What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

We are key members of our integrated care system (borough partnership), which aims to mobilise the assets within our local community and in turn improve the health and wellbeing of local residents. During lockdown, one of the key outcomes of the partnerhsip was the forging of relationships between health organisations like ourselves and third sector organisations who have stepped in to support our response to covid-19. These include a sats probe delivery service staffed by volunteers and support of our hub based flu vaccination clinics which we are running for the first time this year.  The volunteers in many ways represent the communities we serve and so are ideally placed to support patients who struggle to get the most out of their interactions with primary care, either because of a language barrier or poor health literacy.

What does your project aim to achieve?

The aim of the project is to identify patients who are known to primary care whose first language is not English (and belong to a particular community prevalent in our local area), and to match them with health advocates from voluntary organisations who speak their language and can support them to get the best out of their consultations in both primary and secondary care. Patients can contact their advocates both before and after GP/ hospital appointments.

The role of the advocate would be to help the patient identify what they wanted to get out of any given appointment, to help them write a list of questions or concerns (if relevant), to support them with goal setting with respect to management of their long term conditions and empower them to self manage to the best of their ability.

How will the project be delivered?

We will work with local practices interested in providing advocacy to their patients from BAME communities.

We will ask them to identify patients with long term conditions whose first language is not English, who would benefit from a health advocate. This identification can be done electronically using EMR but GPs may also know patients that struggle to get the best from their health appointments due to a language barrier +/- poor health literacy.

We will offer to match patients with volunteer health advocates who can support these patients with their healthcare appointments on an ad hoc basis. The volunteers would be briefed and trained on what this support would look like –  identifying what matters most, goal setting, supporting with compliance/ self-management.

Evaluation would include qualitative feedback, appointment attendance data, long term conditions parameters in the longer term.

How is your project going to share learning?

Health inequalities is very topical, but very few interventions have been trialled within healthcare to address these inequalities. We believe this pilot will provide valuable learning about the real life implications of using advocates from within communities to enhance both patient experience and patients outcomes. If successful, this model could be widely adopted for use in both primary and secondary care. There will be iterative learning from the process which will largely be focused on understanding how the model best works, what  ‘good advocacy’ looks like, and in what settings it’s most effective. We will also explore the implications of scaling up, it the desired impact is seen in terms of improved patient experience/ improved self management/ improved health outcomes.