Alex Smith from Fulfilling Lives introduces an innovative partnership working across the North East to close the gaps that prevent many people accessing GP care across the region.

Change is happening all the time. Often it is something we don’t control, maybe even something we fear will have a negative impact. But as a wise colleague once said to me: “If we can’t change, how can we expect the people we support to change?” It’s true. We have to embrace it. That’s exactly what the Be the Change network is all about. Created a year ago by Homeless Link, it is a unique network of homelessness professionals across the North East and Cumbria, working together to address some of the most acute challenges we face in the sector today.

Tyne BridgeWe all have great ideas. I have loads. At least I think I have loads. In reality, I have a lot of bad ideas and some good ideas that will never work. Change is difficult and part of the reason it is difficult is because systems operate in silos, pushed in all directions by agendas, budgets and outcomes. It’s a real challenge. As a System Broker with the Fulfilling Lives programme in Newcastle and Gateshead, I live and breathe system change. I first went along to the Be the Change network hoping it would be a good fit, and I wasn’t disappointed. The Fulfilling Lives programme works with people with multiple needs across Newcastle and Gateshead. The people we support have a combination of issues – homelessness, substance misuse, mental health problems and offending – and one challenge many of them share is difficulty in accessing GPs, meaning they are more likely to access Accident and Emergency departments.

They often have no ID, they find it difficult to attend appointments, they don’t receive mail and their behaviour can be challenging. The upshot of all of this means a visit to a GP surgery rarely ends (or even starts) terribly well. Homeless Link has done some great work around the Homeless Health Needs Audit and this has highlighted the health inequalities we need to address in the sector. During the third Be the Change event, we all agreed that a project focusing on access to GP services could make a very positive difference. It could improve health outcomes for people, lead to better working relationships across health and housing, not to mention early interventions that prevent health problems from escalating, and a reduction in overreliance on emergency services. Clearly this is a big issue to address, but with so many professionals present at the planning session from across the North East and Cumbria, it became apparent that we had a wealth of experience, knowledge and ideas about where to begin: namely, with GP reception staff.

Reception staff are gatekeepers to accessing GP services, and everyone agreed that there was a general lack of understanding, awareness and appreciation for the difficulties many people face. We knew that with this focus we might begin to dismantle many of the barriers that often come up during someone’s first encounter with GP staff. We’ve already made some great progress and started to make a difference. Firstly, we’ve developed a better dialogue between health and housing with a lead GP in Gateshead and Oasis Aquila Housing now working with the Be the Change network on the project. Oasis Aquila have written a bespoke training package which will be delivered to all reception and administrative staff in Gateshead at a GP Time Out session. Beyond this, we have agreed for Basis Resource Centre on Gateshead High Street to act as a care of address and single point of contact for people experiencing housing issues in Gateshead. We hope to have this up and running over the next couple of months. Change takes time, but in this one project alone, the Be the Change network has enabled a unique conversation to take place and a project with great potential to be implemented. Now that channels of communication are open, we can really start to think about better ways of creating access to health care support for multiply excluded and disadvantaged members of our community.