Community Voices, is a programme coordinated by NHS Norfolk and Waveney Clinical Commissioning Group, and it is delivered by a network of Community Champions/Connectors placed in key District Councils and Voluntary and Community organisations. Access Migrant Support is a provider of Community Voices for the East European Community across West Norfolk. Our Community Champions are trained in having conversations with members of the community about their experiences of healthcare, the Covid vaccine and what matters to them. The aim is for this information to help influence how health service providers deliver their services, what services are provided and improve their communications with the public.
This is a pilot project, and Access has been chosen, as a trusted Community Voices communicator, to speak with communities who may not already engaged with the NHS to hear what is important to them. This information will be fed back and analysed by the University of East Anglia with the intention that this knowledge and insight is used to make positive changes to the way in which we engage with our communities and deliver services.
Our team of skilled project workers have already begun delivering Community Voices. They spend time with our users and ask them to describe their personal experiences of health care in the community. All the information we gather is anonymised and treated confidentially. Having worked across the migrant communities for twenty years, we have gained an insight into what our users need from local health providers. Our aim is to support these health providers in bringing forward new enhanced levels of service delivery, which better serve our communities.
Access was chosen because we are trusted by the communities we serve. Our project workers are migrants themselves and understand the difficulties and hardships newly arrived migrants face.
Access partnered with Cambridge’s European Molecular Biology Laboratory’s European Bioinformatics Institute’s (EMBL – EBI) to provide a supported nature walk in Bawsey Country Park. Our aim was to engage users with nature in a meaningful, safe and responsible way. In addition, we wanted to connect them to the work of EMBL – EBI’s engagement in Darwin Tree of Life (DToL) science in a place-based context project. We also wanted to offer members of our communities the chance to enjoy a great family day out, in a beautiful rural setting. Many of our users experience financial difficulties and struggle to find well paid work and support their families. With Into Nature, we wanted to provide a project that could offer relief from the stresses of everyday life, and improve well being and mental health.
We wanted to create an activity that encouraged and supported our communities to engage with nature, and Bawsey Country Park was an ideal location to deliver this in a safe and enriching way. EMBL-EBI saw the merit in supporting the development of such an activity, through successful application to the Darwin Tree of Life (DToL) Enabling Communities Funding. Our team worked closely with EMBL-EBI to develop the project and connect nature to the communities we serve.
Project Aims:
- Help our communities engage with nature safely.
- Build a stronger relationship with these communities.
- Offer a fun family event.
- Improve well being and mental health.
- Engagement with science through location-based activities.
- Highlight the benefits of an accessible local nature space.
- Encourage use of the park for continued engagement with nature and science.
What we delivered:
EMBL-EBI used Geocaching as the model and we placed a series of geocaches along the route to provide structure to the walk. The initial route, launched on 2 May, is a circular walk to the Brickyard Lake and consists of four stops. A further six stops were added to the Great Lake and launched in October 2022.
Each geocache stopping point provided an opportunity to engage with content related to the DToL project via a species-themed game card – example below;
The card content and format was developed with ACCESS and Bawsey Country Park and the input of EMBL-EBI DToL scientists. Some cards displayed a safety message, for example – the dangers of the lakes and why swimming is not permitted.
The launch event:
On 2 May 2022 we held a launch event jointly with EMBL – EBI and members of our user communities. We encouraged our users, many of whom have young children, to attend, providing refreshments and also offering help with engaging in the event. Some needed help with language and others additional information, such as using the Geocaching app. We also provided a paper-based treasure map which was available in Polish, Lithuanian and Russian – the three languages most commonly spoken by the ACCESS client community.
To further support the messaging about nature and safety at the park we created a quiz with seven questions relating to the information on the species cards or park information boards. All those taking part in the quiz received a gift bag which contained an i-Spy Nature book, magnifying glass, pen and DToL sticker and the quiz answer sheet in their preferred language. We wanted to promote and encourage further exploration of nature beyond the event.
We set up a Welcome Station near the refreshments area to welcome and orientate participants, We set up an information board displaying event information and posters with QR codes to enable participants to easily download the Geocaching and Google translate app – all information was provided in Russian, Polish, Lithuanian and English. At the end of the event we awarded prizes and engaged with the families. This gave us the opportunity to gather feedback from participants. Verbal and written comments were gathered in the following categories and visual icons were used to indicate them so they were accessible to all participants regardless of language spoken.
User Feedback:
“Caches are nice and easy to find for children and those new to Geocaching”
“It made me happy because it was fun, 9/10”
“Boys enjoyed geocaching app and found all the cards”
“It was lots of fun – adding the geocaches was really good”
Our aim was to successfully engaged with our migrant communities to help overcome vaccine hesitancy
The area of Fenland had low vaccine uptake, particularly in areas of deprivation and amongst the migrant and homeless communities. The Hunts Forum was commissioned to lead a Vaccine Hesitancy Community Engagement initiative across the region and focus on migrant and homeless communities. Access Migrant Support was selected as one for two community partners. Access had the skills and experience to successfully engage with these communities. We were tasked with engaging with these communities to help remove barriers and hesitancy towards the vaccine programme. Our project workers, all migrants themselves, encouraged uptake within their communities and champion Covid compliance. We worked closely with Fenland District Council, Public Health England and the local Clinical Commissioning Group. We helped provide generic messaging materials appropriate for different community groups we support. We also sought to tackle the growing online misinformation.
We quickly realised that we would need to make pro-active direct contact with people and businesses in person, as much as Covid restrictions would allow. We also used social media, What’sApp messages and flyers and sought to discuss, engage and build trust with our users. The Access team used their language skills to directly answer concerns, pass on fact-based information and encourage individuals who were still reluctant to read official ‘trusted’ websites and flyers. By continuing to support individual’s in-person, we have built effective, enduring relationships with our migrant communities.
A total of 552 households were helped by Access, including verbal translation and interpretation of vaccination information. Help with testing, especially for those in isolated communities and information for the wider migrant community. We were also able to softly challenge misinformation and culturally based hesitancy. We made regular, repeated visits to key local businesses and community groups to promote better vaccination take-up and Covid compliance, explaining the rules. This was extended to Chatteris and March, also engaging local businesses, community groups and with people on the street. We were also able to established reasons for non-compliance. For instance, many business and individuals had not read public health messaging, due to poor levels of English. Non-compliance was also due to the complex language being used. By providing simple, easy to understand oral explanations, concerns and misunderstandings were overcome.
A significant development was the development of partnerships between Access and other community groups and advice agencies. We invited Healthwatch and Healthy You to visit the Access drop-in advice sessions. This provided opportunities for them to engage with the Eastern European community. Access project workers helped with translation and help feedback issues our users were experiencing. Healthwatch were the able to feed back these issues, such as difficulty in getting appointments. This prompted the offer of personal health checks from Healthy You for our users. This element has endured beyond the life of the original project. We now host Healthy You at our regular Wisbech advice drop-ins, allowing our users to seek direct help with ongoing health issues.
It had been identified that pregnant women from East European communities, would benefit from greater support in their native languages. NHS Norfolk & Waveney Clinical Commissioning Group, and Norfolk and Suffolk NHS Foundation Trust, offered to support a project to deliver additional help. Access was asked to initially deliver a bedside service, to support women through the pre-natal period of the pregnancy. Access would provide help in the appropriate language and translate key documents for women and their partners. In addition, Access would engage with members of our migrant communities and promote the service to our wider user group. The project would be delivered at Queen Elizabeth Hospital in Kings Lynn.
Access has experience of helping and assisting pregnant women from migrant communities. There is evidence that mothers from migrant communities are at a disadvantage in Perinatal Health and require specialist support. We have supported pregnant women and their partners previously, and had to explain how the perinatal services work within the UK, as it does differ from that within their own countries. We have also supported pregnant women who have been subject to domestic violence and currently have an ongoing case.
We were awarded a grant to develop a project. Our key goals were to:
- Recruitment and train volunteers to assist medical staff in their duties
- Offer support during staff training to enhance services and skills
- Reach out to isolated families and support them online
- Support medical staff delivering digital services with translations and cultural insights
- Provide improved online information, the appropriate languages
- Identify and facilitate online referrals to the service
- One to one peer support
Covid Impact
Delivering this project was made much more difficult by the onset of Covid restrictions. We were unable to enter the hospital during periods of Covid lockdown and had to find ways of supporting our users remotely. We had another project to deliver vaccine take-up in neighbouring Fenland. We were able to use our experiences of working through the Covid disruption and what we learnt, to help us deliver this project.
We therefore amended our service to deliver the most effective service under the circumstances. We delivered the following:
- We provided two way referrals between Access and the Queen Elizabeth hospital
- We continued to translate the hospital’s information into Polish, Lithuanian, Ukrainian, Latvian and Russian
- We offered designated ‘pop up’ sessions for service users in the most appropriate languages
- We helped pregnant women and their partners use the NHS maternity notes app.
Whilst we were unable to deliver face to face support to some women, we were able to support them throughout their pregnancy. Our team were available to deliver almost every other element of the project and built enduring relationships with women and their partners. The project is continuing and could be extended dependant on outcome assessment buy the NHS.
ACCESS and Groudwork joined forces in 2017, and successfully secured funding from the MHCLG Controlling Migration Fund, to deliver our “Grow it, Cook it, Share it, Compare it” project alongside Fenland District Council and Clarion Housing. This project sought to improve local community cohesion through the creation of growing areas. These could be communal plots, small garden spaces and even balconies.
Home growing is an experience that some families lack, especially those who live in flats or other homes that do not have gardens. This course allows parents and children to understand the production of fruit and vegetables, and provide information about the benefits of healthy eating and healthy lifestyles as well as environmental issues such as composting and wildlife in gardens.
Groudwork provided family growing and cooking programmes. ACCESS worked across local communities using our deep rooted knowledge and community contacts to encourage families to take part. Our multi-lingual project workers advice skills played a vital role in the success of the project. Our specialist skills and knowledge are unique in the area and were fundamental to the engagement and retention of a diverse range of participants. As a result of the “Grow it, Cook it, Share it, Compare it project” Groundwork East developed an excellent working relationship with ACCESS and we will continue to source new projects, which could provide better engagement with our eastern European communities.
Courses were jointly delivered by members of Groundwork’s Environmental Education team and Access, and ran for six to ten weeks, with an average of ten families per session.
Family activities included:
- wildlife walks
- scavenger hunts
- den building
- building fires
- story-telling
- natural art
- tree climbing
- making stick men
“It was a really excellent course and we all loved coming to it. It was well-run and an amazing experience to learn all about it.”
“We spent time in the garden together and my daughter looks every day to see how much they have grown and what she can pick and eat. We have had so much success growing that we can give some to family and friends.”