Having attended a wonderful celebration of what health and third sector can achieve together with Leeds Community Foundations Third Sector Health Grants and having presented to the people there on our work at Basis Yorkshire I felt compelled to share a story. As I spoke at the lectern, I spotted an NHS commissioner, Anthony (not his real name) who I’d met at a round table exercise to review the projects we were running about 18 months ago. And I remembered a very simple conversation we’d had about A&E – well if I’m honest, at that point, it was a sense of frustration from me a) about the lack of acknowledgement of third sector role in health access and b) a desire to show how we actually, practically are supporting NHS delivery. And so I proceeded to share my frustration about the fact that our Basis Outreach Worker had sat with a woman, Becky (not her real name) for 13 hours in A&E. She sat with her for 13 hours, because she was frightened and might have left without the encouragement and accompaniment of the outreach worker. At 38 years old, she already had COPD, lung damage, vascular problems and poor mental health – she was also isolated and stigmatised. The last visit to a healthcare professional had led to a 19 week stay in hospital. However, the Outreach Worker knew that if Becky didn’t stay at A&E, she might die – sooner or later – she wasn’t sure exactly when. And each time a woman disengages from treatment it compounds her feelings of fear and reluctance to engage again – we often hear – ‘but I’ve let you down’. And on the other side of the fence, we have A&E staff making every effort to get her treated and then potentially seeing her leave untreated.
So, back to the conversation with Anthony. I described this scenario of our colleague staying in A&E with long periods of waiting, all the while reassuring, talking, advocating, communicating with healthcare staff and sitting with Becky, including a trip to pick up clothes as it was decided Becky was to be admitted. And what that meant for a small third sector organisation, including questioning from funders about ‘effective use of resources’ and a workers’ boundaries. What Anthony told me stuck with me. Right the way through till when I stood up 18 months later to talk about the project and saw him in the audience. He recalled being on Director on Call on that day and the hospitals in Leeds being on the highest level of alert. This meant there were regular calls throughout the day between the hospital and the CCG about the beds available; the next day’s planned admissions were already being cancelled and there were 4 beds available across Leeds – out of a potential 1200. He told me that to get anyone a bed was a tough fight, and that it was the tenacity, belligerence and sheer stubbornness that meant the Outreach Worker stayed with Becky that had secured her a bed to allow the admission. I found that such a powerful image – Becky, frightened and so unwell; the Outreach Worker trying her best to calm, reassure and get her to stay; and the staff at the hospital , trying to find a bed with such limited resource. It spoke volumes to me about the concept of ‘team’ and the partnership possible between NHS and third sector organisations and the direct connection between us as professionals. And more than that, if we hadn’t received health funding for that work, it would have been unseen, invisible and unrecorded. Sad for such an intense, powerful and impactful piece of work.
My last thought it this: this work is often the ‘glue’ that holds together people and services. It happens all across the third sector with ‘hard to reach’ people and is not normally funded and seen by formal commissioning processes. And the ability to connect that system with people who are particularly marginalised is critical to better health. While ever there’s an Anthony trying his or her best within the NHS trying to manage beds, there’s probably a 3rd sector worker, sat alongside a Becky.
Note – if you want to know the outcome, Becky stayed and is still alive. She is though, very unwell and continues to need support from Basis and ongoing treatment for her health needs.
CEO Basis Yorkshire