Summary

Positive Help provides practical assistance to improve the daily lives of individuals and families in the Edinburgh area who are affected by HIV and Hepatitis C. In 2012 it launched an initiative which provided transport and domestic support - ranging from cleaning to food shopping and gardening - to people undergoing or preparing for HCV treatment.

Staffed by trained volunteers, the service aimed to overcome practical difficulties in making it to hospital appointments due to poverty, chaotic life circumstances and geographical remoteness – and, more importantly, gives users a chance to speak to someone about the issues affecting them, including the impact of treatment, and get the support they need. These visits improve service users’ living conditions and quality of life and resolve issues that could otherwise disrupt treatment.

Challenge

More than 4,800 people in the Edinburgh area live with HCV and this number is rising: many of the people affected have complex needs and are potentially vulnerable as a result of mental health issues. They also experience social deprivation, poverty and disadvantage.

At the time of launching this initiative, the team was providing similar services to people living with HIV – using trained volunteers to offer transport and domestic support such as cleaning or food shopping to people undergoing or preparing for treatment. The team was confident these would be able to make a difference to those living with HCV too.

Objectives

To enable and support service users to adhere to clinical treatment and social and therapeutic support programmes; and to work in partnership with health and social care workers to improve the overall physical and mental well-being of clients.

Solution

The initiative expanded the delivery of existing services to those living with Hepatitis C so many of the systems to deliver this project were already in place. To help with understanding how they could best help clients, a number of health and social care professionals were engaged in the design of the project. This also allowed the team to cultivate new referral pathways to put clients in touch with services. A system was put in place to identify new, HCV positive clients and measure the frequency with which they received support. Extra capacity was required, so new volunteers were recruited, trained and supported – and potential funders were approached. 

Results

More clients were referred to the team, with demand rising by almost 25% in 2014-15 compared to the previous year. Of the 25 clients questioned, all reported increased attendance at appointments as a result of the initiative: 44% went further to say they would not have engaged with treatment at all without this support. Moreover, 76% of regular service users have shown a noticeable reduction in their anxiety levels since starting to receive the service. Often this anxiety is due to fear of eviction as a result of poor upkeep of their homes - practical help with housework reduces this risk. Overall 96% of clients have reported improved wellbeing which they feel is linked to the support they have received. 

Learnings

The most valuable lesson was to involve clients in the shaping of services. Three other factors are vital: an active volunteer team, good referral links with health and social care providers and sufficient funding to meet costs. A common problem was clients not remembering that a lift or support session had been arranged for them – so by making reminder calls and sending text messages the day before a session, the number of missed appointments has been significantly reduced. Back-up sessions are also arranged, so that in the event of a last-minute cancellation, another client can benefit from this service. 

Evaluation

The success of the project was measured against the achievement of SMART indicators: data for these were gathered from a number of sources including assessment forms, volunteer observation and feedback from clients and the professionals they engage with. The number and regularity of sessions was also recorded to highlight the scale of service delivery. It was observed from discussions with clients that without Positive Help, clients would not have anyone else to turn to for support. Case studies were created for a few of these clients to give a better overview of the positive impact of this initiative on their lives.