Connie Jennings, Director of Stronger Communities, Walsall Housing Group
Viv Marsh, Clinical Lead for Children and Young People’s Asthma Transformation, Black Country ICB
Background
We all know that asthma is the most common medical condition to affect children, but a lesser-known fact is that those experiencing poverty, from some minority ethnic backgrounds, and those living in deprived areas experience the highest burden of the disease. Therefore, children with asthma who experience, or are at risk of experiencing health inequalities are a priority for additional support. Walsall is an area in the Black Country that sits within the 10% of most deprived districts in the country and 30% of children in Walsall are living in poverty.
In December 2020, two-year-old Awaab Ishak died from a respiratory condition caused by extensive mould in a Rochdale Boroughwide Housing property. Awaab had not been diagnosed with asthma but his tragic death has prompted action at the highest level with the introduction of Awaab’s Law earlier this year which will hold landlords responsible in the case of unmet housing standards. The link between asthma and an increased risk of death in damp, mouldy homes is beyond doubt and therefore projects and interventions which align health and housing make perfect sense.
A.C.E (Assisting Children to Excel) is an existing Walsall Housing Group (whg) initiative currently being adopted in a partnership project between health, the voluntary sector and whg to identify and support children and young people with asthma who live in a whg home and have poor asthma control.
The Partners
- whg
- NHS Black Country Children Young People Asthma Transformation Team
- Walsall Healthcare NHS Trust
- George Coller Memorial Fund
whg
We are a social housing landlord owning around 22,000 homes across the West Midlands. We started life in Walsall where we have around 97% of our homes, the majority of which are located within the most disadvantaged areas of the borough. We have a Corporate Plan ambition to not evict anyone into homelessness; tenancy sustainment is something we take very seriously. We know that good health and economic activity helps sustain tenancies, and so have invested in developing our relationships with health partners because it makes sense for us to do so. We now have a number of successful initiatives in place, with our A.C.E programme being a perfect example of how health and housing can work effectively together.
NHS Black Country Children Young People Asthma Transformation Team
The Black Country Children and Young Peoples’ (CYP) Asthma Transformation Team sits within the Black Country ICB and works in partnership with teams across the Black Country Integrated Health Care System to implement the NHS England National Bundle of Care for CYP Asthma. The team supported the design and development of this project and continue to provide strategic and operational support alongside education & training and liaison with primary and secondary healthcare services.
Walsall Healthcare NHS Trust
Walsall Healthcare NHS Trust provides local general hospital and community services to around 260,000 people in Walsall and the surrounding areas. The trust is the only provider of NHS acute care in Walsall, providing inpatients and outpatients at the Manor Hospital as well as a wide range of services in the community. Asthma care at the trust is led by a Paediatrician with respiratory interest and a paediatric respiratory nurse specialist.
George Coller Memorial Fund
The George Coller Memorial Fund is a registered charity and was launched in 2000. Its main purpose is to raise awareness about asthma and to improve the healthcare provisions for all children suffering with the condition. The charity has sponsored a number of asthma improvement projects in Walsall and the Black Country for many years.
The project
The A.C.E programme is based on whg’s award-winning Community Champion model, which sees champions recruited from our customer base to act as authentic accessible role models. With a unique platform of lived experience, they are able to access marginalised groups in a way no other service can. Trained in social prescribing and coaching techniques, they hand hold and nudge people to engage in services available. Often described as a human bridge between the individual and the service required, they increase access and take up of services.
Through the A.C.E programme, healthcare professionals identify children with asthma who are living in a whg home and are either regularly presenting for treatment or not engaging with treatment. Children are also identified through whg teams working in homes and the community and any children living in homes where damp is reported are prioritised. With the consent of the parent, the children are referred to our team of champions, who will begin a conversation with them about asthma and work with them to support their engagement in existing asthma care pathways. Damp and mould issues are managed by whg’s team as appropriate, with any necessary housing repairs prioritised. Families are also provided with self-management support packs, signposted to resources such as Asthma+Lung UK, and supported to arrange and attend health appointments at their GP surgery or the hospital.
A.C.E recently supported a parent and four children, all of whom had been diagnosed with asthma. The parent found managing the children’s asthma alongside her own health needs challenging. She found the support to create individual plans for each child along with help with inhaler technique was really valuable. Her home did not have damp and mould but as she was on a low income, she struggled to keep her home warm. We offered her fuel vouchers and support to purchase children’s coats and shoes.
In the first year:
- 93 children with asthma and their families in Walsall were supported
- 18 damp and mould referrals were made
- 2 families were provided with a new home more suited to their needs
This approach is currently a proof of concept; early signs are promising and outcomes are showing that positive, early intervention designed to improve asthma control can reduce acute episodes of asthma and help to reduce demand further downstream on local health services. We all know early engagement avoids more acute interventions later on, so the potential savings for our health partners as a result of this initiative are expected to be substantial. Its success has led to us working with health partners to create a new Black Country Health and Housing Partnership. This partnership includes social housing providers from across the Black Country and the Black Country ICB and will enable us to replicate and expand this work across the whole of the Black Country.
Acknowledgements
With thanks to the George Coller Memorial Fund for sponsoring 100 self-management support packs and to Trudell Medical for donating 50 spacer devices.
Additional thanks to the following for their assistance in the development and delivery of this pilot project:
Connie Jennings; Director of Stronger Communities, whg
Viv Marsh; Clinical Lead for CYP Asthma Transformation, Black Country ICB
Joanne Hamilton; Principal Specialist CYP Asthma Practitioner, Black Country ICB
Lisa Cummings; Specialist CYP Asthma Practitioner, Black Country ICB
Dr Najma Iqbal; Consultant Respiratory Paediatrician, Walsall Healthcare NHS Trust
Sarah Freeth; Paediatric Asthma Nurse Specialist, Walsall Healthcare NHS Trust
Visit the 2023 #AskAboutAsthma webpage for more blogs, videos and podcasts about asthma care for children and young people.