C4CC: HIV in Hackney

Kristi Adams, C4CC’s Senior Co-production Advisor, recently facilitated the second of two workshops, commissioned by the Homerton University Hospital NHS Trust, with the goal of improving the care and support available to people living with or at risk of HIV.

The first workshop back in March attracted more than 80 people, with a mix of people using services in Hackney, healthcare professionals, commissioners and other key stakeholders providing their input and expertise.

Participants explored what good would look like for people, from prevention and testing through to palliative care.  The group identified the good work already happening and how this could be built on to become even better.

The second workshop drew on a smaller group and was focused on the actions and key points raised from the earlier session, identifying what needed to change and how, and how gaps could be filled.

Below, you will hear from Kristi and the people involved in the workshops about why this work is important and how they will help to improve services for people living with or at risk of HIV.

Kristi Adams – Senior Co-Production Advisor, Coalition for Collaborative Care

I was delighted when C4CC was approached by the Homerton University Hospital Trust in Hackney to co-design and facilitate two workshops, with the aim of improving the quality of service it provides to people living with or at risk of HIV.

The hospital is already recognised for its innovative approach. It employs peer navigators who are themselves affected by HIV, to work alongside people in the co-production of their care and provide personalised support during, what can be for some people, a very stressful time.

There was an understanding by the hospital at senior level that more could be done to improve the patient experience through better co-ordination and collaboration with a whole range of stakeholders in Hackney, such as GPs, commissioners and the local authority. It was clear from the outset there was a collective willingness to engage and embrace new ideas and approaches.

This focus on better conversations, the use of community assets and co-production is the key message that C4CC is promoting with its national partners and we will continue to do our very best to provide support to any organisation that wishes to foster the same ethos.

I am confident that what will happen as a result of the workshops and other connections that were made will be to the benefit of the people of Hackney and we have pledged to continue our work with the Homerton as the programme develops.

Professor Jane Anderson –  Director for Centre for study of HIV and Sexual Health Homerton University Hospital NHS Trust

With more people living with HIV than ever before and at a time when the NHS is under enormous financial pressure, the need for all of us to collaborate across the whole health economy has never been greater.

At the Homerton, like other front-line hospitals, we are well aware of the scale of the challenge and we are committed to ensuring best outcomes for people by exploring new ideas and new ways of working.

It was in that context that we worked with C4CC to organise and facilitate two workshops to allow us to identify both areas where things were going well and also to look at where we need to make improvements for people with HIV in the local area.

It was crucial to ensure that everyone involved right across the care pathway could take part and give their point of view. That meant ensuring we included service users, specialist clinicians, commissioners, GPs, elected political representation and our public health team for Hackney.

The task was made easier because C4CC is an NHS England-based organisation, which gave the workshops credibility within the health system.

At the second event, we could build on the themes and outputs of the earlier workshop held in March, using the momentum that had been generated.

I believe that the relationships and potential working partnerships generated through this process will support the development of a ‘whole system’ approach to HIV prevention, treatment and care in our locality, that is based around the needs, perspectives and aspirations of those affected by HIV.

I am confident we have begun a process that will put the building blocks in place to ensure the best outcomes for those affected by HIV within our local area.

Janine McGregor-Read – Peer Navigator at Homerton Hospital For Positively UK

 As a long-term service user, diagnosed with HIV 25 years ago, I have been able to witness at first hand the vast improvements in the standard of treatment provided by the NHS.

In my job role at the Homerton as a peer navigator, I have been able to draw on my own experiences and others to help shape the service that is provided to people, and I believe what is happening here is above and beyond what is generally available.

But we must never be complacent, particularly with the challenges of a client base that is getting older, many with mental health issues and other complex problems. Faced with this challenge, I detect a real desire to find a way to make the system deliver the best that is available, whatever the funding.

The C4CC-facilitated workshops were able to connect people, to flesh out duplications and gaps in service so we can be as effective and tight as possible, giving priority to the areas that are most important to patients.

People have to trust the service they access and for that to happen we have to understand their needs, their concerns and provide the wrap around support to allow them to prosper.

At the second workshop the service user was put very firmly at the centre of the conversations as we look to develop a better working model. Every individual is different so the system has to be flexible to meet their needs rather than relying on the traditional linear model.

Meeting and sharing views and perspectives with people from outside the immediate hospital environment was an invaluable experience and I am hoping that our collective input will have a positive benefit for the residents of Hackney in the future.

Iain Reeves: Consultant specialist at Homerton Hospital

At the Homerton we pride ourselves on the quality of care that we provide for people living with HIV; most treatments are successful and we have good clinical outcomes. But there is a recognition that we need to move beyond that because we have many people with a complex range of physical and mental health issues, in the main, but not exclusively, because of ageing.

Initially, those problems may have arisen because of the impact of a positive diagnoses and the stigma and discrimination this can unfortunately attract.

For this and a host of other reasons, I believe it is vital that we place people at the very centre of a network of care services to provide the support and help they need.

I attended both workshops and found them very rewarding in terms of getting the right people into a room and stimulating the right conversations. For me, the most valuable connections were made with representatives of primary care and a really positive outcome is that we are now looking at new ways of delivering care and different ways to involve people living with HIV at GP and consultant level.

If you would like to know more about C4CC’s work with Homerton University Hospital NHS Trust, please contact Kristi Adams on kristi.adams@nhs.net

 

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