Gypsy and Traveller Community and a Queen’s Nurse tackle health inequalities in Leeds

An award-winning project that has been improving the health and wellbeing of one of the city’s most marginalised communities has received funding for a further 12 months.

It may be difficult to know where to begin caring for a community that has experienced poor health outcomes and where the average life expectancy is just 50 years of age.

But a pioneering 12 month project in Leeds set out to do just that for its Gypsy and Traveller people, who experience some of the highest levels of inequality in the city. The project, a partnership effort, between the NHS in Leeds, Leeds City Council’s public health team and Leeds GATE (Gypsy and Traveller-led civil society organisation) wanted to build bridges with the community in order to improve access to local GPs and other health and social care services. The original time limited project has since received additional funding from NHS Leeds Clinical Commissioning Group (CCG) to continue its ground-breaking work.

A recent interim evaluation report, produced by Leeds Beckett University and commissioned by NHS Leeds (CCG) for the Women and Equalities Select Committee, looks at the outreach work taking place at Cottingley Springs in Leeds, a permanent local authority Gypsy and Traveller site located to the west of the city. The report states residents face various challenges in regard to social inclusion, access to services and health and wellbeing. In working with the community, the project found residents expressed a strong desire to access mainstream health and social care support.  Health and social care partners responded with the introduction of a Community Outreach Nurse role, to work directly with people at the site and beyond.

Liz Keat, who was awarded the title of Queen’s Nurse in May of this year, is the Community Outreach Nurse working with the city’s Gypsy and Traveller community.  Her role is hosted by Leeds Community Healthcare NHS Trust:

Liz explains:

“My work is varied; the community relies on the spoken word for information – which can be difficult in a health system that relies on written messages, letters and reports.

It’s not unusual to see somebody who has missed many health appointments, or been discharged due to non-attendance. This is often due to not being able to read the appointment letter, or understand how the health system works.

The community experiences higher rates of long term conditions so if patient information is only offered in written form it’s highly unlikely the condition will be managed well. Ultimately, this affects a person’s self-esteem and can cause frustration and apathy.  My role is about looking at the whole person, assessing their needs as fully as possible and not just looking at ‘one bit’ of their story. I use a family centred approach, focussing on the strengths within a family to work out how health services can adapt to compliment this.

My aim is always to build relationships, and trust, in order to open doors to wider health support.”

Key to the success of building those trusted relationships has been working together with Leeds GATE, a community members’ organisation for Gypsies and Travellers in Leeds and West Yorkshire.

Helen Jones, Chief Executive for Leeds GATE, said: “Our communities face some of the worst health outcomes in the UK with local research suggesting a life expectancy of 50 years of age in comparison to 78 for the settled population. The discrimination and exclusion faced by our members and the barriers in accessing basic healthcare services directly impacts on this outcome.

”We are immensely proud of the work we have done with the NHS in Leeds. It underpins our commitment to co-production ‘nowt about me, without me’. We worked with community members to better understand their experiences and potential solutions. The role of the Community Outreach Nurse is to deal with complex issues with humanity and dignity – Liz is brilliant at making sure we have an open, honest and effective partnership that puts our members’ needs and wishes at its heart.

The project is now being heralded as an area of good practice. Leeds GATE was recently awarded the Glaxo Smith Kline Health Impact Award, receiving £30,000 to improve sustainability. The additional investment will mean the project can continue to identify common issues for marginalised groups in accessing healthcare.

Helen Added:

“It’s of note that the work our Gypsy and Traveller members have been involved in, is now bringing an even wider benefit to the city.”

Earlier this year the partnership also contributed evidence of its work to the Women and Equalities Select Committee, who were interested to find out more about work to date and plans for the future.

Sue Wilkinson, Commissioning Manager for NHS Leeds CCG explains:

“We’re delighted our unique partnership is being recognised as an area of good practice. We are hoping that we can build a legacy that means that members of the Gypsy and Traveller community have improved access to healthcare services as well as understand how they can self-care, where appropriate to do so. We have learnt a great deal already that will support our future approach to planning and funding services for those who belong to some of our most marginalised communities.”