Room-to-Breathe & Saving Lives, Saving Money Groundswell Who - - PowerPoint PPT Presentation

Room-to-Breathe & Saving Lives, Saving Money

Groundswell

Who are Groundswell?

• We enable homeless and vulnerable

people to take more control of their lives, have a greater influence on services and play a fuller role in the community.

• Since 1996 - Groundswell have been

supporting homeless people to be involved in delivering solutions to homelessness

• Our work includes: Peer research, client

involvement and peer advocacy.

Homeless Health Peer Advocacy

“… people think that if he can do it anyone can do it.” – Peer Advocate

Homeless Health Peer Advocacy

"As a Peer you can share your experience and show there is a solution, then clients can find their own confidence and begin advocating for themselves.“

Homeless Health Peer Advocacy

In 2015/26:

• 2000 one to one appointments
• 900 Health Promotion sessions
• 23 new Peer Advocates trained
• 62 volunteers: 25 progressing into training and

further volunteering and16 gaining paid employment

• Winner of the 2016 GSK IMPACT Awards

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HHPA supports people experiencing homelessness to improved health

It Works! Saving Lives, Saving Money: Key Findings

“If it weren’t for you guys [Groundswell] coming and taking the time out and getting myself sorted out, I reckon I would have been dead now. That’s how much it made an impact in my life.” – HHPA Client

• Increased attendance at scheduled

appointments; reduction in DNA rates to that of the general population

• Decreased reliance on secondary and

unplanned care; 42% reduction in secondary care use

• Increased knowledge, confidence and

motivation to manage health and engage with healthcare

• Increasingly independent healthcare related

behaviours. “It’s made me more confident in myself and I’m dealing with things now that I never would have dealt

• with. If no one was there with me I

wouldn’t have dealt with it. So in the long run it’s going to help. It really is.” – Client

Reduction in DNA rates

7 12 34 15 10 20 30 40 50 60 General population Homeless population without HHPA support Homeless population with HHPA support

Per cent of scheduled outpatient appointments missed

HHPA support resulted in:

• A 68% reduction in missed scheduled

appointments

• Bringing DNA rates similar to general

population

• Associated cost savings for the NHS in

reduced missed appointments

• Up to £60,000 potential reduction in

DNA related costs at GSST & King’s*

• Increased attendance at scheduled

appointments supports clients to address health issues

* In a twelve month period across all homeless patients accessing services at the Guy’s and St Thomas’ NHS Foundation Trust and the King’s NHS Foundation

• Trust. Based on reduction from 34% DNA to 15% DNA.

“So when you probably without it you would have missed it you go because they’ve given that time to come and you have that trust with them.” – Peer Advocate & former client

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HHPA support results in:

• 42% reduction in secondary care use
• £870 reduction in secondary care costs per client
• For every £1 spent potential reduction of £2.43 in unplanned care

activity costs

• Reduction in unplanned care due to increased engagement with

planned healthcare services and better health management

Reduced Reliance on Secondary and Unplanned Care

“For twenty years being out on the street, this is the first time I’ve ever been in hospital, and engaging.” – HHPA client

• Peers - unique position to highlight

homeless health inequalities.

“Working with clients with breathing problems is

really common. We had one guy referred to us from [Day Centre] who was having difficulty breathing. I went to pick him up. Every 5 steps he stopped and lit a

• fag. I couldn’t get him on a bus… It turned out to be

severe chronic asthma. He was coughing up loads of

• phlegm. He hadn’t been to a doctors for a long while.

He was advised to stop smoking but he said he was 60, he had done it all his life and he enjoyed it.” – Groundswell Peer Advocate

Why Breathing?

Exploring Respiratory Health

“Breathing difficulties have impact

• n all your body. You can’t move,

and you can’t leave. And you cannot walk for a long time… you get tired. When you have breathing difficulties… you have zero energy. Because your body doesn’t get that

• xygen if you want it. You can’t be a

normal person and can’t look after yourself.” – Focus Group Participant

• Designed a peer-led Project
• Extensive Literature Review
• 6 Co-researchers
• Focus Groups
• One-to-one survey
• In total 322 people with

experience of homelessness directly participated in this project.

The Respiratory health of participants

• 26% use an inhaler (8% in general population)
• 20% report to suffer with Asthma (8.4% general

population).

• 4.9% diagnosed with COPD (1.9% in the general

population).

• The longer a participant had spent homeless the

higher the likelihood that they had a diagnosed condition.

• 64% had chest infections when sleeping rough.
• High rates of hospital admissions

“Well I have difficulty with sleeping. In the night I will be wheezing in my chest. I was sweating and so on and so forth… initially they thought I was having asthma so they give me that [inhaler] so I said I use it, but later it stops, so they gave me some tablets… What I normally do is if there is any issues I just rush to the A&E. Then everything is done.” – Focus Group Participant

Homelessness & Respiratory Health

• 85% current tobacco smokers. (18% across the UK)
• 35% have smoked crack cocaine regularly in the past
• Risky Smoking Behaviours – Smoking ‘Dogends’ and sharing Pipes.
• Where you sleep impacts on health - 69% had difficulty breathing

traffic fumes.

• Concerns around living in hostels & temporary accommodation.

Extent of the problem

• Quantities of tobacco smoked places participants at drastically

increased risk of COPD, Chronic Bronchitis and Lung Cancer. 43% of participants have a pack year history of over 20.

• Drug usage can make detection of illness difficult. 80% of

participants find it difficult to know when they are ill.

• Rough sleepers explain symptoms as due to their situation not as an

indicator of underlying issue. 69% of participants reported that they expect to have a cough when they slept rough.

Access to treatment difficult

• Getting to a doctor can be difficult. 63% of participants who have

slept rough find it difficult to get to a doctor.

• ‘Self-management plans’ for managing COPD and Asthma are not

being implemented. Only 40% of people who need a self- management plan have had these created for them.

• Increased risk of contracting influenza. Vaccinations need to be

comprehensive for homeless people.

Smoking Cessation

• Smoking Cessation not available enough. 42% of participants

reported that they have access to smoking cessation support in a homeless service that they use. Licensed Medication underused.

• Support Workers Missing a trick - 66% have not been advised by a

support worker to stop smoking in the last 12 months

• Smoking Cessation is not working. Half of participants want to stop
• smoking. A similar figure to smokers among the general population.
• ‘Harm reduction’ – Smokers should be advised to cut down.

Conclusion(s)

• Peer Advocacy – and Peer Support in general is an effective solution

to tackling health inequalities.

• Respiratory Health is a significant health issue for Homeless People.
• Smoking Tobacco is one of the key factors that drives this.
• Half of homeless people want to stop smoking – just need the
• pportunity and support to do so. Services & Support workers can

play a key role in making this happen.

Thank you!

www.Groundswell.org.uk Martin.burrows@groundswell.org.uk