Dr Vikesh Sharma, GP, The Lambeth Portuguese Wellbeing Partnership
Nov 21, 2017
I’ve been interested in global health for a long time now. I like to understand what drives health-seeking behaviour and how it changes between cultures.
I deliberately chose to become a GP in Stockwell because I knew there was great diversity here. Shortly after I joined The Grantham Practice, speaking to colleagues about global health issues and barriers locally, they told me frustration at not being able to engage with some of our population groups. The Portuguese speaking community stood out in particular.
In Lambeth, around one in six residents is a Portuguese speaker. Specifically in North Lambeth, there was a big wave of migration in the 1970 and 80s, and many arrived from south Portugal and Madeira with low levels of literacy and ended up in low skill jobs.
Deprivation is a widespread issue, but it’s not the only one. Control for blood pressure and diabetes markers is often very poor among Portuguese people, and they have the highest risk of cardiovascular disease compared to any other ‘white’ ethnic group locally.
Perceptions of care can be different too. Many don’t trust NHS care, preferring to go privately or travel back to Portugal for their care.
However, data also shows that the Portuguese are among the best at attending annual health check-ups. They are interested in their health, and if you make it accessible to them in ways they feel comfortable engaging, they will.
I became immediately interested in the Portuguese speaking community when I started working in Lambeth, but I knew that, to help, I needed to be valid in the community’s eyes. I had to be visible and communicate in ways that were relevant to them.
I started by running sessions at the Portuguese speaking community centre in Kennington and involving a GP from Lisbon, Dr Cristiano Figueiredo, to engage with the community and get insights about their health habits.
Eventually a group of multi-disciplinary professionals from, and with an interest in, the Portuguese speaking community started to form. This included GPs but also charity workers and people from the Council. What would eventually become the Lambeth Portuguese Wellbeing Partnership started with a strong ambition to take joint action and build on the data and experience we all had with this community.
Working with Guy’s and St Thomas’ Charity over the past few months has allowed us the space, time, resource and capacity to develop ideas. Our partnership is also helping to define why it’s important to look at this community in the context of multiple long-term conditions, and how do we best engage with them, as part of the development of the Charity’s programme.
The support has also prompted us to think harder about the activities we run, and how they link to outcomes. How does a breakfast session help us improve the health of this community and prevent the onset of chronic conditions?
Finally, it’s helped us to test that we weren’t over-reliant on our group (who has many Portuguese people in it) to guide our efforts. Our successful community event to celebrate St Martin’s Day, an important date in the Portuguese calendar, was a really useful way to check that we were still connecting with our community, and that our vision to build a holistic approach still resonates. We had over 360 people attending, 70 volunteers, 27 statutory and other partners and 19 businesses. People celebrated with others and got health advice whilst enjoying the traditional food and dancing.
The work with the Charity has also catalysed the Wellbeing Partnership group and helped to shape our identity further. It’s also sent a message to the linked organisations - they could see the work and it has given them confidence in us to achieve our mission.
We’ve also reflected on what we’re doing that is different – and how we capture it. We’re coming together as professionals from very different disciplines (from health to housing) and starting to see the issues holistically, looking at entire family units and wider issues, not just an individual and their health.
We think that this ‘household’ approach is quite unique. Still, it links strongly to the values that general practice training has always upheld, and why I decided to become a GP: to be a member of the community and to treat the person as a whole.