By Annie Waddington-Feather | July 11, 2023
Last Updated on July 19, 2023
Annie Waddington-Feather, Volunteer Trustee to The Shrewsbury Ark explains how the charity providing day centre services to the homeless and vulnerable in Shrewsbury, and Collaboration (Integration) Award winner at the Markel 3rd Sector Care Awards 2023, is breaking down barriers and reducing health inequalities through strategic partnerships.
The Shrewsbury Ark day centre cares for individuals who often live on the margins of society; as well as being a place where people can access life’s necessities. It is a place where trust is built, and people are supported and given opportunities to make positive changes in their lives. It doesn’t charge for services, and it is funded entirely by grants and donations.
Homelessness in Shropshire, the current snapshot
At time of writing, the Local Government Association’s report, Understanding Homelessness in Shropshire, showed that:
- A total of 258 households were owed a prevention or relief duty, of which 186 households were assessed as homeless and 69 as threatened with homelessness (during the third quarter of 2022/23).
- The age group with the highest number of main applicants within each household that were owed a prevention or relief duty was 25-34.
- The largest priority need group owed a main duty in Shropshire was households including dependent children, making up 34% of all priority needs households in 2021/22.
- A total of 16 people were sleeping rough in Shropshire in the Autumn 2022 annual rough sleeping snapshot, this is higher than the average of 15 for all English unitary authorities.
Collaborating for better outcomes
Each person who comes through our door has different needs; they have different life challenges and trauma and require different levels and types of support. On a daily basis, The Ark provides hot breakfasts for around 25 people and lunches for over 50 people. The showers, washing machines and driers are in constant use, there is access to phone charging and the internet and staff help with form filling and appointments.
In addition, through Streetlink and other partners, our outreach team actively seeks out those who may need our support and also supports people to live in their own home, teaching basic life skills such as budgeting and cooking.
Creative activities offered at The Ark are delivered by a variety of individuals and organisations who discover hidden talents, while our partnership with Shrewsbury Town FC provides us with 7-a-side pitch to use once a week. Activities such as these contribute to personal development, better physical and mental health and better self-worth.
Since relocating to a larger premises in March 2022, through strategic partnerships, we can now offer the most vulnerable in our community vital access to appropriate healthcare services in a space where they feel respected, safe and secure, while being supported by our staff. This is making a huge difference to the people who use our services.
Negative health outcomes
As well as being devastating, dangerous and isolating, people experiencing homelessness face some of the worst health outcomes. Homeless Link’s report, The Unhealthy State of Homelessness, found in its data collected between 2018-2021, that 78% of respondents reported a physical health condition, compared to 73% in the original cohort (2012-2014). For those reporting a mental health diagnosis, the change has become even more significant, increasing from 45% of respondents in 2012-14 to 82% in 2018-2021.
The homelessness charity, Crisis, states the average age of death for people experiencing homelessness is 46 for men and 42 for women. In addition, homeless people are over nine times more likely to take their own life than the general population. It’s vital therefore, that homeless and other vulnerable people are connected to support services as soon as possible.
According to Crisis, ‘the longer someone experiences rough sleeping, the more likely it is they will develop additional mental and physical health needs, substance misuse issues and have contact with the criminal justice system. The more complex needs someone has, the more help they will need to move on from homelessness’.
Barriers to accessing healthcare
A person who has had complex life challenges and experienced horrendous trauma often lacks the skills and knowledge to cope. Adding to the chaos in a person’s life is substance misuse. If you’ve been abused as a child, come out of care, prison or the forces, or even lost your job due to the pandemic, sometimes it’s easier to turn to something to take the pain away. Substance misuse causes and may exacerbate existing conditions, often brings about changes in personality and can present as extremely challenging behaviour.
Unlike a glamourous film or pop star, who immediately has support and access to resources, many people without homes are pre-judged, stigmatised and ostracised from society. For whatever reason, people experiencing homelessness or other vulnerable people are intimidated or do not feel comfortable accessing health and care services through usual routes. The result is health deteriorates and they only present to healthcare services when they are at crisis point.
The Government’s Ending Rough Sleeping For Good strategy highlights the need to join up systems to provide the most effective support to people sleeping rough, and looks to new local Integrated Care Systems (ICSs) to take account of the health and social care needs of people sleeping rough in their area.
Integrated healthcare services for homeless and vulnerable people in Shrewsbury
In familiar surroundings away from judgemental looks in waiting rooms, people coming through our doors know that any agency or service coming in to contact with them in our day centre is there to help. In collaboration with many organisations, The Ark is able to offer many healthcare services:
- Medical clinics – Providing essential GP services, the team from Riverside Medical Practice regularly runs clinics in The Ark’s dedicated medical room.
Last year, 77 people took the opportunity to visit our in-house GP. The Hepatology Clinic is run in partnership with Shrewsbury and Telford Hospital NHS Trust, and through The Hepatitis C Trust, people are regularly tested for Hepatitis.
If anyone tests positive, we support them with wrap-around care for their ongoing treatment. In the pandemic, teams from Shropshire Community Health came in to offer COVID-19 vaccinations and boosters on site and more recently, podiatrists have joined our offering of healthcare services.
- Oral health – Oral health is being improved by a partnership between the Healthy Smile team, Oral Health Improvement and Shropshire Community Dental Services.
Many people are given access to appropriate clinical dental services. Thanks to donations, we are also able to give oral health packs to those who need them. We are also looking at expanding these services in the very near future.
- Counselling and mental health services – We are a designated ‘Safe Place’ for adults who are anxious, scared or at risk while they are out and about and need support.
Individual trauma intervention sessions are delivered by various counselling providers who give support to survivors of all types of sexual abuse.
- Part of Shropshire Council’s RESET team – As part of the Rough Sleepers Drug and Alcohol Treatment Grant provided by the Office of Health Improvement and Disparities (OHID), Shropshire Council has been awarded £1.4m to provide substance misuse treatment and support services for rough sleepers and people at risk of rough sleeping.
The Council has used the funds to develop RESET, a multi-disciplinary team (MDT) providing holistic wrap-around support and drug and alcohol treatment for those who are, or at risk of sleeping rough across the county. As part of this MDT, The Shrewsbury Ark is working with Shropshire Council, With You at Shropshire Recovery Partnership, the Midlands Partnership Foundation Trust, Shropshire Domestic Abuse Service and Intuitive Thinking Skills.
Based at The Shrewsbury Ark, support includes medical and social prescribing, domestic abuse support and mental health assistance. Critically, people also learn skills to improve resilience against relapse. In addition, by having these various agencies regularly in The Ark’s day centre, people see others benefitting from the service and having a positive experience. Encouraged by staff and others’ experiences, people are less intimidated, and it can help them to approach healthcare and other services when/if they need to at a later time.
Other vital support
Most importantly, we care. The emotional and mental health support from staff and volunteers cannot be underestimated. As a charity, we employ a full-time operations manager and nine part-time support, outreach and admin staff. However, it is through our passionate and dedicated team of over 60 volunteers that we are able to operate at the level we do.
The Ark’s volunteers have been proud recipients of the Queen’s Voluntary Service Award for their work. As well as cooking, helping people navigate the complexities of housing and other support services and lending a listening ear, volunteers help with food runs, admin support and wrap-around care. They also take people to essential appointments or quietly support people with the challenges of running a home, ensuring they remain connected and engaged with the community, helping to prevent a mental health relapse.
As a Volunteer Trustee, I am honoured to be working with ten other Volunteer Trustees who ensure the charity operates professionally and efficiently and adheres to all regulations.
While the health services at The Ark do undoubtedly improve health outcomes and reduce hospital admissions, most importantly, people in crisis are being accepted and supported by volunteers and organisations working together in a place of trust.
The Ark is a refuge, a non-judgemental place of relative calm for people with chaos in their lives. For those who chose to engage in practical support, it’s a place of hope and a stepping stone to a different life. Lastly, for those who are unable to make decisions or make that step, we are here to care and support them to live each day.
Names have been changed in the following real examples of The Ark’s work.
Raymond’s story
Raymond had previously been diagnosed with testicular cancer. Due to his diagnosis, a testicle had been removed and he needed ongoing regular tests to maintain his health.
He was extremely scared of attending hospital and doctor appointments, and without persuasion and assistance would probably not have attended follow-up appointments. Following a meeting with Raymond’s probation officer and other support workers, it was agreed the best way forward was for our support worker to manage his appointments.
Our support worker often accompanied Raymond to these appointments and/or arranged taxis to ensure he arrived at the hospital. Due to her continued interventions, Raymond did not miss any appointments, vital NHS time was not wasted with ‘did-not-attend’ statuses, and he was given the care and attention he deserved.
Gordon’s story
Due to a number of traumatic experiences, Gordon had a huge mistrust of everyone. After a short period of time and much encouragement from The Ark’s staff, he had a GP appointment and was tested for Hepatitis C. The test was positive, and our support workers ensured he took his medication and completed the required prescription.
Our staff believe that had Gordon not had these services at The Ark, he probably wouldn’t have visited any healthcare services. More than likely, he would have passed the virus to others in the community and probably would have had serious liver failure. Through access to The Ark’s facilities, the virus was caught early, Gordon was treated, and the chance of further transmission was lessened.
For more information about The Shrewsbury Ark, visit its website.
Annie Waddington-Feather is a Volunteer Trustee at The Shrewsbury Ark.
Twitter: @shrewsburyark
Email: [email protected]