#HealthNow partnership demonstrates the transformative value of Peer Advocacy

From providing a lived experience perspective for the development of NICE guidelines on Integrated Healthcare for People Experiencing Homelessness, to setting up a National Peer Network, to establishing local alliances led by lived experience, #HealthNow’s contribution to national and local conversations about homeless health inequalities has been huge.

Groundswell’s Homeless Health Peer Advocacy (HHPA) model was a core element of the #HealthNow programme. Locally tailored HHPA services were established and delivered in Newcastle, Birmingham and Greater Manchester to help people to access the healthcare they need and are entitled to.

Peer advocacy to tackle barriers to healthcare

Delivered by volunteers, who have themselves experienced homelessness, HHPA helps to improve people’s confidence in using health services and increases their ability to access healthcare independently. In many cases, accompanying clients on a bus or booking a taxi was enough to help them get to an appointment. In other cases, a phone call reminding them about an upcoming appointment or a conversation about what to expect from a healthcare appointment made a huge difference.

Through HHPA, #HealthNow was great at helping people to overcome barriers to accessing health services. For anyone familiar with Groundswell’s work in London, this finding is hardly surprising, but our evaluation also showed us the significance of the holistic approach that Peer Advocates take. We saw evidence of additional health improvements and sustained changes in health-related behaviour; for instance, Advocates often helped clients adopt healthier lifestyles by supporting them to consider their diet or quit smoking.

Peer advocacy to raise awareness and change practice

HHPA brought about other positive impacts. Peer Advocates worked together, not only to tackle individual barriers to healthcare, but also to challenge systemic complex issues. #HealthNow volunteers, including Peer Advocates, were fundamental to raising awareness of health inequalities, whether by holding decision makers to account at local alliance meetings or by providing training to staff and students working in the healthcare sector.

In Birmingham, volunteers devised and coproduced a ‘Health Champions’ initiative to deliver training for local NHS staff on working with patients experiencing homelessness. As this training developed, NHS staff learned to adapt to working alongside trainers with lived experience of homelessness, doing so in an increasingly trauma-informed way. This peer-led training helped staff to question and challenge their own assumptions about homelessness. A volunteer involved in this training reflected that, “it makes them see things differently and see homeless people in a different light, not just by the stereotypical ways”.

Peer advocacy to inspire others

Clients identified being unable to trust people easily as a barrier to accessing healthcare. Peer Advocates’ ability to relate directly to clients’ experiences was instrumental in overcoming this by building trusting, positive relationships. Advocates became a source of inspiration for their clients and others in their social networks, showing them a potential route out of cycles of homelessness. #HealthNow volunteers demonstrated living evidence that change was possible, that things could be different.  

Read the full #HealthNow evaluation here.

Read the summary of the #HealthNow evaluation here.

Biography

Jo Brown is Head of Research at Groundswell, a charity who work with people with experience of homelessness, offering opportunities to contribute to society and create solutions to homelessness.