From Brazil to Westminster: How health pilot is proving a force for good for patients and the NHS
We are standing in front of a large block of council flats in Westminster, central London. The entrycom buzzes.
"Hi Mrs Dikir, how are you?" Jessica asks. And then "thank you" as we're let in and make our way up five flights of stairs.
Inside the flat, in the living room, Mr Jaber Dikir sits on a soft, plush armchair. It has to be comfortable because Mr Dikir spends most of his days sitting here.
"I have a heart problem, I have open heart surgery and now I have heart failure," Mr Dikir explains. "I have water in my chest and that gives me big trouble to sleep, to breathe," he adds as he begins to wheeze.
I ask Mr Jaber how Jessica has been able to help him.
"She hears you, she listens to you," he replies. "She understands everything. She even called the doctor and he gave me permission to stay at home (for my blood tests). That's really appreciated. I couldn't walk properly, I couldn't go to the clinic."
Jessica is a community health and wellbeing worker (CHWWs). That's where the nickname comes from.
CHWWs work in small teams, going door to door in some of the most deprived areas of the country.
It's part of an NHS pilot inspired by a successful programme in Brazil.
A simple but effective intervention
Jessica says her role is "to make life easier". Mr Dakir, she tells me, is struggling with his mobility. So is organising a designated disabled bay.
"Mr Dakir is struggling to get out to his appointments, and the GP needs a blood test from him. So I was able to speak to the GP and he's been labelled as temporarily housebound so the district nursing team can come in now and take the bloods for him at home."
A simple but effective intervention that has a huge impact on Mr Dakir and the NHS.
The project is currently being used in 15 neighbourhoods around the country. In Westminster, there has been a 7% drop in A&E admissions and an 11% reduction in hospital admissions year on year.
There has also been a 47% increase in the likelihood of households having vaccinations, an 82% increase in cancer screenings and a 7.3% drop in unscheduled GP consultations.
Taking community care right to the patient's door
Dr Melinda Creme is a local GP. Jessica acts as a conduit between Dr Creme and her patients.
"We need to look at the costs of what might happen downstream if disease is not picked up earlier, if health inequalities are not addressed sooner, and so there should be potential huge savings down the line.
"It might take five years, 10 years to make a difference and that's the issue, because obviously governments change within that time.
"But if there's a long-term lens on this, then we stand a chance of being able to afford a health service free at the point of delivery."
This is exactly what the government wants, what the NHS wants, to bring care into the community. With this project, they are taking community care right to the patient's door.
Dr Creme says the days when people would go to their GP and expect their family doctor to look after anybody and everybody about everything are gone.
"We can't possibly do that. We're not equipped to do that because the population is expanding and we cannot address all needs."
Labour's 10-year health plan set for launch
The government is expected to focus on personalised and community care in its 10-year health plan when it is published on Thursday.
It will look to ease pressure on buckling emergency departments and models like this have shown early signs of good results, but they require time and investment.
Projects like this can help ease the strain on services facing record pressures and tight budgets. They could be a significant part of a wider NHS plan.
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