A journey through our yearAnnual review 2010/2011

our health, our community

Great strides to positive outcomes Join us on a virtual health walk through our year to see some of the places where we work and to meet people who benefit from the services we deliver. Step by step we will chart our progress and show you the real impact that each of our services has had during 2010/2011.

We have come a long way from our beginnings in 2006. Today we operate successfully across Birmingham and a growing area of the West Midlands. Health Exchange is a not-for-profit social enterprise, solely focused on a social mission to promote health and wellbeing and to address health inequalities. Like all limited companies, we compete in our marketplace for business; however any trading surplus is invested back into enhancing our services. Our credibility is built upon our ability to deliver strong results and meet challenging targets.

We work closely with local communities to make a difference to people’s lives. Together, with our partners, we promote healthy living by empowering people to make positive choices that lead to positive outcomes.

During the past five years, we have helped thousands of people to gain the confidence and capability to improve their quality of life – and more than ever this year. Learning gained from this is now enabling us to develop innovative new services which place focus on addressing the real health needs of our clients and their communities. We have pioneered new ways of working with our community partners; promoted inter-trading between third- sector organisations and championed social enterprise as a proven business model, highly relevant in today’s new economic climate. Our business carries the Social Enterprise Mark – awarded by the Social Enterprise Coalition and an endorsement of our commitment to strengthening this sector.

Quality standards and innovation are the cornerstones of our business ethos, and we continue to make ground with these. In 2010 we achieved accreditation to the national Matrix Standard for Information, providing external confirmation of our excellence in information management. We were also the first non-NHS provider in England to be accredited to the QISMET standard for self-management programmes.

Our holistic view of each individual client guides them through our services on a journey to improved health – and, most importantly, it is they who make the choices that change their lifestyle.

The link between physical and mental health reflects an essential element of our service. Early intervention in cases of mild depression and low level anxiety has proven to be extremely valuable during the year for some of our clients. We also gained membership of the Birmingham Mental Health Consortium and continue to strengthen our partnerships in this area.

Our social mission also enables us to help people into work too. In many cases we recruit staff with a deep understanding of local culture and local issues – people trusted by their communities – and, often, this is their first step on the employment ladder. In addition, last year we helped 24 people gain work experience through six-month work placements under the Future Jobs Fund initiative. Four of these now have jobs with us and we hope to help others through the government’s new apprenticeship and work programmes.

We are also developing a greater understanding of our clients’ needs by establishing a knowledge-sharing culture supported by new data and communication technology. This now enables us to track client relationships and measure our impact and its success more effectively – continually adding value to the work we do every day in our communities.

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A year of energy and focus

CEO Graham Beaumont’s review

This year has seen sustained energy and focus at Health Exchange – despite the global economic challenges facing us today. In line with our business plan, we have extended our geographical boundaries and worked with more clients across a more diverse landscape. Turnover has grown

and we were able to declare a small surplus after tax, which has been reinvested in our

services. In all respects, Health Exchange is in a stronger position at our year end, which is

great news for our clients too.

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Our brand is now strongly associated with delivering additional value both to our clients and commissioners. In all that we do, we seek to deliver the best health and wellbeing outcomes for the individual, their family and the community.

Two areas of notable success have been in our Support Plus and Quality of Life for Older People services. Some commentators have referred to these services as ‘life coaching for disadvantaged communities’. These cost-effective services have had a very positive impact on individual people’s health and GPs now recognise them as ‘highly valuable”. We far exceeded the targets set by commissioners and delivered significant improvements. Our success in all areas is linked to selecting the right people to work for us – people like Hama Doulay whom you will meet on page 19. He believes that everybody deserves the best and is personally committed to delivering excellence to all his clients.

Our success is also linked to our belief in enhancing traditional commissioned services with additional skills, knowledge and resources – because this then enriches the service to our clients.

Increasing uncertainty about the future shape of health and wellbeing services could have been unsettling but Health Exchange has remained focused on delivering excellence while the changes in NHS commissioning have continued to be debated and evaluated around us.

In 2010 Health Exchange set itself a challenge of broadening services across the West Midlands. We recognise that our strength is in delivering excellence in partnership with other world-class providers. During the year we took our services into the Black Country, Telford and Wrekin, and Coventry, as well as strengthening our presence in Birmingham. We are also extending our reach into Shropshire, Staffordshire and Herefordshire.

Health Exchange will continue to grow through a strong focus on excellence and partnership, borne out by compelling evidence of the impact that our services make – just some of which is featured in this annual review.

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One of these health walks starts from the Afro-Caribbean Millennium Centre (ACMC) in Winson Green where New Style Radio is based. ACMC has been one of our community partners from our early days, providing access to all our services, for members of the community which it serves. ACMC’s mission is to support the city’s African-Caribbean community by tackling social exclusion. The one-stop centre helps people with social welfare matters and also offers business support including radio and multi-media training.

New Style Radio – the first black community radio station to start broadcasting in the UK – invited us to pioneer health promotion live on air. This has since opened the door to health promotion slots with other community radio stations across the city.

DJ Dave Prince hosts a weekly live health promotion discussion on his show with Health Exchange staff and then joins our weekly health walk from ACMC. Around a dozen people take part in the walk each week – enjoying each other’s company and learning about and enjoying their local environment. Jonathan Baker is the new volunteer walk leader and, at 74, is a strong role model in his local community. He says he feels ‘great’ and walks at least 20 minutes every day, as well as taking exercise at the gym in Handsworth Park three to four times every week.

“I like to make good use of my time – not just sitting and relaxing,” said Jonathan, who tries to provide inspiration to the people he meets. “Young kids at the gym say there is no way they could be so fit when they get to my age but they respect me and I try to get them to share my attitude.”

This year more and more people have joined our health walks, which average two kilometres and take between 30 minutes and an hour – at the last count there were 781 regular walkers taking part in our activities programme. Each of our walks is led by a trained Walk Leader from locations across the city, including GP surgeries, community sites and parks.

In January this year the programme was accredited by Natural England’s ‘Walking For Health’ scheme, which encourages people to become physically active in their local communities. Walking for Health (WfH) was established in 2000 and contributes to improving the health of 75,000 regular walkers nationwide.

Catherine Fletcher, Macmillan and Physical Activities Programme Lead, said: “I have seen walkers from a variety of communities and cultures improve their fitness, their confidence and their general wellbeing. The social aspect of a walking group is very important and friendships develop easily.”

All of the walk leaders on Health Exchange walks are trained by Walking for Health qualified trainers to understand all aspects of health walks, route mapping and risk assessment. Health Exchange then continues to offer support as walks are set up, developed and sustained. All walks and routes used are fully risk assessed and the

walks are insured through the accreditation with Walking for Health.

In March, Health Exchange issued a pedometer challenge for delegates to the Voice 11 Social Enterprise conference

at the O2 arena. Delegates were handed a pedometer and asked to text or tweet to us the number of paces they walked during the day, with an aim to get delegates to collectively walk the distance to New York and back. Based on the feedback received, the conference managed to cover a distance of 6,900 miles, New York and back with 190 miles to spare!

Walking to a healthy life-styleEvery week hundreds of people are walking their way to a more healthy way of life – thanks to 39 Health Exchange health walks across Birmingham, which are free to take part in and first started in 2009.

ACMC health walkers in Summerfield Park.

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• Currently we have 30 active volunteer walkers

• This year our healthy walkers walked 13,800 miles

– equivalent to walking around Birmingham’s

Outer Circle Route 512 times in 11 months

• 781 regular walkers

• 39 regular walks

Sue is a Family Support worker at Lillian

de Lissa and Belgravia Children’s Centre

in Birmingham who has been leading

a ‘Step & Stride’ walk every Tuesday

morning since she was trained by Health

Exchange as a walk leader. When the

walk first started they followed the same

route but it became apparent that people

didn’t really know their neighbourhood.

“So I decided we would use the children’s

centre catchment area to produce

different routes. People gained a better

sense of their environment, community

and its history so that they could then

venture out with their own families.

Parents brought their toddlers and babies

along – setting a great example of healthy

exercise.”

Volunteer walk leader Jonathan proves that he can still sprint through Summerfield Park at the age of 74 – after some positive

encouragement by weekly walkers from ACMC. 7

Health Exchange staff explain their services on the Dave Prince show.

I want to thank Health Exchange – it’s fantastic to be able to share health information and it was a golden opportunity for me personally to take up the walk challenge. I’ve also started mountain biking 12.5 miles three times a week – something I have never done before! Jonathan is an inspiration to everyone – to people of all ages – and it’s great to see our listeners taking up the challenge too.Dave Prince DJ, New Style Radio 98.7 FM

“

At the heart of our communityBalsall Heath Health Centre is among more than 100 surgeries where our Health

Trainers have been working closely with GPs this year – helping their patients make positive lifestyle choices. With their support, patients have been

setting their own personal health goals such as stopping smoking, losing weight, being more physically active or drinking less alcohol and are

able to monitor their progress and achievements.

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• In one survey 82% of people said they

had decided to make a change to their

lifestyle after working with our Health

Trainers: Of these, 95% said they now

ate more healthily, and 86% said they

are more active

• Over 60% of people surveyed rated

their own health as ‘better’ or ‘much

better’ after taking part in our Health

Trainer programme

• We exceeded all our Health Trainer

targets this year, and next year our

Health Trainers will work with nearly

3,500 clients

• Our Health Trainers were the first

in the region to complete maternal

health obesity training

The health kiosks have had a fantastic reception – the ability to view and print off advice while waiting for a prescription is key to empowering patients to learn about their health and making online information accessible to everyone.Harnek Chera, senior pharmacist at Balsall Health Pharmacy

“

Qudsia Bibi, one of our Health Trainers, spends half her working week at the health centre – supporting three GP practices. She regularly attends practice meetings and GPs refer patients to her who they have advised to adopt a healthier lifestyle. These patients are offered up to six appointments each and she meets with up to 10 of them every day. GPs find the service so effective that they have asked Qudsia to update their patient’s records directly, allowing them to monitor patients’ progress more easily. Increasing numbers of GPs are working with our Health Trainers in this way.

“Since Qudsia started it’s not only me that’s pleased, my patients are also happy with the service she provides. They have been successful in achieving their goals towards better health and losing weight,” said Dr A K Sinha, whose practice is based at the centre.

We have also strengthened our partnership with Balsall Heath Pharmacy where one of our health information screens is installed, providing free access to information on a wide range of health topics and services such as our online diabetes support centre.

Survey results show that our work

with Heart of Birmingham PCT (HoB)

and Birmingham East and North

PCT (BEN) is making a measurable

difference in our communities.

Maureen Webb, a Health

Improvement Practitioner from

Birmingham Public Health, recently

assessed HoB and BEN Health

Trainers for a Birmingham-wide

project involving pregnant women

with a high BMI (Body Mass Index).

“I was delighted to report to Health

Exchange that the pass rates and

standards were both very high and I

was very impressed with the Health

Trainers’ performance,” she said.

The Health Trainer team gained

excellent feedback from those

attending a regional conference

this summer where they were able

to present their success stories

and achievements. Delegates

commented on the high quality of

our presentations and some said

they planned to adapt our ideas to

develop their own services.

One of the case studies we shared

involved an Asian woman in her

thirties who referred herself to

the Health Trainer service at Soho

Road Medical Centre. She had

believed that the only way to lose

weight was to “almost starve”

herself. However, over nine weeks,

she lost five kilogrammes through

a combined programme that

included walking 40 minutes a day,

four days a week and sitting down

with her family at meal times. She

said she couldn’t believe that she

had lost weight without dieting.

Our Health Trainer team is now involved in three new initiatives aimed at helping people to lose weight, working alongside PCT staff and pharmacists. Since Birmingham has been identified as the “fattest city in Europe” this work is time-critical.

Meanwhile we continue to build the team’s skills so that our service remains unique and delivers enhanced support and value to the wider community. Qudsia, introduced above, is one of four Health Trainers selected to become the first Maternal Health Trainers for Heart of Birmingham PCT and she’s already working with her first client.

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Qudsia Bibi and Doctor A K Sinha at Balsall Heath Health Centre

Walk-in centre is a first Erdington Health and Wellbeing Centre is where we opened our first Health Information Shop in July 2010 – in partnership with Birmingham East and North Primary Care Trust (BEN PCT). The aim of the joint initiative was to increase access to GPs – especially for young people from BME backgrounds.

Health Exchange’s challenge was to signpost 150 young people to a service each month and, 12 months on, we have exceeded this target with the help of our partners. Partner organisations deliver a range of services at the centre – including Connexions, Aquarius, Citizens Advice Bureau, Birmingham Industrial Therapy Association and BEN PCT Stop Smoking Service – alongside our own Health Trainer service.

The centre on Erdington High Street also hosts a walk-in GP service 365 days a year and the New Attitudes Contraception and Sexual Health Service. Young people can access free contraceptive and other sexual health services on a walk-in basis. Shoppers can drop in for face-to-face information and advice or sign up to Health Exchange services as well as a range of free services provided by our partners. A health information kiosk also enables everyone to have access to a wide range of health information simply by touching the screen.

Through our out-reach work at the shop, this year we have formed a vital partnership with Birmingham Metropolitan College’s Sutton Coldfield Campus. As a result of this, a mini Health Information Shop has been set up in the student area of the college. Health Exchange staff attend each week during term time to take blood pressure, measure body mass index, provide health information and signpost to other organisations. We are now training students as wellbeing champions.

The centre has also attracted attention from local and national politicians, including the Lord Mayor of Birmingham Len Gregory and Erdington MP Jack Dromey at the official opening. In September 2010, Anne Milton MP, Parliamentary Under Secretary of State for Public Health, visited the centre and said she was very impressed with the facilities.

We regularly promote the Health Information Shop in a monthly health promotion slot on Switch Radio – the community radio station for north and east Birmingham.. We even recruited one of their DJs to join a Health Trainer programme while we were on air!

Birmingham resident Denise Walker

took part in a ‘pedometer challenge’

in January when our staff took to

Erdington High Street with the mobile

unit, promoting physical activity and

offering shoppers the chance to take

part in WiiFit dancing. Each visitor

to the unit was given a pedometer to

record the number of steps they took

during the day and Denise was the

winner of a draw for all those who

texted their total steps to us. Her

prize was a Nintendo Wii Fit of her

own to help her keep active. She and

her partner now use their pedometers

every day and she says she has

noticed an improvement in her health.

“I even get off the bus a stop early so

I can walk a bit more,” said Denise.10

• 49% of students who visited the shop

were from BME communities

• Of 90 people who had undertaken a

service from the shop and were surveyed

by telephone, two-thirds said they had

improved their lifestyle

• 57% of people surveyed by phone said

they had stopped smoking, 48% were

eating more healthily and 47% were

more active

• Nearly 4,000 people have engaged with

Health Exchange through the shop and

have made positive lifestyle choices

Why not join our free health walk from our Health Information Shop in Erdington High Street every Thursday at 1pm? 11

The cancer support service has

continued to engage effectively

at all our community sites,

helping Health Exchange to win

a new contract with the Heart of

Birmingham Primary Care Trust

– leading its national bowel

cancer screening programme

in the area. This programme

started in February with the task

of engaging with people from

specific ethnic groups between

60 and 74 years old via a seven-

week health promotion drive.

Originally tasked with targeting

3000 members of the African-

Caribbean, South Asian and

Somalian communities – and

engaging face to face with 1800

individuals – it has actually

reached over 8000 people and

supported more than 2000.

One of our free health walks starts at Central Library every Friday at 1pm. The 2k Floral Trail Central Library Walk takes 35 minutes. 12

In step with our partnersIn 2010 Health Exchange’s “Hub” at Central Library in Birmingham became the base for our operational teams – making them more visible and highly accessible to members of the public.

• 4,500 people have accessed our Cancer

Information and Support Service

• Over 2,000 of these people were

supported directly – exceeding our

target of 1880

• In addition, we reached 8,000 people

via the bowel cancer screening

awareness programme

• Over 200 Health Exchange staff and

partner staff have received cancer

awareness training to increase their

knowledge and effectiveness and to

integrate the Macmillan service into

our services and the communities we

support

We organised an Expert Patient

Programme course for some of BARC’s

service users and received encouraging

feedback from our partners. Centre

manager Chandrika Gordhan said: “We

have been able to work collectively and

to share best practice and expertise.

This has helped to improve patient and

service user experience and outcomes

by removing barriers between the two

agencies. For instance, it has enabled

the realisation of ideas more effectively

and efficiently; it also led to a co-

ordinated approach.

This increased presence has helped us strengthen our links with the library – one of our original foundation partners – and also to deepen other partnerships with Macmillan Cancer Relief and with Birmingham Arthritis Resource Centre (BARC) which shares this location with us.

Working with Macmillan we provide a Cancer Information and Support Service for all the organisations and communities we work with, enabling the Macmillan message to reach into the communities we serve in a culturally sensitive way. This service has made a real impact this year, expanding into 18 community sites where Macmillan Information Pods have been installed.

A year-long programme, set up by Health Exchange and sponsored by Macmillan, to help diverse communities in Birmingham to understand cancer and break health taboos has reached thousands of people. We have featured the programme in our community events, at our Health Information Shops, and in our regular broadcasts on community radio stations.

From March to May 2011, Macmillan piloted an information service at Boots pharmacy in the city centre, with some sessions facilitated by Health Exchange, which raised the profile of the cancer support service.

We were then asked to provide a cancer awareness week in February at the Boots store in the Fort Dunlop shopping centre – this resulted in more people engaging with our services.

We are now taking part in a nationwide scheme with UK volunteering charity CSV to help break down barriers around mental and sexual health, as well as bowel and prostate cancer.

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Our partnership with Health Exchange has enabled Macmillan Cancer Information and Support services to be provided in the heart of the city in many community settings. Working with Health Exchange has also provided further opportunities, due to its flexible approach – maximising potential lifestyle opportunities that people affected by cancer can benefit from.Jo Judges, Macmillan Cancer Relief

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Innovation leads the wayHealth Exchange’s new head office at Avoca Court in Digbeth is right in the heart of one of Birmingham’s most exciting regeneration areas. We moved here in July 2010 – in the process reducing our operational costs considerably and locating ourselves within half a mile of three of our community partners.

Our new head office has enabled access to the latest low-cost communication and data technologies – something not possible from our previous base. Our front line workers now use netbooks to securely access our website, intranet and online databases from any location, enabling them to provide a better service for our clients. By capturing and sharing the collective knowledge throughout our business we are developing a greater understanding of our clients’ needs and how to address them effectively.

New technologies also support our drive to innovate in the way we promote health and wellbeing. The power of the internet and social media is an essential element in extending reach and access for people – making it easier for them to learn more about their health and how to take control of it.

Our new website launched early in 2010 and we continue to enhance the content and services available. Available through PCs globally, the website is now accessible through our simple-to-use health information touch-screens at 90 community organisations and pharmacies across Birmingham.

In November 2010 we launched our interactive diabetes support centre. Developed specifically in response to pharmacists’ requests, it is tailored specifically both to help diabetes sufferers understand and manage their condition and to assist pharmacists

to tackle Birmingham’s diabetes rate, which is the highest in the UK. Since its launch, the diabetes centre has received over 16,000 internet ‘hits’ and is consistently amongst our most popular web pages.

Pharmacists are essential partners in helping us to promote health and wellbeing in local communities. 67 Healthscreens are installed at pharmacies throughout the Heart of Birmingham PCT area. Pharmacy customers are welcomed by Mr Pharm – an animated pharmacist ‘avatar’ – who invites customers in multiple languages to learn how to take control of their health while waiting for their prescriptions.

Our Picture Prescription tool translates prescription dosage instructions into a simple pictorial reminder. Devised specifically for use by pharmacy staff, it helps them overcome the challenges of dispensing medicines in multi-ethnic communities.

The Health Information Shop in Avoca Court’s reception area enables us to make a full service offer to our clients living or working in the immediate vicinity. Health Supporters can make referrals, offer information and help visitors to access our website Healthscreens.

Our website, text messaging service and social networking sites have all reached much wider and more diverse audiences this year.

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The Avoca Court Networking Walk takes place from our office in Moseley Road every week

• Our website received 79,539 visits

from 99 different countries

• Over 14,000 of these visits were from

health information screens in our local

communities

• 15,293 visits to our online picture

prescription service launched in

November 2010

• Each of these visitors spends nearly

three times longer than average on

our site and 78% are finding what

they need when they visit

• Sample survey show 81% of clients

would recommend Health Exchange

to a friend

• Over 1,000 people were referred on to

services as a result of our attendance

at community events

New innovations under development include a stop smoking desktop ‘widget’ – providing relevant daily support for clients who are trying to ‘kick the habit’. Research gained from our text messaging service – launched in October 2010 – helped us to develop this new innovation. As the year ended, we also began to re-design our text service – enabling users to access information on exercise, diet, smoking, alcohol and sexual health via their mobile phones day and night.

We also completed an assisted living research project with the Medilink West Midlands. This vital research is now helping our technology partners to roll out a mobile patient care service for people with health issues using a smart phone and a health app. This is the first of its kind in the UK. Other technological innovations we are trialling include the use of Bluetooth as a means to deliver information on demand to smartphone users.

Our latest innovation is adding QR (Quick Response) codes to our printed information – these two-dimensional bar codes help people to navigate to specific areas on a website using special software on their camera phones. This is all part of our drive to improve accessibility to our services.

Mobile shop extends our reachOur mobile Health Information Shop – which takes our services into communities – gives us a physical presence at larger community events. It is also equipped with PCs and TV screens to enable delivery of our services. People can access our website, pick up leaflets and have blood pressure and BMI (Body Mass Index) checks carried out by our qualified staff.

This year we’ve supported almost 150 community events attended by over 15,500 people from children’s centres and churches to colleges and job centres. In the future we will be running themed events aligned to national and regional health campaigns, working with the NHS, GP consortia, local authorities, community partners and many other groups.

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Engaging with new groupsIrish in Birmingham (IiB, formerly IWIC) in Digbeth is a relatively new Health Exchange partner, and works with a community where, traditionally, people can be reluctant to discuss their health openly. Initially, by just taking part in our regular health walk, service users gradually developed trust in our other services. This year 20 people completed our Chronic Disease Education (CDE) course – just over 80% of the available service users – and they also joined in the health walk on St Patrick’s Day.

Carmel has been taking part in

this walk for the past 18 months

along with other people who

regularly attend the centre. When

the opportunity arose to become

a trained walk leader, she decided

that this was just the thing for her.

Health Exchange provided a day’s

training for Carmel and a group

of other volunteers, which taught

them the skills and knowledge to

be successful walk leaders. Since

then Carmel has been leading the

walk every week, and enjoys the

socialising, meeting new people

and improving her fitness levels.

The walk takes place every Thursday at 11am – meeting at St Anne’s Centre in Alcester Street.16

If anybody else’s health isn’t very

good, I would recommend them

joining these session. Learnt a lot

– excellent knowledge gained.

Made me feel as if somebody

cared about me.

“

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Developing deeper relationships such as that with IiB has been key to extending the reach of our Self Managed Services this year. These services encourage patients with long-term medical conditions to take control and manage them more effectively through training designed for their needs. They consist of the Expert Patient Programme (EPP), a highly structured programme of training to manage a wide range of conditions, and our Chronic Disease Education (CDE) service, which has a more flexible format and focuses on specific conditions including chronic heart disease, diabetes and chronic kidney disease.

CDE courses are delivered at locations across the area by Chronic Disease Educators (CDEs) and were originally focused on GP practices and GP referrals. This year availability has been extended to wider community groups, enabling us to offer a service to those who may be reluctant to engage with courses at their doctor’s surgery.

We have also run successful CDE courses with new categories of patients – for example, people identified as pre-diabetes and those diagnosed with high blood pressure. Our work with pre-diabetes and hypertension patients is the first venture in Birmingham where non-clinical staff deliver self management courses. This development focuses on preventative techniques, rather than treatment options, and has been made possible by working closely with the cardio vascular disease team at Birmingham Community Health Care Trust to establish the most appropriate courses for individual patient needs.

Research from Birmingham University – still being evaluated – suggests compelling evidence of the impact of our self managed services. 65% of patients rated the course 10 out of 10 and 80% reported better health after completing a CDE course. Most of the patients said they valued the interactive elements in the course; the way that information was explained and, most importantly, the relevance to their community and culture.

The Expert Patient Programme (EPP) courses we deliver have also grown. This year we delivered EPP on behalf of

PCTs in Birmingham, Coventry and Telford and Wrekin, establishing yet more new community partnerships and

reaching people from many different backgrounds who were previously unable to access this kind of help.

A highlight of the year occurred when Health Exchange became the first non-NHS provider in England to achieve certification from the Quality Institute of Self Management Education and Training (QISMET), confirming that our EPP programmes are delivered to the highest possible standards.

• CDEs engaged 2,067 people with

coronary heart disease, diabetes and

chronic kidney disease

• Of these, more than 1,700 completed

a chronic disease education course

• Over 82% of patients completed

a programme – compared to the

Department of Health’s national

average of 60% for people who join

self-management courses

• CDE course completion is highest

among white and black/black

Caribbean communities

• Women suffering from diabetes were

most likely to demonstrate greatest

improvements in their lifestyles

• 231 people completed the Expert

Patient Programme, 115% of our

target

• 80% of EEP completers were from a

BME background

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I changed my eating habits, starting to have brown bread, less sugar intake, more fruit. Feeling much better.“

New one-stop support serviceSoho Health Centre is another of our community partners where we have seen significant progress this year – mainly thanks to our Supported Services teams. Our Health Supporters and Support-Plus ‘Buddies’, recruited from within local communities, work together to support people in making positive lifestyle choices and then staying committed to them. Their skills are supplemented by our Health Trainers and Chronic Disease Educators (CDEs) – all working together in the interests of patients and visitors to the health centre.

Miss M, a young Pakistani woman, was referred by her

GP to one of our buddies because of employment issues

which were having an adverse affect on her health. She

had been off work for over a month from her full-time job

because of a range of concerns including bullying and

harassment, causing her to feel depressed and stressed.

Miss M wanted to address these issues and return

to work – but did not have the confidence to contact

her employer and raise them. Her Buddy was able to

reassure her and to act as a mediator with the company

and finally new working arrangements were agreed.

She is now back at work with the same company and

enjoying working with her colleagues. She is also back

to her normal weight and socialising again. Initially

assessed as suffering from moderate depression, she

was assessed at ‘minimal depression’ before she went

back to work.

Support Plus ‘highly valuable’GPs know that patients’ social circumstances have a big influence on their health and can be the real cause of visits - often repeated - to the doctor, but they have lacked a systematic way of responding to these needs. Health Exchange’s Support Plus service helps people to overcome the wider social factors that can negatively impact their health – for example, problems with debt, benefits, unemployment or housing. It aims both to reduce visits to GPs for non-medical causes and to decrease depression levels, which are measured using recognised processes such as PHQ9 questionnaires.

The Support Plus service has proved both popular and successful. To date, it has been adopted by 30 GPs who all rate the service as “highly valuable”. Waiting lists have been reduced as doctors have referred more than 4,000 patients to our ’Buddies’ who provide cost-effective one-to-one support. Of those patients initially assessed as suffering moderate or severe depression when they were referred to Support Plus, 84% had improved to mild or minimal depression at the end.

Results show that the service is most successful for all stakeholders when the Buddy becomes a virtual member of the GP’s practice team. By taking part in relevant team meetings and providing direct updates to patient records they can enable the smoothest exchange of information and a stronger focus on patient needs by all involved.

An example of this is the work of Mahmood Zahid, one of our Support-Plus buddies based at Soho Health Centre. He won an ‘Above and Beyond the Call of Duty’ award from Heart of Birmingham Teaching Primary Care Trust this year. Staff and doctors at the centre nominated him because they have seen first-hand the successes that Mahmood has been able to achieve with their patients.

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Support-Plus

• 100% of GPs questioned about the

service said they found it valuable

• In an independent survey in 2011 79%

or 271 patients valued the service as

“very helpful”

• Out of the 271 patients questioned

66% said they would recommend the

service to others

• 2,296 patients were seen under the

Support-Plus programme during the

year, of which 27% had severe or

moderately severe depression when

they joined the programme

• Of those patients, 84% had reduced to

mild or minimal depression at the end

of the programme

An elderly gentleman was referred

to the Quality of Life Programme

through his GP practice. Support

Plus buddy Hama Doulay carried

out an assessment and referred

him to the Older Peoples Access

Service (OPAS), who installed two

handrails in his home.

“I didn’t expect this simple job

would make such a difference

to his life,” said Hama. “But this

gentleman had always prayed five

times every day until becoming

unable to because of his age, and

this worried and depressed him.

Since having the handrails fitted

he has been able to continue

praying, and his son told me he is

now much happier and back to his

normal self.”

Health Supporters champion good healthOur Health Supporters have been actively involved with our community partners on a regular basis during the year. In addition, they have provided health information, guidance signposting and support to people attending nearly 150 community events, including larger events where we utilised our Mobile Health Information Shop.

Health Supporters provide blood pressure monitoring, body-mass index measurements, information and signposting on health and wellbeing and referrals to other services. This year Health Supporters interacted with nearly 13,000 people – doubling previous achievements and evidencing how much communities and individuals value this service. They work flexible hours to provide convenient access and suit the needs of the communities we serve, and their multi-lingual skills, flexibility and cultural sensitivity all contribute to the success of this team.

Improving the wellbeing of older peopleDuring the last two years, we have been working in Soho, Springfield and Sparkbrook GP constituencies on the Quality of Life for Older People programme, together with Age Concern and Birmingham City Council. This programme is designed to help people, aged 55 and upwards, engage or re-engage with their local services.

Our target clients were people who hadn’t seen their GP for a year. Wellbeing Advisors, drawn from our Health Supporter teams and sympathetic to the backgrounds and needs of patients met with them to discuss their circumstances. The programme takes a holistic approach and offers services dependent on clients’ needs – many of whom have benefited from more than one service.

The service has demonstrated that many elderly people’s quality of life is reduced due to a lack of awareness about services and facilities that are available to them. As GPs heard the positive feedback from their patients they began to refer to the service more often, and referrals rose to an average of 80 clients per month. Due to the clear evidence that the service added value for patients and GPs, the programme exceeded its targets for the year.

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Health Supporter

• Health Supporters interacted with over

13,000 people this year – up from 6,000

the previous year

• Information on healthy eating is most

commonly requested, with 3,753 people

requesting something on this topic

‘QOLOP’

• 1,600 clients completed our Quality of

Life for Older People programme, and

referrals continue to grow

• 43% of clients surveyed between

January and March 2011 gained

positive outcomes which made a

difference to their quality of life

within three months of being referred

to the programme

• The positive outcomes enjoyed by

clients included improved security

and safety, increased mobility,

reduced isolation, being better

informed, and having better health

and wellbeing

Stronger working partnerships We have been working successfully with City Hospital in Birmingham for some years, with one-stop information and advice – as well as simple health checks such as blood pressure testing – freely available to patients and visitors from our Health Supporters.

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Health Exchange has made a positive contribution in terms of promoting health awareness and tackling health inequalities within the Muslim community, particularly through their work with partners at the community sitesSalem Ahmed, Business Development Manager, Muath Trust.“

This year we have extended the reach of our services into outpatient clinics. Our Health Trainer team is also now working with City Hospital’s physiotherapy department – providing health and wellbeing support to their patients. The hospital promotes our service on the wards as well as when people are discharged.

“The partnership working between City Hospital and Health Exchange gives us an excellent opportunity to offer health information that is easily accessible within our centre based in the Birmingham Treatment Centre. We stock a wide range of health information and have computers that the public can use to access internet-based information and a Health Exchange touch screen kiosk, with the facility to print information. Health Supporters provide invaluable one-to-one support with the aim being to let the public make their own lifestyle choices,” said Nayna Patel from Sandwell and West Birmingham Hospital NHS Trust.

We also work with the Pertemps People Development Group support centre in Newtown, Birmingham, which has been selected to run the Work Programme – this will enable us to stress to job-seekers the importance of staying healthy when looking for work. Pertemps site manager Stuart Baxter is very pleased with the success of this partnership so far.

“We do all we can to ensure we have the resources available to overcome people’s barriers to work under one roof. Our customers have varied issues affecting their employability and health is often a

contributing factor,” he explained. “Health Exchange staff are valued within our centre and contribute to the positive experienced we aim for our customers. This is even more

relevant now that we are increasingly working with clients with disabilities and so the advice and guidance from Health Exchange is vital and very much appreciated.

Overcoming or learning to better manage a health condition gives our customers confidence to consider employment opportunities they previously would not and so can change their lives.”

We continue to develop new community partnerships alongside our existing ones. One example of this is Birmingham Pragati Manadal (BPM) a Hindu Gujarati community group in Bordesley. We have set up a health forum addressing health inequality in all age groups and a Women’s Network with a specific focus on the Hindu Gujarati community.

“Partnership working with Health Exchange is contributing to better health outcomes for both our members and the surrounding community. We look

forward to continuing to work with Health Exchange in the coming year,” said Jay Chauhan, Chair of Trustees.

This year we have endeavoured to find new ways for our services to reach into communities, collaborating with a number of new partner organisations, including CEIA

Telford, GHC, Freshwinds, Brook, and Birmingham Metropolitan College.

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Looking to the futureWe are confident that Health Exchange will continue building its presence in our communities and this will be a particular focus for us next year. In addition, as the year 2010-2011 ended we were preparing to deliver new services we have been awarded.

In Sandwell, we have been awarded a contract to provide a Stop Smoking service, alongside other organisations. We will be developing new partnerships to support this work, and innovative, motivational support in different languages alongside free nicotine replacement therapy.

Our new Breastfeeding Peer Support service will extend our reach to women in Birmingham through workshops and personal eight-week support programmes face to face or over the telephone.

Health Exchange has also won a contract to operate a Health Trainer service in Dudley. This service will continue to be delivered locally by local people and we intend that it will benefit from the learning we have gained in operating similar services in Birmingham – and from our drive to innovate and add value to all of our services.

We are determined that our work – and our commitment as a social enterprise – will continue to a make a difference in the communities we serve.

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Dudley

SandwellPrimary Care Trust

Heart of BirminghamTeaching Primary Care Trust

A viable business enterpriseHealth Exchange continued to grow this year as a viable business enterprise – delivering a good set of results, despite the economic conditions in our principle market. We achieved a small surplus and have modestly improved our balance sheet – and are pleased to report that our income grew by four per cent.

We now employ more people – with headcount standing at 72 at year end – and we invested in new programmes to support and enhance the services we provide. This investment – thanks to growing market awareness and our multi-channel capabilities – was all financed through our existing cash flows.

Our proven track-record has enabled us to secure two new large contracts - securing income for the next three financial years. We have also accelerated our diversification plan to become more integrated into the community – reducing our dependency on publically funded programmes.

We are mindful of the challenges facing the UK economy in the year ahead and have been building our reserves so that we can withstand the effects of this and changes in the commissioning landscape. Our business remains in a strong position and we have a clear roadmap for the future. We will invest in our business to deliver this plan – creating an efficient platform from which to grow and manage our risks.

We are determined that Health Exchange will remain sustainable. By adapting and integrating our services we can offer more benefits – both to our clients and commissioners.

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Income£2,381,104

(£2,289,885)

Surplus

re-invested

£104,550

(£24,559)

Net assets

£344,204

(£209,654)

Staff72(62)

freephone: 0800 158 35 35 www.healthexchange.org.uk Health Exchange CIC Ltd, trading as Health Exchange Registered Office: Avoca Court, 27 Moseley Road, Digbeth, Birmingham B12 0HJ

Thank You!The work we do would not be possible were it not for the help provided by a number of different people and organisations. These include our:• customers and commissioners, who purchase our services on behalf of local populations; • clients, the people we serve; • GPs and pharmacists, who refer patients to our staff and to our services;• community reach partners, through whom we engage with communities;• service partners, whose skills and capabilities further enhance our own services;• Health Exchange staff - the most important asset in our business.Without the support and encouragement of all the above, we would not be able to successfully pursue our mission to promote health and wellbeing, and reduce health inequalities, throughout the West Midlands region.Sue Turton, Operations Director

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