Who: Lambeth Portuguese Wellbeing Partnership
Start date: December 2017
End date: Dec 2019
Funding awarded: £335,000
Supported through: Multiple long-term conditions programme
Find out more: @LPWPartnership
Our Neighbourhood Schemes focus on driving change within a small geography, testing whole-system solutions to health challenges facing the local communities.
One in six Lambeth residents is a Portuguese speaker (around 35,000). They have a higher than average prevalence of long-term conditions and are 20% more likely to have three or more long-term conditions than the general Lambeth population.
The scheme aims to improve the health of Portuguese speakers, particularly those who live with multiple long-term conditions by helping reduce inequalities in access to health and other services.
As part of our work testing whole-systems solutions to improving a complex health issue in a defined geography, the North Lambeth Neighbourhood Scheme aims to improve the health and wellbeing of Portuguese-speaking people living with multiple long-term conditions in Stockwell, south Kennington and north Brixton.
Using new ways of generating and organising support from within the community, the scheme aims to help reduce inequalities in access to health and other services, and to provide more holistic support for families.
Established a ‘learning partnership’ with the Lambeth Portuguese Wellbeing Partnership to understand the community better and how best to engage with them.
The North Lambeth Portuguese Neighbourhood Scheme starts working with a first focus on defining its identity and leadership.
Development begins on the 'Household model of care' approach, using a user-centred design approach to engage families and design solutions. Work also starts to review holistic assessments by GPs and voluntary organisations.
Beginning of 2019
A theory of change guides the work of the Partnership and the 'Household model' is used to pilot new ways of working and solutions with local families.
The initial two-year support for the neighbourhood scheme ends, and lessons from the work are shared.
The scheme is led by the Lambeth Portuguese Wellbeing Partnership (LPWP), an emerging grassroots network of local groups and community members built around a shared goal of supporting the health and wellbeing of local Portuguese-speaking residents. Working with the LPWP over an initial two-year period, they aim to identify people at risk of developing multiple long-term conditions, in particular those who are ‘hard to reach’, to intervene early by addressing unhealthy lifestyles and behavioural issues, and by connecting with local GPs and voluntary organisations to help deliver person-centred care, specifically working with whole families affected by long-term conditions.
The neighbourhood scheme builds on the work the LPWP has been doing since 2015 in north Lambeth. It follows on from the learning partnership we started in 2017 to understand how best to engage communities, build relationships and explore the risk factors contributing to the disproportionate prevalence of multiple long-term conditions in the community.
The scheme is helping to develop a plan that is truly led from the community, while being aligned with the ambitions of the local healthcare providers. Health and wellbeing networks like this are at the heart of Lambeth Together, a borough-wide strategy to improve health and reduce health inequalities.
It takes time to build a deep understanding of communities. The ambition is to form a functional, well-networked partnership to help:
In Lambeth, around one in six residents is a Portuguese speaker. Many concentrate in and around the area known as ‘Little Portugal’, in Stockwell, but increasingly also throughout the borough. In the 1970s there was a wave of immigration and many arrived from south Portugal and Madeira to settle in the borough. Most had low levels of literacy and held low skill jobs.
The local Portuguese-speaking community is one of the largest users of A&E services and often present late for treatment with complications. They are also more likely to have multiple long-term conditions.
The local Portuguese-speaking community is one of the largest users of A&E services and often present late for treatment with complications. Control of blood pressure and diabetes is often very low, and the group has the highest risk of cardiovascular disease compared to any other local white ethnic group. They are also 20% more likely to have three or more long-term conditions than the general Lambeth population.
With its high concentration of Portuguese speakers, the areas of Stockwell, Kennington and Brixton, in north Lambeth, provide a significant opportunity to improve the group’s generally poor health outcomes. Through our neighbourhood scheme approach, we are testing whole-system solutions in a specific geography and with a discrete community, working with a network of partners to deliver a mix of interventions. By working in close partnership, we also want to learn from this work and share with others working with the same or similar communities elsewhere.
The Lambeth Portuguese Wellbeing Partnership is a growing and inclusive network of over 40 organisations and individuals working and living in the borough. They combine their knowledge, passion, resources and skills to improve the health and wellbeing of the Portuguese speaking community in Lambeth.
They do this by bringing together local people, community organisations and health and care staff to listen to each other and work in partnership on projects aimed at enabling people to live the healthiest lives possible.
The scheme is enabling the LPWP to develop as a sustainable network to drive health and wellbeing improvements for the local Portuguese-speaking community, with a specific focus on people with multiple long-term conditions. The ambition is for a strong and well-connected network of partners delivering a combination of coordinated interventions resulting in:
Since December 2017, the LPWP has been bringing together medical professionals and community experts to do joint holistic needs assessments with Portuguese-speaking Lambeth residents. These assessments are helping to understand what support, medical and beyond, people need to improve their wellbeing.
Local resident Luiz, originally from Brazil, took part in the pilot. Luiz lives with a heart condition, Type 2 diabetes and anemia. He lives on his own and he doesn’t speak much English. During the joint assessment, Luiz explained he felt stressed by debt and having to rely on family for help. He felt very isolated and talked about how his only social interactions were seeing his family infrequently, going to medical appointments and talking with his landlord in very basic English when he comes to collect the rent once a month. Luiz explained he spent his days between the TV and the computer. He also felt that he had not been eating enough because he doesn’t like eating alone. He believed all these things have affected his health.
The community liaison officer, Gustavo, was able to speak with Luiz in his native language, build up a relationship and help work through some of these issues. Gustavo helped Luiz review his finances and gain access to £400 a month additional benefits that Luiz was entitled to, but was not previously claiming. Gustavo has also helped Luiz to contact his landlord to request an entrance ramp for his home, rearrange medical appointments and respond to letters. He has also invited him to attend Stockwell Partnership’s ‘Hug’ group of older Portuguese people, a group that meets regularly for social activities.
Luiz has been delighted with this help and support and when asked about his experience he said: "I am very happy with the service and would recommend it to everyone I could".
The pilot is a collaboration between the Stockwell Partnership, a neighbourhood-based community development charity, and the Grantham Practice, a GP practice in Stockwell. This brought a combination of community, language and medical expertise together to provide Luiz with holistic and tailored support.
The initial learning partnership we supported, between August 2017 and January 2018, started to cement the LPWP’s identity and ability to deliver a programme of work. The network highlights the period as a valuable experience in having:
Portfolio Manager: Michael Parsons
28 July, 2018
We've looked at data and talked with local people to learn more about how and why people progress to multiple conditions.
27 July, 2018
A collective approach to tackling multiple long-term conditions to create a strong neighbourhood.
26 June, 2017
Bringing together communities and the healthcare system to reduce inequalities.