since the first Community Navigator walked into a GP surgery in Brighton & Hove .... of the GP and other health prof
A new pilot project in Brighton & Hove
Introduction
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What is Community Navigation?
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External evaluation summary findings
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Our approach to volunteering
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A Navigator’s viewpoint
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Service development and next steps
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Contact details / More information
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Introduction Welcome to Community Navigators – A new pilot project in Brighton & Hove. It is 7 months since the first Community Navigator walked into a GP surgery in Brighton & Hove last October and we’re presenting 6 months of figures in this interim report. We’d like to take the opportunity in Volunteers’ Week 2015 to share with you some of the things our volunteer Navigators have achieved, and what we as organisations have learned along the way. As a new piece of work, the EPIC Community Navigators project has attracted a lot of attention, heaps of praise, some concerns and lots of questions – all of which we welcome! In this brief report we hope to show you our broad approach, and key learning so far. This is only a snap-shot of the work we are doing, though, and we are planning a full evaluation in the autumn. We have been delighted to work together and with health colleagues to establish this project in Brighton and Hove. This is work that has had a huge impact on the lives of patients by supporting them to access voluntary and community sector services, and we look forward to the next phase of the project.
Jo Ivens, CEO Brighton & Hove Impetus
Jessica Sumner, CEO Age UK Brighton & Hove
Front photograph: Bunty, Community Navigator for Benfield and Burwash, meets Rob Wilson, Minister for Civil Society
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What is Community Navigation? The project is being piloted in 16 GP practices in Brighton & Hove who asked to be involved: Mile Oak Medical Centre Benfield Valley Hub Brighton Health and Wellbeing Centre Hove Medical Centre The Practice PLC, Hangleton Ardingly Court Surgery Stanford Medical Centre Brighton Station Health Centre
Charter Medical Centre Sackville Road Surgery The Practice PLC, Boots North Street Warmdene Surgery Beaconsfield Medical Centre The Practice PLC, Willow Surgery Bevendean The Practice PLC, Whitehawk St Peter’s Medical Centre
What Community Navigation is We are part of the EPIC (Extended Primary Integrated Care) programme designed to improve access to primary healthcare services in Brighton & Hove. It is a way of linking people up to activities in the community that they might benefit from and connecting people to non-medical sources of social, practical or emotional support. There is increasing evidence to support the use of social interventions for people experiencing a range of common health problems.
What Community Navigation is not
Counselling
Medical advice
Social work
The helping hand of Navigation
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The Navigation process
Set expectations Explore the situation Guided conversation
Provide information and do facilitated referral
Bring meeting to a close Record notes
Assist the client if necessary
Identify the need
Review (telephone/future)
Initial monitoring First 6 months of project starting with 4 navigators, increasing to 12
Number of Clients
190 clients, 108 completed/closed cases during this period 45 40 35 30 25 20 15 10 5 0
Note some clients have more than one issue 3 3
Two snapshot case studies
The Navigator met the client in her home around mobility issues, recent bereavement and finance issues. The Navigator found out about a small trust and helped the client apply for a grant to buy a new motor scooter. The Navigator also did a facilitated referral to a community activity and money advice service. The application for funds was successful; the client can now shop independently, attend a weekly activity and also see her doctor at the surgery instead of the GP and other health professionals making regular home visits. A woman was referred for on-going low mood and self-esteem, the Navigator worked with the woman to identify a weekly activity that might be helpful until her counselling offer comes through. The client now attends a local weekly yoga class, where she is enjoying meeting people and learning relaxation techniques.
Some essentials for our Community Navigation project Having a robust recruitment process for volunteers; supporting volunteers through bespoke training and continued 1:1 support and group support; ensuring we learn from the volunteers and shape the project on their experience. Working within GP practices so that we enable the service to be integrated within the primary care offer; making positive use of the knowledge and skills that GPs have in order to know which of their patients would benefit from navigation; having relationships with all stakeholders that are based on mutual respect. Being responsive and flexible to the different needs of all involved – practice staff needs and processes, client needs and volunteer needs – while making sure that we have clear values, processes and roles. Avoiding duplication; being a bridge between community activity and GPs; not trying to provide activities or a service but navigating people to the right on going service. Empowering clients; working with them; promoting self-awareness, choice and self- care. 4
External evaluation – Summary findings from NHS England
Read the full report here: bit.ly/1AoUIDD
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Our approach to volunteering This pilot has been based on volunteer Navigators and as such we have focused strongly on the quality of our Volunteer Management. In particular, as we know that this is a challenging role as well as a rewarding one, we have placed emphasis on the individual support as well as group support. Clair Farenden, Community Navigators Service Manager (above), sets out our approach to volunteering: 1. Provide an interesting and varied role that involves a sense of responsibility. 2. Have a well-developed and transparent recruitment process; application form, informal interview, training. 3. Have a clear role description and person specification that outlines the expectations of the role and minimum time commitment. 4. Have a well-designed training programme that meets the needs of the role. 5. Putting a support package in place for volunteers to carry out the role effectively and with confidence; ALS, ongoing training, one-to-one debriefs, news bulletin, telephone support, paying expenses, DBS checks. 6. Encouraging active involvement of volunteers by being open and responsive to changes and developments in the process; examples including addition of 3 way meetings when introducing a navigator to their surgery, changes to monitoring system, use of email, etc. 7. Flexibility, e.g. doing 2 shorter sessions per week instead of one longer one, other roles, sabbaticals. Research community activities and resources / make links themselves at their own speed so their roles develop as their confidence increases. 8. Putting a quality control process in place. Involves spot checks and contacting clients at random (which is also a good way of building case studies for evidence). 9. Supporting professional/personal development and longer term goals of volunteers, e.g. training and, keeping a support record for each volunteer that can be used as evidence for references. 10. Working with other professionals, e.g. practice managers and surgery staff, funders, etc., as appropriate to assist them in understanding the needs of a volunteer and the context of working with a volunteer.
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A Navigator’s viewpoint Julia started volunteering as a Community Navigator last November. She sees on average three people a week through GP referral at the busy Brighton surgery where she is based. Julia says:
"Being a Community Navigator is about empowering people. It’s a service that can give them time to talk and explore non-medical support or activities in the community. Many are coping with a chronic illness, anxiety or depression, isolation, loneliness or loss: often a combination of all these. "Our first meeting lasts for 45 minutes. Once we have built trust we move forward to look at local agencies and organisations that will offer the most practical and suitable help. On average I see people for three appointments. "My role is to guide them back into their community, to help them regain their self-esteem, but to remain in the background, offering support for them to do it for themselves, which is much more powerful. "There is a large gap to be bridged for older and vulnerable people who do not have access to the internet, the media, or the written word. "I would recommend volunteering to anyone with a little time to give, especially if you want to get back into work, change your life, or give something back. I am part of a busy professional team who always support me and make me feel valued. Everyone gains from this marvellous scheme!"
- Julia, Volunteer Community Navigator From the April 2015 issue of the Better Care Bulletin: bit.ly/1AoUIDD
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Service development and next steps The project has been delivered and developed by a new partnership between two local charities – Brighton & Hove Impetus and Age UK Brighton & Hove – and Brighton Integrated Care Service (BICS) as part of the wider EPIC pilot. We are working in GP practices with both clinical and non-clinical staff; clinical staff refer clients they think will most benefit from the service. During the pilot we have developed the Community Navigation model, processes and procedures, allowing for some flexibility in order to fit with individual surgery needs and systems. We work in an empowering way to promote choice, understanding, self-care and information about community projects and activities that exist within the city. This pilot has been well resourced in order for it to be delivered by a group of trained and supported volunteers. We are working with a variety of clients who are facing a variety of issues. We do more than signpost; we facilitate people accessing services and activities within their community and across the city. Community Navigation is a short term intervention to support vulnerable people to make good use of the services that exist to serve their needs. Having made positive links with groups and organisations across the city we try to keep abreast of changes within service provision and community activity. Because of the intense nature of the role and the short term nature of the navigation relationship, alongside the variety of clients being worked with, some of whom have complex needs, the volunteers need ongoing support. During the pilot we calculate that for every volunteer we need 1 hour of Volunteer Coordinator time per week. Next steps: A word from Jenny Moore, Service Development Manager
The EPIC pilot was funded initially for 9 months and has successfully been awarded a 6 month extension in line with the other 4 EPIC workstreams in order to: Gather 12 months of data to measure impact and outcomes for evaluation. Seek to increase the navigation where it is being well utilised, continuing to work with BICS and GP representatives to fine tune the model and learn from delivery. Through connections with strategic groups within the city, Impetus and Age UK B&H will continue to share learning and scope interest to expand the project. 8
Contact details Get in touch if you want to find out about:
How we set up and run the project How to volunteer with us The impact we have had so far Website: bh-impetus.org Telephone: 01273 775888 Email:
[email protected] @BHImpetus Brighton & Hove Impetus
Brighton & Hove Impetus works to support vulnerable adults in the city to improve their quality of life and wellbeing. We take a particular emphasis on ‘Volunteering to End Isolation’ and volunteers are at the heart of much of what we do. As well as Community Navigation, we provide befriending, mentoring, advocacy, social groups, supported volunteering and training for individuals and organisations, all with a strong emphasis on user involvement and participation.
Age UK Brighton & Hove seeks to improve the quality of life of all older people in the city through the provision of high quality services that promote independent living, campaigning, innovation and research.
Brighton and Hove Impetus, Registered in England and Wales. Registered Address: 1st Floor, Intergen House, 65-67 Western Road, Hove, BN3 2JQ Registered Charity: 1083390. A Company Limited by Guarantee: 03895574
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