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Success for pioneering nurse outreach scheme on Gypsy health

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A ground-breaking project that has seen a community outreach nurse work closely with Gypsy and Traveller people in Leeds is to be extended, after an evaluation found it had boosted health and wellbeing among this marginalised group.

Under the pioneering partnership scheme, Queen’s nurse Liz Keat has successfully forged trusting relationships and supported people to access mainstream health and care services.

“My role is about looking at the whole person, assessing their needs and not just looking at ‘one bit’ of their story”

Liz Keats

Her role, which is hosted by Leeds Community Healthcare NHS Trust, was specially created as part of the joint project between the trust, Leeds Clinical Commissioning Group and Leeds GATE (Gypsy and Traveller advocacy group), an organisation that works to improve the quality of life for Gypsy and Traveller people in West Yorkshire.

It was devised in response to concern about the welfare of Gypsies and Travellers in the city, who were found to have an average life expectancy of about 50 years of age, compared with 78 in the settled population.

They also experienced poorer health outcomes, including higher rates of infant mortality, long-term conditions and suicide among young men.

The scheme has seen Ms Keat work with residents at Cottingley Springs, a permanent local authority Gypsy and Traveller site, as well as roadside Travellers and housed Gypsies and Travellers, offering holistic health checks and advice.

The post was devised in conjunction with Gypsy and Traveller people, who also took part in the recruitment process.

“The role involves discussing many issues and providing broad-based support”

Research report

An interim evaluation by Leeds Beckett University, published earlier this year, found evidence the role had boosted the health of community members and acted as a “pathway” to a range of other support services.

Initially set up to run for one year only, the project has now been extended for another 12 months, with additional funding from Leeds CCG.

Issues that can get in the way of Gypsies and Travellers accessing health provision include lack of access to transport, literacy levels, difficulties getting GP appointments, social factors and mistrust of healthcare professionals and statutory services.

The Leeds Beckett University research, which was commissioned by the CCG, highlighted the importance of the outreach aspect of the new nurse role.

“The role involves discussing many issues and providing broad-based support,” said a report on the initiative.

“The importance of the outreach aspect of the nurse post needs noting, as other healthcare delivery models do not allow such freedom and flexibility, or holistic focus,” it stated.

Leeds Community Healthcare NHS Trust

Liz Keats

Liz Keat at a QNI function

Ms Keat, who was awarded the title of Queen’s nurse in May this year, said her aim was to build relationships and trust “in order to open doors to wider health support”.

“The community relies on the spoken word for information – which can be difficult in a health system that relies on written messages, letters and reports,” she said.

“It’s not unusual to see somebody who has missed many health appointments, or been discharged due to non-attendance,” she said. “This is often due to not being able to read the appointment letter, or understand how the health system works.”

When it came to dealing with long-term conditions, she said it was important that people received appropriate guidance.

“If patient information is only offered in written form, it’s highly unlikely the condition will be managed well,” said Ms Keats.

“Ultimately, this affects a person’s self-esteem and can cause frustration and apathy,” she said. “My role is about looking at the whole person, assessing their needs as fully as possible and not just looking at ‘one bit’ of their story.”

Helen Jones, chief executive of Leeds GATE, said discrimination and exclusion were among factors that contributed to poorer health outcomes for Gypsies and Travellers.

“The role of the community outreach nurse is to deal with complex issues with humanity and dignity – Liz is brilliant at making sure we have an open, honest and effective partnership that puts our members’ needs and wishes at its heart,” she said.

“We have learnt a great deal already that will support our future approach to planning”

Sue Wilkinson

Leeds GATE was recently awarded a Glaxo Smith Kline Impact Award, run in conjunction with leading health think-tank the King’s Fund, for its work to improve the health and wellbeing of the local Gypsy and Traveller population.

Earlier this year the partnership project provided evidence to MPs on the Commons women and equalities committee, which is looking into the health inequalities faced by Gypsy, Roma and Traveller communities.

Sue Wilkinson, commissioning manager for Leeds CCG, said partners were “delighted” it had been recognised as an example of good practice.

“We are hoping that we can build a legacy that means that members of the Gypsy and Traveller community have improved access to healthcare services as well as understand how they can self-care, where appropriate to do so,” she said.

“We have learnt a great deal already that will support our future approach to planning and funding services for those who belong to some of our most marginalised communities,” she added.

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