of why this person might be an Asylum seeker. There can be all kinds of trauma; challenging issues in some cases including war, torture and abuse. The fact is, the actual process of going through asylum seeking can be a very long one and it brings a lot of stress, and can really contribute to prolonged uncertainty and mental ill health. We have a Specialist Counsellor here who works with people post trauma and with mental health problems in fact GPs might want to refer people to us when they have a patient in this position who might need our specialist counsellor s support and/ or advice. I m always very happy to talk to other GPs about cases they are dealing with. I d strongly advise GPs to make sure they use a proper translator or interpreter face to face is best but Language Line is very good too. It s too easy to think you re communicating but misunderstanding happens, leading to misdiagnosis; partially because something is missed and partially because the patient will want to appear very compliant and cooperative and will tend to say yes, yes to all questions and this often needs more probing. 5

4 Meet the team When we meet Maggie, Clinical Blood Borne Viruses Nurse Specialist, she has just been discussing with two migrant workers they call me Babushka because I believe in being firm I find this is the best way of keeping people engaged I don t want people to DNA (not turning up for clinic appointments). Maggie Panou Maggie deals with Blood Borne Viruses and arranges treatments like interferon and Ribavirin for hepatitis. She has great experience from working in prisons and with ex-offenders. BBV Nurse Specialist Recently we couldn t get Lithuanian translators and had to use Russians Lithuanians (like many other ethnic groups we meet) speak a number of languages and Russian was one of them! Ayse Sanverdikose Support Worker Penni Hendry is a registered social worker who began her career working with children and families. She worked for a mental health trust in substance misuse and is experienced in both working with complex clients and working to an outreach model. Anna Bennett is a Social work student on placement at the MVA Head Office. Social Worker & Social Work Student 6 Ali Achak & Sarah Hoddell Bi-lingual Support Worker & Registered Social Worker Sarah Hoddell is a Registered Social Worker who has a background of working in substance misuse. Sarah is part of the management team in Health Outreach and has an interest in risk management and clinical governance. Milly is a Community Psychiatric Nurse who specialises in Drug and Alcohol issues. She told us about some of the cases she is dealing with where English is not the first language. Milly Plater Community Psychiatric Nurse I recently visited a Romany Gypsy family. These families in Ipswich are from Romania and speak little English. Their first language is Romany Gypsy (for which there are no interpreters) and their second language is Romanian. They are not entitled to benefits, unless they can prove they have lived and worked here for a period of time. They all have large families and live in very cramped conditions. This family has 12 children, two with severe disabilities (one has to be supervised 24 hours a day) and are in a two bedroomed house. Ayse Sanverdikose is a support worker who speaks Turkish and Arabic. A number of HO staff speak other languages and we also use language line to get translators. Though that can be difficult too. Penny Hendry & Anna Bennett Ali Achak works for Health Outreach as a Bilingual Support Worker. He has worked with Refugees and Asylum seekers for a number of years, and supports this client group in accessing primary medical care services. I am also working with a family with seven children, one child with Epilepsy, who is also mute and immobile and requires 24 hour supervision. They live in a one bedroomed flat. The child is awaiting a Special Needs placement for schooling, but this is taking months. There are two families with four adults and six children between them living in a two bedroomed house. Three of the children are refusing to attend school because of bullying. I m amazed that all the families seem to have a disabled child; predominantly epilepsy. I ve spent a lot of time referring these children to GPs and specialist services; all are now registered with GPs. There have been some problems, mainly around translation of medicines and medical documents. The language is the main problem. Services need to use Language Line or similar services and that makes a big difference! 7

5 Join us! You can become a member of North Essex Partnership in Suffolk it s a way of really getting involved in the future of the service. We have 400 members already so if you really want to do more, this is the time to join in. If you want to know more about the service, perhaps want to arrange a meeting or pass on some feedback, comments or complaints please get in touch. Just Foundationtrust@nepft.nhs.uk or call us for free on What people are saying Just to say thank you to you and your team for NHS Health Outreach's support of the Breakfast Advice Service so far, it has really helped us in supporting clients - both known to us and new to the area. Ipswich Homelessness Transition Project We have a lead clinician for each area so if you need our help please contact the people below on or them at: Ipswich Lyn Jones Lyn.Jones4@nhs.net Contact Us Mid Suffolk Kat Saunders Kat.Saunders@nhs.net Babergh Penni Hendry Penni.Hendry@nhs.net St Edmunsbury Nicholas Footer Nicholas.footer@nhs.net Forest Heath Sarah Hoddell Sarah.Hoddell@nhs.net Suffolk Coastal Edwina Hughes Edwina.hughes@nhs.net Waveney is provided by a different service. Just wanted to say thanks for supporting me with the Legal Highs conference that I spoke at yesterday in Chelmsford. Couldn t have done it without your help and support and thanks for recognising what a big deal this was for me. You have been really supportive and I just wanted to let you know. thanks again! Got something to tell us? If you have some comments, please contact Communications@nepft.nhs.uk