INSPIRING oTHERS:THE iMPACT OF fAITHON pUBLIC hEALTH

Collected practical accounts of what grassroots organisations are doingOctober 2015

About FaithActionFaithAction is a national network of faith and community-based organisations involved in social action. We empower these organisations by offering support, advice and training – we help the ‘do-ers do’. We also have a key role in facilitating partnerships, sharing good practice between organisations and between sectors, and acting as a connector between government and grassroots organisations. We work to highlight the contribution that faith-based organisations are making to communities up and

down the country. We believe that the extent and impact of this work, and the reach of faith-based organisations into communities that are often marginalised, mean that faith is too significant to ignore.

FaithAction is a member of the Health and Care Voluntary Sector Strategic Partnership, working with the Department of Health, NHS England and Public Health England. As the faith ‘voice’ within the Strategic Partnership, we ensure that faith is taken into account in the development of new health

policies and initiatives. We believe that faith-based organisations have a role to play in raising health outcomes, particularly among communities that typically suffer from health inequalities. Our recent report, The Impact of Faith-Based Organisations on Public Health and Social Capital, looks at this issue in more detail. You can read more at www.faithaction.net/report.

Thank You!We would like to gratefully acknowledge the Department of Health for its financial support for this project through the Health and Care Voluntary Sector Strategic Partner Programme.

We would also like to thank those groups who agreed to be participants and those people who took the time to speak to us about their work. In particular, we would like to thank:

• Monsignor Daniel McHugh, Birinus

• Dr Bhajneek Grewal, Dementia Friendly Gurudwaras

• Brent Robinson, TheFunkyChoir.com

• Dr Ronke Olulana, Harmony Clinic

• Seeta Lakhani, Peepal Care

IntroductionThe following case studies give an idea of the work that faith groups are conducting within their communities and how they can work with public health agencies and the wider healthcare sector.

As a national network of faith-based organisations, FaithAction is aware of the important work faith groups are involved in doing around public health, supporting health and wellbeing outcomes throughout the UK. This role was recognised as being significant in both our ground-breaking report, ‘The Impact of Faith-Based Organisations on Public Health and Social

Capital’, and our accompanying Symposium on Faith and Public Health. This brought together academics, public health officials and faith-based organisations to discuss the part faith can play in public health.

However, there was a lack of understanding within public health as to how faith groups can help to improve health in their communities. This lack of understanding can be broken by public health agencies taking the time to understand the work that faith-based organisations do, and coming to view faith groups as part of the “armoury” of public health.

This responsibility does not fall on public health officials alone. Faith groups need to be confident that their approaches to public health interventions work, that they can successfully present their work by demonstrating to public health agencies what their unique selling point is, and that their approaches make a real impact on the health and wellbeing of the communities they serve.

By working together, public health agencies and faith-based organisations are in a position to make real positive change in the health and wellbeing of communities around the country.

Communitas Wellbeing Project

The Communitas Wellbeing Project is a multi-faith project in Birmingham. The project brings together two groups from two different communities - one a Catholic church, the other a Muslim community organisation - to help improve wellbeing and tackle isolation among the elderly population of their communities. The project provides opportunities for social interaction, assessment and support of needs, chances for education and skills training, and regular opportunities to get advice from experts to help people with their wellbeing. The project targets over-55s and draws its participants mainly from the two communities the partner organisations serve, where the majority are from Pakistan and Ireland, but it is open to all living within the local community.

This unique collaboration between the Muslim and Catholic communities of Sparkhill in Birmingham began when the Muslim Educational Consultative Committee approached Monsignor Daniel McHugh, founder of Birinus, a Catholic community outreach organisation. Originally looking for an accountable body for a project, MECC also wanted to explore the idea of collaborating with a local Catholic group in a project they were hoping to run.

English Martyrs Catholic Church in Sparkhill then became the Christian part of what would become the Communitas Wellbeing Project. The two groups have worked in close collaboration to develop the project, identifying the main areas where the elderly from both communities were struggling, and learning from each other as they developed support specifically for their own communities, as well as coming together to run sessions and giving people from both communities the chance to interact with each other. The project has found the local authority to be very supportive of the work as it

recognises the unique benefits for social cohesion created by bringing together groups from two different communities.

The project starts for each participant with an assessment of their needs and what they would like to gain from their involvement in the project, along with signposting to other services if required.

There are two main areas of support. The first is a weekly session held by the two groups in community spaces. These sessions provide participants with the opportunity to come together with other people in similar situations, allowing them to socialise and form friendship bonds as well as to provide each other with support. It also allows them to talk

with members of the Communitas Wellbeing Project team about any needs or concerns, and allows the team to regularly monitor those who attend. Alongside social

activities, the weekly sessions also provide regular talks and sessions from experts from different organisations, particularly those from groups focused on wellbeing, to provide participants with information and the chance to make changes that will affect their own wellbeing.

The second area of the project is home visits to those who are unable to attend the weekly community sessions. Community Outreach workers from the project visit participants, spending time with them, talking through any issues or concerns they have and providing some other services such as fetching shopping. Both areas help to tackle the loneliness and isolation that older people can find themselves in.

The project reaches between 45 and 50 people on a monthly basis. The initial assessment that participants complete when they first join the project monitors a person’s needs by looking at the areas where the person feels they need support, the support and contact they have with family and friends, and what other opportunities they would like to gain from attending the project. This gives the project workers a good baseline from which to continue to monitor the wellbeing of the participant as they attend sessions. A continuous system of follow-ups is used, with participants often reporting an increase in their feelings of wellbeing after

attending sessions.

A lack of available funding was seen as being a major challenge for the project. Thanks to its unique nature, the Communitas Wellbeing Project has been fortunate in attracting support from the local authority and other organisations, including the Department for Communities and Local Government’s Together in Service fund, which FaithAction administered. However, as local authority funding has been cut and the priorities for local authorities have shifted, it is felt by

project workers that this funding is not necessarily guaranteed, and therefore to continue to grow and expand, other sources of funding will need to be found. The local Clinical Commissioning Group (CCG), whilst supportive of the project’s efforts, has been unable to provide funding, and this is something that project staff wants to pursue.

Monsignor McHugh thought that faith plays an important part for

both the volunteers and part time members of staff working on the project, and those who participate in it. For the staff and volunteers, faith plays a key part in why they choose to give up their time for the project. For those who attend sessions or are visited at home by the project’s outreach workers, having a faith connection and a sense of belonging to a faith community gives them the confidence to become part of the project. Monsignor McHugh also believes that there is a spiritual aspect to wellbeing: health and wellbeing encompasses more

than the physical and certainly for those of faith, the spiritual plays an important role in overall wellbeing.

The Communitas Wellbeing Project leaders want to continue with the project’s unique approach to helping the elderly of their communities by extending the project to more churches and Muslim community organisations, and by continuing to work in close partnership together.

Dementia Friendly Gurudwaras

With an ageing population, dementia and its effects on people and the community is becoming an increasingly key health concern. Recognising that awareness of dementia is particularly low among South Asian communities, the Dementia Friendly Gurudwaras project, based in Bradford, hopes to raise awareness of dementia among the congregations of gurudwaras. The project aims to use the gurudwara as a community space to spread the message about dementia, both within Bradford and extending to other gurudwaras around the country.

The project, founded by two doctors alongside other healthcare professionals and carers of people with dementia, was initially run within the gurudwara where the

group worshipped. The group started by conducting research into the awareness of dementia within their congregation through a validated questionnaire, and found that awareness of dementia, its risk factors, management options and the impact it has on lives, was low. However, according to Bhajneek Grewal, one of the volunteers of the project, these findings provided a useful baseline of what awareness there was within the community and provided them with guidance on what their programme of activities should look like.

The project runs a number of education based approaches to inform people about dementia. Around 40 people from the gurudwara attended a Dementia Friends workshop. Based on

the Alzheimer’s Society initative, and delivered by an Alzheimer’s Society trainer, the workshops look at the facts around dementia and

how people with dementia see the world. The group wants to adapt this training into Punjabi and run it on a regular basis, allowing more members of the community to access it. The project has also used a lecture model, where dementia-related messages are delivered during Sunday services, and targets children and young people through specific classes to provide them with a lifelong awareness of dementia and its effects. It has also made physical changes to the Gurudwara to make it more accessible to those suffering from dementia, and ensured that the volunteers involved in the project are available for people to speak to on a one-to-one basis.

The intention is to make the project’s website, dementiafriendlygurudwaras.com, into a virtual information portal for gurudwaras. The site already hosts links to advice leaflets produced by the Alzheimer’s Society in both English and Punjabi - which are also printed and placed in the gurudwara - as well as podcasts and videos highlighting the importance of awareness and what can be done to raise it. The website also hosts a toolkit based upon the activities and learning done by the project, to help other gurudwaras become dementia friendly.

The project has found a formal measurement of outcomes difficult, especially as it is primarily an education programme. The project group has found it difficult to find families who are willing to talk about the impact that the project has had – such as where their increased knowledge has enabled them to get a diagnosis of dementia or to support a suffering family member – largely due to the stigma that still surrounds dementia in many Punjabi families. The project group knows that a lot of families have benefited from the programme; however, while people are willing to share stories of how things were before the project existed, they are less willing to discuss the project’s effects on their own lives.The project group found engagement with the community

difficult as dementia was not a common conversation topic and there were a lot of misconceptions around the condition. They found that developing relationships with people and encouraging them to take part in the programme really helped with this. Time was also a big challenge, as the project is mostly run by healthcare professionals who volunteer to give their spare time to the programme.

The support that the project received from the Gurudwara’s management committee was seen as being vital to the success of the initial project. The success of the project in extending to other gurudwaras will depend on their management committees’ willingness to embrace change.The project has emphasised the cultural rather than the religious aspects of the gurudwara, using the gurudwara as a space to

engage the community. Since Sikh communities within the UK are made up of different cultural communities, these cultural communities are likely to have different views on dementia, so a package of support appropriate to each community is likely to be necessary.

The project won the best Voluntary Organisation Award at the 2014

Alzheimer’s Society Dementia Friendly Awards, and has received lots of press coverage from this. It is hoped that this will spread the project’s message, so that many gurudwaras around the UK become dementia friendly.

The Funky ChoirThe Funky Choir is a community choir based in Crewe. Its mission statement is ‘Soften hearts, lift spirits, raise hope and build people’, which Brent Robinson, the choir’s founder, feels embodies what the choir is attempting to do. A Christian-based organisation, the Funky Choir have a policy of being a choir for the community, accepting members from any background and any singing ability, and has 80 members.

Brent hopes to increase people’s wellbeing through singing, having observed the effect that singing can have in improving the wellbeing of those with conditions including Parkinson’s disease, stroke and dementia, as well as the general boost that singing and being part of a community seems to bring. The choir began in 2010 and has since built up a strong

community of regular attendees and a following of organisations asking it to perform on a regular basis.

The choir comes together for rehearsals once a week. These sessions not only allow the group to practise songs for events, but give them the opportunity to meet as a community on a regular basis, to discuss their problems and issues, and provide support to

one another. The group performs at concerts and events throughout the year, ranging from a Christmas festival organised by their local council, to fundraising events held by other charities, to concerts in care homes and residential centres. The choir does not charge for its performances, which is something the organisation considers important, as it does not

want to exclude groups that could benefit from its help just because they would be unable to pay a fee. Brent describes the style of music as ‘funky’ and believes that this, along with the enthusiasm that the group gives to performing, has an important effect on the wellbeing of those they perform for, with many commenting on feeling uplifted and more joyful after having heard the choir. This is particularly important for the choir’s performances in care homes and residential centres, where Brent reported that staff of these centres commented on how the choir’s performances seemed to have an effect on the wellbeing of the residents.

The group is developing a workshop package to deliver in care homes for people with dementia and Alzheimer’s disease. With research suggesting that singing can have a positive effect for those with Alzheimer’s, as people’s ability to sing is less affected than other areas of the brain, and singing seems to have a positive effect on their wellbeing,

The Funky Choir has developed a pilot course specifically designed for these residents. It has run a trial of this project with seven patients and received positive feedback from their care workers. The choir hopes to be able to roll this programme out across many of the care homes and residential centres it already serves, as well as to develop relationships with the local authority and others in the area to help it deliver this programme to more people.

As a project based around the roles social interaction and community have in building up a person’s wellbeing, the group does not have any form of formal assessment of outcomes, but does collect testimonies and stories from its members on the impact being part of the group has had on their wellbeing. Lots of the stories focus on how attending the choir has helped the members with their mental health. One person mentions how being a part of the choir gave them an opportunity to have some respite from pressures at home and gave them something to look forward to. Another mentions they are a long-term carer for a parent and the choir gives them a chance to relax and re-energise and helps them as they go back to the home environment. There are also stories of improvements in physical health. One person recounted how being part of the group helped their recovery from cancer in their salivary gland and

particularly how it raised their spirits as they found they were able to sing again after having operations and treatment.

The main challenge identified by the group is its concern about getting its services recognised and signposted to. While it has developed a network of groups and organisations that it already works with, and is always happy to engage with others, it has already seen the benefit that singing can have and are wants to extend this to more places. It is particularly looking for new groups to take on its dementia workshops, and is keen to work with local authorities and public health officials to help them to take this programme forward.

The Christian faith that drives the founder Brent Robinson is clear and greatly influences the ethos

and atmosphere of the group. However, it is the commitment of the group to be a choir “by the community for the community” that really shines through, and to improving the wellbeing of that community.

Harmony ClinicHarmony Clinic, based in Dagenham in East London, is a church based health outreach project. The project aims to fill the gaps that exist in healthcare by being available right on people’s doorsteps. Harmony Clinic provides check-ups for over-40s, the elderly and those from Black and Minority Ethnic (BME) and asylum seeker communities in community settings: at a local supermarket and library, at community events and at community group meetings and places of worship. People from these groups are widely seen by statutory services as some of the hardest to engage with and those least likely to visit GPs or other health services.

Harmony Clinic is staffed by volunteers from one local church, Harmony Christian Ministries. The church realised that a number of its

members were involved in working within healthcare and wanted to give back to the community using these skills. The group realised that there was potential to reach those who were felt to be hardest to reach through the contacts that the church had built up.

The main activity run by the project is its health checks within community settings. The health checks monitor for cardiovascular disease and diabetes and refer patients to GP care where necessary, as well as taking a general look at the person’s wellbeing and providing advice and guidance when a person wants to stop smoking, lose weight or improve their diet and exercise. For those wanting to make changes to their weight, the project runs free exercise sessions on Saturday mornings. The project also runs pregnancy courses to

help support mums who are unsure about their pregnancy and want help and advice.

In 2014, 64 people were seen by the clinic at various events, at a local supermarket and a local library. 91% of those who had a health check felt that the health check was helpful, and a number of those seen chose to modify their lifestyle after being seen, including 46 people who wanted to increase the amount of exercise they did, 43 people who wanted to make a change to their diet, and 31 who wanted to lose weight. For the last year for which data is available, 2011-12, 156 people were seen by the clinic as part of its over-40s health check programme. The clinic found that 41% of those seen had a BMI of over 30 and 22% of those seen were at either high or medium risk of cardiovascular disease, something that these people may not have been aware of without having a health check.

The changing local healthcare landscape brought in by the Health & Social Care Act and changes to local government funding has proved to be an issue for Harmony Clinic. A good relationship had been developed between the project and the Primary Care Trust (PCT), which recognised the value of having Harmony Clinic reaching communities that it considered hard

to reach. This relationship has not carried forward with the new local CCG or the local authority, and the previous contract Harmony had to run services ended in 2014. Harmony Clinic have continued to provide a service through voluntary support but it hopes to reconnect with public health officials to show them how important it is to help people within their communities, where they are easier to access. It also hopes that this will lead to further funding, which would allow it to employ a full-time person to work with local GPs and chart what happens when people are referred to their GPs after a health check.

The project is staffed by volunteers, who work within various health and social care settings and give up their time to staff the health checks. Ronke Olulana, the director of Harmony Clinic, believes that it is the passion and commitment of the volunteers which makes the project successful and this is something that is driven by each individual’s faith. Thus faith plays a key part in the project’s success.

Harmony Clinic hopes to continue to show the difference engaging with people within their communities can have on health outcomes, especially for

those least likely to engage with the traditional healthcare system. The group hopes to continue to extend its community outreach, and is currently speaking with a local mosque about running health checks for women within the local Muslim community, a group which is in need of healthcare support. It hopes that with this evidence, it can demonstrate to the CCG and local authority the importance of its role.

Peepal CarePeepal Care is a home care service based in North-West London. The organisation provides paid-for personal care and domestic support to older people, especially those from the Gujarati community. The service is designed to give older people dignity, support their independence and help improve their wellbeing and offers either an hourly solution for those with basic needs, or live-in care for those with particularly severe needs. The organisation works with the client and their family to design a care package that suits the needs of everyone involved.

Peepal Care was set up in response to a general sense that there was a real need for elderly care in the local area. The organisation focused on the Indian community, particularly those from a Gujarati background, as there is a large elderly population within the local area who have specific language as well as care needs, and whose particular needs were not being met. The founder also noticed that there was a need for a service that catered for clients within their own homes and in close collaboration with their family and friends, making sure that everybody’s views and needs were accommodated. Starting with just one carer, the organisation has grown to employ several carers serving 50 families at any one time.

The organisation places specific focus on the needs of the client and their family. The aim is to keep the client as independent and able to live life as they wish as possible, whether that is by providing small amounts of care to complete basic tasks like shopping or dressing, or through long-term, live-in care for clients with complex needs.

Each client has an individual care plan, which is designed with direct input from them and their family. The care plan outlines how the individual needs of the client will be managed, taking into consideration not just their healthcare needs but also how to provide them with support to live life in the way that they want, to be able to go where they want and do things they like to do. Each carer is carefully matched with the client, based not only on whether the skills and experience of the carer match the care needs of the client, but also on whether they come from the same cultural and religious background, and whether they speak the same language. This can be particularly important for the South Asian client group Peepal Care operates

within, where English may not be widely spoken by the elderly members of the community. This matching process allows the carer to effectively communicate with the client, as well as allowing them to build up a relationship and better understand their needs. The client’s care plan is constantly monitored to ensure their needs continue to be met, with input from the client, their family and their carer.As a professional organisation providing care, Peepal Care is subject to Care Quality Commission (CQC) inspections and must follow CQC outcomes, which among other things look at whether the organisation respects and involves the people who use its services and at the care and welfare of these people. In the most recent CQC report the organisation was particularly praised for the way that it works with its clients and their families to support their care needs.