Common Ambition: 1 Year of Co-Producing Improvements to Homeless Healthcare in Brighton and Hove

Common Ambition, a co-produced homeless health project based in Brighton & Hove that gives people with lived experience of homelessness paid opportunities to improve their local health services, has been in operation for 1 year.

Run by a partnership of organisations including Justlife, Arch Healthcare, University of Brighton, Brighton & Hove CCG, and Brighton and Hove City Council Public Health Department, the project is rooted in co-production and empowers people who have experienced homelessness to co-design improvements to the health system that they use.

The project is delivered by the Common Ambition Steering Group: a mixed group that is representative of the homeless population in Brighton, with every member being free to contribute in their own way. The group meets every week to share ideas, have discussions and co-produce service improvements to homeless health care.

In phase 1 of the project, the group worked together to identify the ways of working that would ensure safe, productive and enjoyable group work. Collectively, the group agreed to abide by certain principles such as being open-minded, empathetic towards others, and working as a team. The group is also on a journey of understanding what trauma-informed co-production looks like to care for ourselves, hold open conversations sensitively, and avoid re-traumatising ourselves and each other. The group refers to this as ‘caring co-production’.

After a couple of months of building trust, the group established a set of objectives, created a timeline for the group’s activities, and pinpointed the ideas that they wanted to take forward into the next phase, such as mapping out all the services that are available in the city and gathering and analysing feedback to identify what the needs and barriers are to accessing health care when you are homeless.

In phase 2, we mapped out the existing services and healthcare pathways for people experiencing homelessness in Brighton & Hove. Understanding the current system has taken time, but has been a vital stepping stone on our journey towards identifying what can be improved.

When the group brainstormed all of the homelessness services in the city, they were surprised to find such a high number of services, which brought to light challenges around knowing what help is out there, but also around your eligibility to receive certain services. It became clear that while an abundance of services exist, not everyone is eligible to access them, or they may have to jump through various hoops in order to receive help.

While there are challenges, it’s important to recognise that Brighton is home to various homeless health care innovations: Arch Healthcare is a specialist GP surgery specifically for people affected by homelessness, the Step Down Beds scheme discharges people from hospital into facilities where they can recover, the homeless health inclusion team consists of community nurses, occupational and physical therapists, a dedicated homeless mental health team and Justlife’s Health Engagement project helps people who are placed in emergency accommodation address their mental and physical health needs, to name but a few of the projects that are out there.

The steering group operates as a team, every decision is made as a collective, and every group member has a say on what we do, how we do it, and what we are taking forward into the future. Group members have ownership over the direction of the project, but there is no pressure to contribute - people can share if and when they choose to and it’s up to them to contribute in their own way. They are also offered payment for their time, which is important for ensuring a level power dynamic and ensuring that people are reimbursed for the hard work they put in.

Recently, we formed a “Media and Communications” subgroup who are interested in creative mediums such as social media, filming, design and event planning. The group decided on their purpose together: to promote the Brighton and Hove Common Ambition project, to share information and knowledge, network and build engagement and raise awareness around homeless healthcare issues and the project. We look forward to seeing how the group uses their creativity to deliver on this purpose, and we plan on delivering training to develop their skills in these areas.

Outside of the project, the members really value the social aspect of the group, we have had a Christmas dinner together and plan to do more social activities in the future. Meaningful interactions within the group play a huge part in building trust and comfortability with one another, which is vital for fostering honesty and open communication within the group.

The group are currently entering into their first service design phase, working together to co-create and deliver service improvements. This will culminate in an event in June where the group can share what they have achieved to date and engage partners in the next steps of the project.