As part of our Innovation for Healthcare Inequalities Programme (InHIP), Health Innovation North East and North Cumbria (HI NENC) conducted a series of Healthy Heart Check sessions were for Black-African, South Asian and the indigenous underserved communities in Middlesbrough.
Working closely with Shazia Noor, Director of Nur Fitness, Programme Managers Tracy Marshall and Emily Whales were instrumental in screening 149 women, which resulted in 27 women referred to their GP for further review (18% referral rate).
Tracy and Emily have reflected on the value of providing healthy heart checks in community settings rather than patients to attend clinical settings.
How did you get involved with the Healthy Heart Checks with Nur Fitness?
Tracy: The reason we got involved with the Healthy Heart Checks at Nur Fitness was that they were already involved in the Innovation for Healthcare Inequalities Programme (InHIP) and needed women-only testers. Personally, it ended up being so much more than just a healthy heart check, and I think a lot of that was because of how welcome we were made by Nur Fitness. The women made us feel really welcome and they looked after us, and the fact that we could refer on to GPs, they were so invested in the whole process.
Emily: Tracy and I have worked together for years and already have a good relationship, and because Nur Fitness are so proactive, Shazia Noor in particular, they were really invested in it as well, which really helped us. Their staff got involved and did the heights and weights of the people that attended, they did all the appointments, and they did loads of social media.
I’ve just been on a health literacy community practice, and thoughts are changing about communities being referred to as hard-to-reach populations because they’re absolutely not; services do not take into account the challenges and barriers these communities face and therefore make them less accessible. They weren’t hard to reach at all when we went.
Tracy: It’s thinking about the potential barriers that they have in accessing healthcare. The women let us ask questions about their culture and they were really forthcoming in sharing information. For example, if they couldn’t get an appointment with a female GP, they’d wait, which then put a delay on them receiving treatment. And if there still wasn’t a female GP or healthcare professional available, then potentially they would have to take their husband, or somebody else with them, which again would delay treatment. It’s those different nuances that they need, which we were able to take into their community, and we had an overwhelming response. We were never not busy at any of those sessions.
What access did the Healthy Heart Checks provide for women?
Tracy: We had a bespoke session for Arabic ladies one afternoon and not many of them spoke English, so there was a dedicated interpreter that came with those ladies. And a couple of sessions in, Shazia asked us to do an evening session, and when we gave her the go-ahead, literally the appointments filled up in about half an hour!
We were invited to represent HI NENC at their Iftari event, and it was noted at the event that nothing was too much trouble with what we had provided at the Healthy Heart Checks, and that we always obliged and tried to fit people in where we could, staying over our time to make sure that the ladies were all seen. There was so much of a need for the checks.
Emily: The other learning point was that it wasn’t just the undertaking of the PocDoc cholesterol test; the ladies would come and speak to us about all sorts of health problems. We had some healthcare knowledge that we were able to impart to them, but the ladies just found the space very comfortable to ask any questions that they wanted to ask about healthcare. If we didn’t know the answer, we would give them information and advice to signpost on. It was that open forum, and possibly mine and Tracy’s approach, not being flummoxed by any questions, and we were happy to have that conversation about anything.
What impact did the Healthy Heart Checks have?
Tracy: They were there for their height and weight, blood pressure and cholesterol test, all those things that impact on your cardiovascular health, but that was just the catalyst. For example, there were menopausal women, and your cholesterol can go up when you’re in the menopause, so then they asked us other questions about menopause. I think it was that comfortable open space. Some women don’t have that, and I don’t think that’s just a cultural thing either.
Emily: You want to make a positive impression, and then they can impart that message into their family, even the healthy eating, diet and exercise information that we talked to them about. They might impart that information to their children and their husbands. It’s not just them that’s going to benefit them, it’s potentially the whole family.
What are the learning points you have taken from the sessions with Nur Fitness?
Emily: It was interesting for me being immersed in another culture, rather than them coming into the NHS culture; we went to them. We learned a huge amount! I was a bit scared, to be honest; I was frightened that I was going to make cultural errors, and I think that was the learning point, you just ask. The women were absolutely fine about answering any questions.
Also, some places have health buses, which are great but I think the next step forward with these sessions is that we were literally lifted and shifted into their environment, which they already knew. I think even if we’d had a bus parked outside, you could easily walk past, but if it’s a comfortable environment that you know and you’re going to see a friendly face, I think that can make the difference in getting checked.
Tracy: I really looked forward to those sessions, and one of my takeaways is that I felt quite empowered by empowering them. I know that probably sounds really cheesy, but it was women supporting women, and I just felt that that was a really powerful situation to be in.
Funding Upscales Healthy Heart Checks for Underserved Communities
HI NENC has successfully secured funding to provide further Healthy Heart Checks for underserved communities.
The funding, provided through the North East and North Cumbria Integrated Care Board’s Healthier & Fairer Programme, will enable the delivery of Healthy Heart Checks across the region for the next two years.
This upscales a series of Healthy Heart Checks provided under HI NENC’s Innovation for Healthcare Inequalities Programme in Middlesbrough.
The newly-funded programme will be headed up by Tracy Marshall.