The London Network
For Nurses and Midwives
The Florence Nightingale Foundation / London
Network for Nurses and Midwives
Homelessness Group
Homelessness Group Project 2012-14 Evaluation
Aims
The London Network of Nurses and Midwives (LNNM) Homelessness group
received a small grant of £5,000 from the Florence Nightingale Foundation in
October 2012. The original purpose of this project was to provide a framework for a
support programme which is aimed at developing a pan London approach to clinical
development for specialist nurses/midwives working with homeless people
The project entailed two different work-streams; an action learning set for front-line
nurses working with homeless people, and a pan-London conference to disseminate
the LNNM’s activities entitled ‘Transforming London’s Homeless Nursing Services’.
The anticipated overall benefit of this project was to improve the health of homeless
people in London through:
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Reducing the isolation experienced by nurses and midwives working with
homeless populations across London.
Creating stronger networks of nurses where sharing best practice and ideas
can take place.
Providing support for nurses to develop their services and deliver improved
health care to homeless people in London.
Summary of project content
The project content included:
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Seven two-hour action learning set meetings for six members of the LNNM
homelessness group, who were recruited through e-mail invitations to the entire
group membership. Those who had been involved in the previous action learning
set were excluded. All action learning sessions were facilitated by external
facilitator Miranda Coates (Amalfi Partnership).
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Master-class at the Florence Nightingale Foundation conference in February
2014, led by members of the action learning set and chair of the LNNM group.
The content of the master-class was divided into three main sections:
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For Nurses and Midwives
1. Introduction to action learning, including the premise that the master-class would
be modelled on an action learning session.
2. Model of an action learning session, i.e. uninterrupted talk from master-class
presenters. Content to flow from the following questions:
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Questions from the floor, including:
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What did I work on?
Why did I work on it and what impact did it have on clients?
How did action learning help me accomplish this?
How did action learning help us to achieve our project objectives?
How does action learning work?
Pan-London conference organised by the LNNM Homelessness group (please
see separate evaluation report).
Evaluation of action learning set
Evaluation of the action learning set occurred at two junctures; at the end of the final
facilitated session, and from feedback received by participants of the master-class at
the FNF conference.
1. Evaluation of action learning sessions. Following the conclusion of the final
session, each participant was asked to provide evidence of change in practice
that was influenced as a result of the action learning set. The key themes that
arose from this process of evaluation are set out below:
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What did action learning give you?
Makes me stop and think
Gives me a space to talk
Gives me a space to listen and reflect
I feel less isolated
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What specific areas of best practice have you explored?
Partnership working
Assertive outreach
Lone working
Self-development
Rebuilding and rethinking our own boundaries
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How have you applied your learning at work?
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Increased my client engagement
Used my voice to stand up for myself and colleagues
Been more demanding of peer support and supervision arrangements
Been more demanding of partner agencies
Reviewed and applied consistent boundaries
Reviewed and improved my prioritisation decisions
2. Evaluation from the master-class delivered at the FNF conference. Please see
attached document for feedback received from attendees. The master-class
session was not well attended, but was well received by those who participated.
Subsequent reflection on the session focused on the choice of title for the
master-class, and the need in future for a title that would broaden its appeal to as
many delegates as possible at a national conference.
Costs
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Seven two-hour action learning set sessions at £500 per session: £3,500
LNNM Homelessness group conference (with 100 delegates): £1,500
Total: £5,000
Project partner
Action Learning set facilitation supplied by Miranda Coates from The Amalfi Partnership.
The London Network
For Nurses and Midwives
London Network of Nurses and Midwives Homelessness Group
‘Transforming London’s Homeless Nursing Services’
Friday 4th April 2014
INTRODUCTION
On Friday 4th April the LNNM Homelessness Group ran a one-day conference for 120 people
entitled ‘Transforming London’s Homeless Nursing Services’. This was made possible due to
the kind sponsorship of the London Housing Foundation (£3,500) and the Florence Nightingale
Foundation (£1,500). The event was run at St. Martin-in-the-Fields. The total costs have not
yet been summarised, but were around £7000. The deficit was made up with ticket sales.
The conference was run entirely by volunteer members of the LNNM group using free website
provision e.g. Eventbrite and Wordpress. Tickets cost £27.30. 90 tickets were made available
for sale (there were 24 speakers / workshop facilitators and 6 service users attendees), and
the event sold out.
PROGRAM
The program is attached and included the following key note speakers:
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Professor Viv Bennett – Director of Nursing at Public Health England
Caroline Alexander – Chief Nurse, NHS England – London Region
Crystal Oldman – Director, Queens Nursing Institute
Helen Mathie – Director of Policy, Homeless Link
Martin Gibbs – Deputy Director, Health inequalities Unit, DH
There was also a panel discussion involving Charles Fraser (CEO St. Mungo’s), Dr Adrian
McLachlan (Lambeth CCG Chair), Alison Danks (Adult Services Manager, NHS Westminster),
Dr Penny Louch (Lead Nurse, Health E1) and Stan Burridge (Service User Lead, Pathway).
There were 8 workshops covering Personality Disorder, End of Life Care, Human Trafficking,
Homeless Families, Mental Capacity, Hospital Discharge, Asylum and Refugee Health, and
Reconnections.
Additionally there were two functional aspects of the conference:
1. A post-lunch networking session to establish the concerns of the conference
attendees, and establish their top 5 priorities for change (the results of which are
outlined below)
2. Commencement of a google map of homeless health services (see outcomes section
below)
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NETWORKING SESSION FEEDBACK
The networking session feedback is going to be properly analysed. However this represents
a quick summary of the flip-charts, notes received in.
WHAT IS GOOD ABOUT CURRENT HOMELESS HEALTH SERVICES?
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Specialist, drop-in services are provided in most areas
Services are patient centred, flexible, and tolerant
Multidisciplinary approach (often nurse led)
Good partnerships with voluntary sector
Outreach and case-finding provided where services are able
Services are public health focused
Hospital discharge is beginning to improve
Services are populated with individuals with dedication, passion and creativity
Services want to network and share
WHAT AREAS NEED IMPROVEMENT?
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Lack of consistency in the specialist services provided
Better understanding / mapping of existing services
Ability to share information across specialist services (e.g. more integrated IT )
Barriers to access to specialist services e.g. borough boundaries, hours of opening,
disabled access etc
Homeless people are still ‘hidden’ to services e.g. those that sleep on buses
Short term commissioning of services
Not enough focus on prevention in young people
More student placements
Clear response to people with No Recourse to Public Funds
Barriers to mainstream primary care access
Insensitive media coverage
TOP 5 PRIORITIES FOR CHANGE IN LONDON:
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Pan – London centralised commissioning of homeless services
Integrated IT system across pan London services (creation of a ‘virtual
community’)
Greater understanding / mapping of existing services
Greater integration of health and social care in homeless services
Better housing provision (particularly for families – no family should be in a
B&B)
In addition the following issues came out as the top priorities for change nationally:
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Better education of health professionals around homelessness
Better, more co-ordinated response to those with no recourse to public funds
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More focus on prevention with young people
INTIAL OUTCOMES
The following represents the initial outcomes of the conference:
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Caroline Alexander to follow up with Adrian McLachlan and Alison Danks re
proposing a conversation at the Clinical Commissioning Council about pan London
Commissioning
LNNM Homelessness group to present the results of the networking session to the
London Health Commission
LNNM Homelessness Group to be linked NHS England’s Health in the Justice
System and Vulnerable Adults Strategic Clinical Network
Proposed linking the LHF Homelessness Atlas and Homeless London resources into
our google map of homeless health services
LNNM Group to work with Inclusion Health to see if the members can contribute to
evidence around the identified ‘Hidden Needs’ identified in the recent March 2014
Inclusion Health report
FEEDBACK FROM ATTENDEES
Feedback forms
We distributed feedback forms at the end. 44 feedback forms were received back.
41 (93%) responders said they would come again if the conference became an annual event
(1 didn’t answer, 1 said maybe, 1 said no due to limited funding).
Attendee comments:
‘This is the best conference I have ever attended, because it felt like there was a real
purpose to it’
‘It was brilliantly organised’ ‘I must say the organisers were amazing’
‘A great event… Do it again please!’
We received considerable positive feedback about the low ticket cost. It enabled workers
normally disenfranchised from these types of events able to attend.
Workshop feedback:
We asked attendees to grade workshops 1-5 (where 1 was 4, and 5 was excellent). The top
graded workshop on Personality Disorder received an average score of 4.8. Overall the
average score received from all workshop attendees was 4.1.
General comments:
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For Nurses and Midwives
21 (47%) of people spontaneously commented that the best part of the day
was being able to make connections with other services, and meet people they normally only
e-mail! This function of the conference was clearly extremely valuable.
The formal networking session, panel discussion, Personality Disorder and End of Life
workshops were all well evaluated.
Contributor comments
We are trying to get contributor comments in now.
Contributor comments:
Crystal Oldman - ‘It was a real privilege to be at your event and meet so many committed
people’
Caroline Alexander - ‘I found the panel discussion really helpful’
Helen Mathie – ‘It was very good event’
Suggestions for improvement from both attendees and contributors (which we asked for)
have included:
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More time for service users
More time for the panel
Delegate list to be distributed
A Politician to be involved
Involvement from Social Care and Addictions
More time
Multi-disciplinary focus
SUMMARY
This was a valuable event with some very tangible outcomes. A formal report will follow.
We are indebted to the London Housing Foundation and Florence Nightingale Foundation
for their kind sponsorship, but hope they will consider the money very well spent!
The London Network
For Nurses and Midwives