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Meet the team: Bristol Community Health and Brigstowe Project

Also:

  • Mathew Areskog, Bristol Community Health, Head of Patient and Public Empowerment;
  • Rami Ghali, Chief Executive Officer, Brigstowe Project;
  • Nicola Mead, Bristol Community Health Diabetes and Nutrition Service Manager and Clinical Lead for Diabetes Specialist Nursing;
  • Lauren Tittle, Peer Mentor Coordinator, Brigstowe Project;
  • Claire Valsler, Patient Leader living with Diabetes;
  • Gemma Hargreaves, Head of Business Development, Bristol Community Health;
  • 2 x GP practice managers / GP partners in Bristol

Note: This idea has been edited following feedback from Q members re: integration with primary care and feedback from the QBrings2 event on 14th June 2018.

Our partnership                                                                                                                                                                       

Bristol Community Health is not-for-profit social enterprise and the leading provider of publicly-funded community health services for adults, children and offenders to a population of around 500 000 in and around Bristol.  As well as clinical services, we provide a service for older people to address social isolation, and have an active and valued cohort of volunteers working across our services, with the appropriate resource, support and infrastructure.

We have successfully developed volunteer Peer Mentors in our prison healthcare setting – see attached supporting document.   

Prisoners trained to work with other prisoners with a history of substance misuse, support them to understand and better manage their health and wellbeing while in prison and on the outside.  The mentors gain a qualification, which improves their confidence and skills and ultimately, their chances of making a contribution to wider society on release. 

Our programme has been highly valued by the Peer Mentors and the prisoners accessing the service, and we now want to roll out this tried and tested  model in the wider community,  to support people managing long term conditions such as diabetes, COPD and heart failure.

BCH are partnering with an innovative local charity – Brigstowe – an organisation which shares our own values and has extensive experience of – and evidence based methodology  for – delivering peer mentor support (See http://www.brigstowe.org/get-involved/volunteer-stories/), which we will combine with our own clinical expertise for this project.  

Brigstowe provide advice and support to people living with, or affected by, another long term condition – HIV. Their vision is a world in which people with HIV live long and healthy lives, free from poverty, stigma, prejudice and discrimination. They help Positive people to increase and maintain independence and to meet their changing needs. Their strategy is to diversify their existing, extensive experience of supporting people living with HIV to supporting people with other long-term conditions.

This is all entirely consistent with our approach to keeping people with physical health conditions safe and independent, and empowered to self-manage. 

Our Peer Mentor project

Our unique project combines our own clinical expertise, Shared Decision Making and Patient Activation approaches with Brigstowe’s peer support model for people newly diagnosed or struggling with their HIV diagnosis.  In so doing, we will create a bespoke programme to support people newly diagnosed with diabetes, with a view to extending it to other long term conditions. 

We know that any diagnosis is a time of uncertainty and anxiety for many people.  It can result in isolation, denial, depression, risk-taking and a general physical decline.  For people with long term conditions, it is essential that the correct support is offered to educate and build confidence, and reassure that with the right informed choices, they can continue to live their lives. 

BCH’s Specialist Diabetes service already provides a range of education and self-care tools and resources, but messages are often better received – and behaviour sustained – if they come from a peer with lived experience, rather than a healthcare professional alone.

Individuals on our programme will meet with their volunteer Mentor on a regular basis for up to six months.  Mentors will be recruited, trained, supported and supervised by a Peer Support Coordinator, with the option of becoming qualified in an Open College Network Peer Mentoring Qualification.

We will offer people with diabetes a safe place to meet with someone who can help them understand their diagnosis, experience acceptance and explore the impact of lifestyle on their condition, as well as sharing information and advice regarding treatment and how to navigate the healthcare system.

We will interface with primary care with a small group of GP practices to ensure we follow the patient journey and identify opportunities for collaboratively working in  a person centred way.

Expected  outcomes

The main outcomes of the Brigstowe Peer Mentor service include improved health and management of an HIV diagnosis as a long term health condition, better emotional and mental wellbeing and feeling less isolated and more connected.   As an example, in 2016-2017, 85% of service users reported an increase in understanding and knowledge of HIV, 83% reported an increase in engaging with medical treatment, 93% reported a better knowledge of available services and confidence to access if required, and 93% reported an increased sense of purpose in life

We will be measuring similar elements for the diabetes project and assess this during the development phase. We will expect to see similar outcomes.

19/20 articles published between 2000 & 2012 showed significant evidence of  benefits of peer support to population level management of diabetes & individual benefits for the patient. 14/20 diabetes papers that reported pre & post measures,  average HbA1c declined from 8.63% pre to 7.77% post intervention. (Linnan et al. Am J Health Promot 2012 28. TAHP2-10).

The service will also provide the volunteer Peer Mentors with an opportunity to gain new skills,  increasing their self-esteem, confidence and sense of purpose and reducing  isolation.  This will help them to take a more active part in their wider community, therefore increasing community cohesion.

Conclusion

Our project and partnership will provide and demonstrate a genuinely holistic model of care for people living with diabetes, putting a person-centred approach into practice. Providing peer mentoring support means that people with lived experience supplemented by expert clinical support can provide real life examples of the benefit of effective self-management to others.

How you can contribute

  • Peer feedback about our idea and how it could be improved.
  • Shared experience if anyone else has done this type of project before.
  • Lessons learned.
  • Support for project evaluation.

Comments

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    Hi, Thank you Matthew Areskog for phone call to chat about your idea and our idea on patients in QI. I have experience of Peer support in Vocational Rehab Service for people with neuro conditions and the value of patients sharing their experiences. Although this was not formal peer mentoring, an important lessons was how health professionals interacted and support the knowledge and experience between patients. I support this idea as to really support people to self manage we need to invest in peer mentoring.

  2. Guest

    Joanna Garrett 2 years, 10 months ago

    Establishing an effective peer mentoring programme to improve education about long term conditions is a great way to improve self management skills. Working in the emergency setting I am all too familiar with the side effects of poor education in the management of diabetes. As your comment above suggests it would be great to see this develop across the healthcare system.

    1. Interesting perspective to think about how we can partner re: emergency setting care on this too. Thanks for your comments, really appreciated.

  3. As a GP, the idea of peer mentoring seems to intuitive and I am so pleased to see your idea. I believe there is so much that we could do to improve the lives of people with long term conditions, particularly by igniting their own intrinsic motivation and I think peer mentoring would be right in the middle. Great idea.

    1. Hi Hein, thanks so much for your comment. I completely agree that the right support can enable someone to find their own motivation, inspired by other's lived experience.

      We'd be particularly interested in how we could collaborate across primary and community care, to follow the patient journey rather than provider silos. If you have any ideas on this let me know!

  4. That sounds like a great idea, happy to collaborate

  5. Hi

    our bid includes peer/ buddy support for QI - would be good to share learning and ideas about how to do this well?

    https://q.health.org.uk/idea/putting-patients-and-families-in-the-driving-seat-of-quality-improvement/

     

    Cheers,

     

    Sarah

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