Wild Card - Whose Shoes?

45. Noreen Bukhari - supporting women from ‘BAME’ communities

• Gill Phillips @WhoseShoes

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Health inequalities are in the news at the moment, with  NHS organisations setting out to understand and address them, with a strong focus on the needs of people from different cultural backgrounds.

But where do third sector (community) groups fit in? 

How do you build trust with women and families from Black and ethnic minority communities and design services that are flexible enough to meet people’s needs?

It is not a quick fix.

They seem to be doing something right in Coventry but it is a formula that has been built over many years and involves a holistic, integrated approach.

Today I am talking to Noreen Buckari, who tells us about the work of FWT, a  community-led organisation helping women fulfil their dreams and contribute fully in life and work. The work thrives because of close relationships with maternity and other statutory services in Coventry, working together to support families, and specifically now as we emerge from the pandemic.

When I tweeted saying I was looking forward to talking to  Noreen, there was an outpouring of love. Noreen is making such a difference to women, and particularly those from Black, Asian and ethnic minority communities, and I’m proud to have her on the podcast.

Lemon lightbulbs  🍋💡🍋

  • Collaboration is key - statutory and community services working TOGETHER 
  • ‘MAMTA’ means ‘motherly love’ in South Asian languages!
  • Women from ‘BAME’ community have individual needs - there is no ‘one size fits all’
  • Building a holistic service, based on trust, flexibility and relationships takes many years - not a tick box!
  • Good support is not just  health - but the social determinants of health: housing, debt management, parent education +++
  • New parents (and staff!) have had a tough time during Covid. The damage can run deep
  • Invest in small, specialised organisations; recognise the value they bring
  • Empower people to help themselves
  • Listen to women - the impact of our Whose Shoes work in Coventry!
  • Creativity - Coventry, City of Culture!
  • The Symphony of Us – there is more that connects us, than divides us
  • Anna Geyer’s visual recordings help the ongoing impact of Whose Shoes events
  • Small, flexible community-based organisations are excellent value for money
  • Do something specific and do it well
  • Integration relies on all the pieces in a jigsaw, don’t take away pieces of the puzzle!
  • If it works, keep funding it! Innovation is needed when things are not working
  • Don’t mess with people’s lives, to fulfil the needs of your short-term projects!
  • Sustainability is key – empower people to support themselves

Links

FWT - a centre for women

Whose Shoes - latest workshop in Coventry 

Warwick Uni film - link coming soon

Whose Shoes  in Croydon re the needs of ‘BAME’ women using maternity care https://youtu.be/rlfwwT0dvUg

Meet Gaynor Armstrong, Head of Midwifery in Coventry

Symphony of Us
City of Culture carnival

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I tweet as @WhoseShoes and @WildCardWS and am on Instagram as @WildCardWS.

Please recommend 'Wild Card - Whose Shoes' to others who enjoy hearing passionate people talk about their experiences of improving health care.

Gill Phillips  00:10
My name is Gill Phillips and I'm the creator of Whose Shoes a popular approach to coproduction. I was named as an HSJ 100 Wild Card and want to help give a voice to others talking about their ideas and experiences. I'll be chatting with people from all sorts of different perspectives, walking in their shoes. If you are interested in the future of health care, and like to hear what other people think, or perhaps even contribute at some point, Whose Shoes Wildcard is for you.

 Gill Phillips  00:46
Today's podcast guest is someone I've been looking forward to talking to for a long time. It has just occurred to me this episode would have made a brilliant contribution to International Women's Day. But then it's good to talk about important issues all year round, and not just on one particular day. So today I'm talking to Noreen Bukhari, a wonderful champion of women everywhere. Noreen is the sort of person who wears lots of hats. I met her a few years ago, and she has been a fabulous champion of my Whose Shoes work. And we've worked together around women's voices in maternity care, including a very recent workshop that UHCW in Coventry, in partnership with Director of Midwifery, Gaynor Armstrong, you can meet Gaynor in Episode 19. But today I'm looking forward to hearing much more about Noreen as a person and the work that she does with FWT, a fantastic community-led organisation, helping women fulfil their dreams and contribute fully in life and work. When I tweeted saying I was looking forward to talking to you Noreen, there was an outpouring of love. You're making such a difference to women, and particularly those from Black, Asian and minority ethnic communities. So welcome, Noreen. Could you tell us a little bit more about yourself and the work that you do?

Noreen Bukhari  02:11
Wow, Gill, that was a fantastic introduction. I'm so humbled by what you've just said. And you yourself Gill, an absolute gem, you know, you're such a lovely person, and a great advocate for women, and particularly those within maternity. It's been absolutely excellent working with you over the last few years and your passion is something that's very infectious, and your enthusiasm that really motivates us to want to do better. And so it's been a pleasure to collaborate with you over the years, around maternity services, and also the fantastic people that you've mentioned, Gaynor, and various other sort of heads of midwifery and practitioners that we've been working with. It's been a fantastic, I would say, 20 years working in the third sector. I think being really privileged and humbled to be able to have worked with fantastic colleagues l
at FWT and also the partners across Coventry as a city as a whole. As a city, we are very passionate in supporting the community at large. But I think with regards to FWT we have the privilege to be able to support and focus on women and empowering women to take control of themselves and their families, and whatever they want to choose to do. So it's very much, I would say, a needs-led service. An organisation is really about a wraparound support for women in a holistic way. And if I may, I'll just talk to you a little bit about FWT, which is a centre for women. It's based in Coventry. It's award winning. It's a women-only centre and has been operating since 1989. And we're dedicated to helping all women in Coventry and in the surrounding areas. And we work around supporting women socially and through health and economic programmes, accessing education, training, healthcare and employment opportunities. So SHE women in the communities really, we're trying to help them move forward. And we've worked on various programmes throughout the years. Because we're third sector, a lot of our projects that we have, we have to source external funding for, though we apply for the funding and we have an X number of years that we can work on a particular programme. But our ethos is still around sort of social health economic programmes is around supporting women around SHE so that's our expertise. And health programmes are particularly focused on black Asian minority ethnic groups. And I've been working at FWT, I would say, for the last 20 years. I came from a chemistry background, worked in pharmaceutical and also technical sales. And I saw this opportunity that came up from MAMTA, and MAMTA means motherly love in South Asian languages.

 Gill Phillips  04:53
That's lovely. I didn't know that.

 Noreen Bukhari  04:55
Yeah, it's actually pronounced 'munta' in the Language and it's such a warm word. And the programme itself started off. The coordinator process advertised about 20 odd years ago and I was just had been made redundant from one of my posts around then. And I saw that and I thought, wow, that would be something I would love to do. And then I applied for it, got the job as a coordinator, and it was really an idea on a piece of paper, and then myself and a few sort of really passionate midwives collaborated together. And the head of midwifery at the time, Bernie Marshall, we went to see her, and I just talked to her about some of the gaps, what were the gaps with regards to women from different ethnic communities accessing services. And we realised that women from Asian communities at that time was just a bigger South Asian group. And black communities weren't necessarily accessing parent craft or parent education, or potentially getting the most out of parent education. So we set up the first specialist parent craft in Coventry.

Noreen Bukhari  06:03
And that was with two passionate midwives who really, really wanted to work with us on that. And we developed a course, a programme really to try and support women from those communities to be able to have a space that was safe, that was culturally appropriate and had language support. So that has been running for the last 20 years. It's changed slightly with regard to the model, but the principle is still the same. Our communities now in Coventry are very diverse. We have over 100 dialects that are spoken within the city. We have people that are from all over the world for different reasons. They've come to Coventry, our biggest group is still, the South Asian community. They're the largest group that are giving birth to babies in the city. But we're seeing more women coming from the Middle East, from Africa, from Europe, whether it's for economic reasons with their spouse and migrants, whether it's a student or refugees and asylum seekers. So we're a city of peace and reconciliation. And Coventry is like a magnet to a lot of communities really, and it's very diverse. And we have a massive population churn. So we've seen lots of communities come and go, and different ethnicities, but we've been able to adapt the service with regards to that. So MAMTA's aim really is to support women in pregnancy and after baby's born. Our focus is trying to support and educate women in the pregnancy period from 16 weeks onwards, up until baby's three months old. We've recently changed the model. Before we used to have our support focused on the three areas that had the highest ethnic communities in Coventry. Now we're based at FWT. But we're commissioned by public health via Swift, under the family health and lifestyle service. And that service that integrates Health Visiting, school nursing, be active, be healthy, stop smoking in pregnancy, FNPs

 Gill Phillips  06:03
Wow. 

Gill Phillips  07:53
What's FNP? 

Noreen Bukhari  08:02
Family Nurse Partnership, which is a programme that focuses on young parents, and it's a specialised programme and nurse programme. There's a dedicated nurse that supports those young people from pregnancy up until a certain period after the baby's born. And people referred into the service by midwifery. So it's a specialised programme. 

Gill Phillips  08:24
And the magic word that you mentioned there was 'integration'. That's what I'm hearing. And ... 

Gill Phillips  08:29
Yes. 

Gill Phillips  08:29
all those different aspects, all those different communities, the different needs that people have got and actually working together with other services and such a strong link between the third sector where you're working, and the formal maternity services at UHCW. It's a very special relationship, I think.

 Noreen Bukhari  08:46
Absolutely. And I would say that, I think MAMTA, the journey of MAMTA over the last 20 years, we've worked very hard as peer workers that we have within the team, worked hard to support women in pregnancy and after baby's born, but also, we've got a fantastic relationship with UHCW maternity services, and also the other health practitioners that support women and families. And we've built those over the years. And all of us are working to improve outcomes really. And those relationships are really important. And I think we're very unique. Over the last three or four years, being part of that integrated programme has meant that we're working alongside health practitioners at the NHS to be able to then deliver services to the community.

 Gill Phillips  09:31
It feels as if Coventry is so far ahead of other areas in this respect. That kind of integration seems to be exactly what people are striving for.

 Noreen Bukhari  09:40
The new model that we've got that's been sort of launched last year was really to ensure that every woman in Coventry, that was from a BAME community had access to MAMTA whereas before we couldn't do that. And part of that integral pathway is maternity services that are referring those women to us. And our aspiration is to ensure that every BAME woman is referred to MAMTA so we can support them to actively help to eradicate a lot of barriers and issues that people might face with regards to access and engagement within health. And there are different barriers that women do face. And it's about ensuring that we, as a service, support those in an appropriate way and help to then also link back to those services backed to health. And being integrated makes such a difference, because it means that lots of work is evidence-based. We provide a bridge really between community and health. So we have the trust of the community, but also we have those relationships with our practitioners and our professional partners, then to be able to deliver in a very worthwhile all-round holistic service. We have the flexibility in being third sector to be able to still do certain things that maybe health partners might have restrictions to. So it works, it's a win-win situation for us, as partners, as well as ourselves, and women that we support. We've supported, I think over about 40,000 BAME women since the inception of the service now. And it's absolutely fantastic. You know, it's mind boggling. And, you know, we've been really humbled because it's been recognised as well. We've gone for partnership awards. So we've won a few compact awards in Coventry, again, celebrating the partnership with our health partners, UHCW maternity services, or whether it's our Health Visiting partners or our public health partners, City Council partners. We've had Channel Four News come and visit us. And they did a little piece on reducing infant mortality. Yeah, we were named as a good practice programme to be trying to address some of those issues. We had the BBC come and spend a morning with us. Their health correspondent came in and talked to some of our service users. And we appeared in a podcast actually. And we've been mentioned in certain articles, women invited to talk about the programme, and, you know, the good practice. And we've won various awards. An Oscar award, I think, a few years back with maternity services around the collaboration that we've got. I suppose supporting those women holistically, really makes a difference, because we're able then to offer that peer support to women. And to create a good relationship with them, you know, a trusting relationship, and try to identify what it is that might stop them from accessing services. And there might be lots of reasons there might be some mistrust, or a lack of information or knowledge of what goes on here in the UK, or there might be family restrictions, or, you know, there's lots of reasons why certain women might not necessarily get access to the information that they need to have. So we try to eradicate a lot of those barriers. And then what we do is we link those women to services that are they need. So it's not just about health professionals, it's other services as well. So it might be around housing, it might be around debt. So he's trying to sort of look at the social determinants of health and address inequalities in health by looking at the wider picture and offering that holistic support in a way that's appropriate. And the parent education classes are still running and we love them to bits. So we have a lot of their family health and lifestyle partners come in. So we start with an exercise class in the morning, and then we go on to some education with the midwife around sort of birth and pain relief, etc. And then we might have 'stop smoking' or breastfeeding teams come in. Now the peer workers work really hard to get those women to come into the session and a new group of women come in every week. We have interpreters present for women that can't speak English. So the feedback is brilliant. But then we offer the one-to-one support, the peer support throughout pregnancy and after baby's born up until baby three months old. And at the appropriate time we give the right messages and ensure that those women have everything that they need really to have better outcomes. But as you know, with MAMTA, we've been able to also look at other programmes. You know, we've been really fortunate that the team, because we're so experienced, that if we do get funding from other places, we're able also then to work on other things. So we've done lots of research programmes over the years. We've worked with Coventry University, we've worked with Warwick University, on the experiences of parents, and again, focusing on the BAME communities and what their needs are. And we recently did a piece with Warwick University around parents' experience around COVID. Because that was a very difficult time. And because it was part of the City of Culture, we managed to do a little video of the voices of some of the women and what their experiences were and how they felt. But we've also worked on various programmes and research which we've been really, really privileged to be able to do. We've worked with the City Council on public health around other programmes - things like smoking cessation. We did a genetic counselling programme as well. We've done COVID messages, we've cascaded those out to the community. And alongside that, we're able to also do other health programmes at FWT. So we work on a cervical screening programme, but also breast screening, and bowel screening, and trying to educate the community on the benefits of screening and to try to increase uptake. So we work with local GPs and the integrated care body in Coventry and Warwickshire to try and increase those rates and support the community. So it's a two-tier model really, around community engagement and supporting practices with their calls.

 Gill Phillips  15:35
Can I stop you and minute, insofar as what you're saying, I think, is absolute gold, you know, in terms of, you're just naturally reeling off these different relationships. It's all about relationships. And I think what I'm hearing is, this is built very naturally over many, many years. And things like trust and trust between communities and perhaps a lack of trust or information isn't quite right or not understanding that kind of cultural awareness. It's never a quick fix is it? I'm thinking of, perhaps the fact that obviously, the issues around five times more and black and ethnic minority communities and the essential need to address the issues in certain communities and make things so much better across the country. Other people are now trying to do some of this work. And I'm very proud because I mean, Coventry is my local city. And I used to work for many years, for 30 years, for Coventry City Council. I think Coventry had the most diverse communities in terms of the numbers of different communities and dialects in the country. And I'm sure, I don't know if that's still the case, but it probably is. And that was a source of great pride, really, in terms of welcoming people and genuinely looking to find people's needs. And, as you say, with funding, I mean, that was something that that I was involved in a bit from the other side and these fantastic community projects. And I know, you know, I've got a really close relationship with Grapevine in Coventry. I think they're amazing. They've been going 25 years, this is long standing, very genuine work, isn't it? 

Noreen Bukhari  17:18
Absolutely. And Grapevine do some fantastic work. And they're a great specialist organisation, I think particularly around people that have learning disabilities or other needs, and they have a, I would say, a specialism around that. And I think Coventry is very diverse with regards to the organisations. I'm talking about third sector, we have lots of organisations that have specialisms and that you said that grow from a passion, and it's very genuine. And it's to try and meet a need that's really pertinent in that community. And then over the years, seen some organisations that have closed and some that have grown. Unfortunately, it's one of those things, it's around sort of funding, and how much funding people are able to apply for and how much is available. So, unfortunately, we can't deliver the programmes that we're delivering without sufficient funding. Some of those have a year, two years, three years. And then we have to apply for further funding again, and it depends on the priorities and like you talked about the diverse communities and the BAME communities. We've got more attention, haven't we the more of a spotlight on especially on the MBRRACE report?

 Gill Phillips  18:28
Yes, yes.

 Noreen Bukhari  18:29
With the rates of maternal deaths. Unfortunately, they are very high within certain communities compared to the rest of the nation. And I've done this for like with MAMTA, it's been 20 years and unfortunately, reducing inequalities and reducing infant mortality, maternal mortality has been one of our targets for a long time. And I'm saying unfortunately, because obviously, we want that to improve. But because we've got such a population churn in Coventry, compared to 10 years ago, 15 years ago, the population was very different compared to what it is now. So I think having services like MAMTA or organisations like FWT or organisations like Grapevine or various other specialist organisations working within those fields, those issues and those problems are always going to exist. So it's really truly investing in those organisations to be able to do the work that they do in such a good way. Because those needs need addressing all the time. You know, 15-20 years ago, when we started MAMTA and the majority the population was South Asian, like I mentioned before, and now we have different ethnic groups and diverse groups in Coventry. We've had refugees and asylum seekers that have come in and have their separate needs. That wasn't the case 20 years ago. The dynamics of what's going on around the world has an impact. And obviously, immigration has an impact, but it's celebrating diversity. I personally, I love it. I love the fact that we've got lots of different cultures, religions, languages that are spoken in the city, and it's really about trying to adapt services. So everyone has a better outcome really. And our funding really is an issue. And I think we need to try and target where we've got specialisms. So I think we've been really lucky with MAMTA that we've had that trust that you've mentioned, from the community and also the trust from our commissioners, and our practitioners and our partners, to be able to deliver an effective service and partnerships. So we've been really lucky and humbled by that. But it's a lot of hard work by all of us really. And to be flexible, and to meet the needs really, and flex the model, to be able to then meet the needs of the community and the landscape that we're in at the moment, always changing. And obviously, the government's always changing, strategies change, and priorities change. But health inequalities has always been something that FWT as an organisation always focused on. And rightly so really, because, you know, it's about looking at the wider determinants of health and how that has an impact on women as a whole. To try to empower women really to be able to look after themselves, their families, or whatever they want to do. And, you know, addressing those barriers, it gives them the power and the confidence to be able to do those things for themselves.  And I remember being pregnant myself and it was at when I started my, up to 20 years ago, in the first year I think, I became pregnant. And even though I was managing the service, working with midwives and cascading all those messages to the community, I felt very vulnerable myself. And I'm born here in the UK. And I speak English well. But then I chose to go to MAMTA for my parent education. Because I felt quite shy going into a mixed setting. And let's say needing information as the service user myself, and actually going through that journey pregnancy, and also through birth at UHCW as well. I felt vulnerable. So I think every woman that goes through that experience, even though it's trying to normalise it as much as possible, is going to know we provide the right services. So there's people that come to us that don't necessarily need this as a service, you know, we will refer a signpost to those people on to the appropriate service. We speak to women, we engage with women and they they want to go to a mix antenatal class, do that now, which is absolutely fine. Everyone has different needs is just really trying to understand that. 

Noreen Bukhari  21:33
And that's the personalised care isn't it, to just listen to women and hear what they need individually and help them work through that in a safe way?

 Noreen Bukhari  22:33
Absolutely. Absolutely. And it listens to women's voices really. And as you know that also being part of the Maternity Engagement Group (MEG) and Whose Shoes and also prior to that I used to chair the MSLC.

 Gill Phillips  22:46
Previous version to Maternity Voices Partnership, isn't it so that people ... so working with women then was it the Maternity Services Liaison Committee that was the previous name wasn't it?

 Noreen Bukhari  22:56
It was yeah. 

Gill Phillips  22:57
and you chaired that for five years as I remember?

 Noreen Bukhari  23:00
10 years!

Gill Phillips  23:01
Was it 10 years? Yeah, for 10 years? Yeah.

 Noreen Bukhari  23:06
I think the the commissioners at the time, which was a PCT, then it went on to the CCG were happy for me to carry on.  and so were the partners and midwife team and I was really, really honoured to be able to do that for 10 years.  And yeah, so the Maternity Liaison Committee again, we had very similar aims and objectives to the MVP, which really is trying to hear the voices of service users to try and to shape and help improve maternity services. And it was a very similar set-up; we had multi agency partners sitting on there; Heads of Midwifery, modern matrons, infant feeding leads, commissioners, and service users. And it was really trying to capture that service user voice. And I think, working within the same area where we want to try and capture the 'BAME' voice as well, we were able then to be able to cascade out surveys, we have that user engagement and listen to women, and what they were saying and feed into those meetings. And I felt really, really passionate about that; really passionate about working with Heads of Midwifery to look at their vision. And then obviously with the MVP, when the structure changed, I started to chair the Maternity Engagement Group in Coventry, which oversaw Coventry and Rugby. And again, it was trying to hear the service user voice, it was more service user-led, but t he main groups and that would feed it to the MVP, and every single woman that came to those meetings, and also some of the dads as well, and their experiences of how that maternity experience took to them. And a lot of people don't realise that some people, they take that with them for the rest of their life. They always remember where they gave birth, they always remember their midwife. They always remember that experience that they had. And in some instances it can traumatise some people, and in some instances, if they've had bad experiences, it can be very, very positive and something they'll look back on with fondness. But working with patient experience midwife in UHCW was fantastic and also the Head of Midwifery, just to be able to work on an action plan. And the Whose Shoes Action Plan was created, Gill, where we did the, just before lockdown I think that we had an event at UHCW, which was brilliant. And to be able to attend that event, and capture everyone's experiences and views - and our key themes really, that we wanted to look at and focus on, really gave us some direction really, you know, a delivery plan, really, and what we wanted to look for going forward. And then we had lockdown. Following that we just had a very recent event, like you mentioned at the beginning, the Whose Shoes event that we did with with Gaynor Armstrong, and Louise Clarke, and Leanne. And again, it was great to see practitioners there, service users there again and forming their views and key themes that again will be the new action plan, going forward. Unfortunately, I've stepped down as MEG chair, as we've got a new structure that's coming and going forward for the MVP, I thought it was really timely for me to hand that over to somebody else. But I really have been honoured to be able to do that role and being able to sort of chair the MSLC and also the at the Maternity Engagement Group for for so many years, over a decade, that I've been really privileged to be able to have done that and just make a difference, really.

 Gill Phillips  26:22
Big difference. Yeah. I mean, you were talking then. And even that was really innovative. So the event that we did with Gaynor at UHCW and obviously all the team, was very collaborative, I saw is as really innovative because we wanted to reflect on people's experiences during the pandemic. And I think the realisation that the women and families, and what it felt like to give birth, during the pandemic, and the isolation and the very unique issues, but also for the staff to be in that midwifery unit. And to have to say, "sorry, your partner can't stay" or with the changing government guidelines as Gaynor described, literally, by the day, you know; having to catch up and work around trying to keep really good communication with women, including through Facebook, and some, you know, more modern media. And you mentioned ... I wanted to come back to, you mentioned briefly and it was so fantastic. It was something that really stuck with me, the film that was made with Warwick University. And I love the fact that it was obviously incredibly powerful, but it was the voices of the women. It didn't need to be a video, you didn't need to actually see the person. And I suppose that's, that perhaps links with what I'm trying to do the podcast, sometimes the power of audio, and just hearing people's experience and that whole power of storytelling. Tell us just a little bit more about that film. Because is it something we could link to Noreen? 

Noreen Bukhari  27:56
So our website is www.FWT.org.uk and we've got a little brief on the project there. And you're absolutely right, I think sometimes just hearing a voice or voices of people and their experiences has a massive impact on yourself. And they're relatable. And because we had the privilege of working with Warwick University on that, and being able to have the City of Culture funding, because obviously, Coventry was awarded City of Culture funding, which allowed different local organisations to be able to do something a bit different, a bit innovative. So rather than just working on something that was like, for example, research based, it was producing a piece of artwork or something that was different. So there was a legacy that was left once it was finished. So our aim is really for that programmer was to see ... I mean, COVID was a very difficult time anyway, for everybody. All of a sudden, in the month of March, three years ago, we we were told that we couldn't leave our homes. And this horrible virus was going around and people were dying. All we could see within the news was the numbers of deaths every day. And it was very frightening. It was a horrible time for everybody, wherever we were in the UK. And obviously we didn't know too much about it, about how we, we would contract the virus. We were scared to go out. And you know, people that were women, particularly that were pregnant during that time, it was very, very difficult for them. And as a service, you know, supporting pregnant women. Fortunately, we didn't close. We were very lucky that we were able to then carry on but we just had to very quickly adapt as an organisation at FWT to working remotely to offering the remote services, online services, adapting the service so we were still supporting women and able to sort of carry on with work, just like all our other partners. I mean, some organisations had to close down altogether and some remained open. All those women were very, very anxious and anxiety levels hit a peak, particularly the women that we were supporting. And staff, as well included, as you know from the impact of that event that we went to. Staff, midwives, practitioners, they had to be there; whoever is out there supporting patients and the families were also anxious and also going through those difficulties, and really tried to reassure the women as well, and their families at the same time. So with our professional hats on, and I remember sitting in a couple of meetings whereby practitioners were crying because they'd lost their loved ones through COVID. Yet they were still coming to work and having to be able to support women and families who were anxious as well. So families that we knew, I think everybody knew someone who had passed away of COVID, or they had been impacted by COVID, during that period, and being able to then also offer a service at the same time. So this particular project with Warwick University was to look at what COVID in parenthood was like. I captured the voices of 'BAME' women, particularly. So we worked in partnership with Warwick University to be able to recruit women to tell their stories. And we had a focus group, we had one-to-one sessions that took place with, with Warwick University, really trying to capture their voice. And then some of their comments were  put together into this audio. And that's something that was the impact of the programme, really. And that audio is available on our website. So people have a have a look at that. And listen to that if they wish to do so. But we, at the Whose Shoes event, it was great that we were able to play that really because it really set the scene, because a huge user event was really looking at COVID and the wellbeing, the impact of the last couple of years, and looking at ways of ... how to go forward. And I learned from that. We are in a lot better place now. But at the time, it was very, very scary.
 
Gill Phillips  32:14
It was and I think it's really important to take that time to reflect and I was thrilled we managed to do that together through that workshop. So the City of Culture brought some amazing opportunities to Coventry, and one of my previous episodes, which I just did on my own because I was so affected really by attending the 'Symphony of Us' at Coventry Cathedral. I don't know if you came across that at all. But it was the most amazing Storytelling Event deliberately blending very, very different people in terms of you know, if you stereotype people. The six people who kind of starred in this little production, which was all backed by a full orchestra all the way through it, it's quite an extraordinary event, against the backdrop of the beautiful glass etching at the back of the new cathedral, looking onto the old cathedral. And one of the participants was Sam, the bereavement midwife at George Eliot hospital, who was one of the people who tweeted to say, "well, you're talking to Noreen, she's fantastic". All these different threads that get woven, and I think why that event affected me so much was learning that six people that were deliberately chosen to be about as different as they could be, and then coming together as a group and finding out that genuinely, they had got more in common than you might think, if you just stereotype people in society in that I think that was a very, very imaginative Coventry-style event! And I think the kinds of things that you're talking about, I don't think that you realise how just those golden threads that you're sowing so naturally through what you're saying about all the different people who've come together, and then during the pandemic, how people had to reshape and do things differently, but that core support, that core value was still there. Very special. 

Noreen Bukhari  34:07
Oh, thank you, Gill. And you know, I didn't go to that event, I would have loved to have gone. 

Gill Phillips  34:12
You would, yeah. 

 Noreen Bukhari  34:13
And the way you described it, I can actually picture it in my head because it is such a beautiful venue. And I've been to a couple of events there, and especially these multicultural events and multi-faith events and, you know, partnership events and Coventry to do that really, really well. And it's great to see that diversity - like you said, the different types of people coming together and sharing their stories is so powerful. And there is so much more in common that there is that divides us and I think with COVID and the experiences of COVID. And even though we've tried to capture the experiences of BAME women, they're BAME women from different backgrounds. So you know, we might come across somebody from Poland or from Romania, or someone from Africa or from Syria. or someone who's from the UK, who's Asian or Asian Pakistani. And all those women, there's, there's so many things that they share that are in common, but they have different experiences. And I think, like I said, Coventry are very good at it. We are great at coming together and embracing that. And thank you for mentioning Sam. Sam is somebody that I've known for for many, many years, where she worked at UHCW, as a bereavement midwife. She's very passionate in what she does, and instrumental in supporting so many families over a very difficult time. And we are fortunate with regard to  ... they talked about a lot ... some of the threads with MAMTA, that we've done other programmes that are linked to it. So one of the the other programmes that we're working alongside MAMTA, but funded by CWPT, is the perinatal mental health programme, which is focusing again on BAME communities, and supporting women who have anxiety or low mood in pregnancy or after baby's born. And also linked to the loss pathways, as well, which again, is looking at supporting or raising awareness and communities about the support available for families who have lost a baby, you know, or had a miscarriage, for example. So there's so many different links that we have got established, but they all overlap. And they're all really important services, and really important to be able to support the community. And it's been a great privilege, really to be able to have worked in Coventry with so many fantastic partners, through the community and also across health. We're all really, really passionate about what we want to do. And I think, for us at FWT, I think people do  see that passion, they see it is genuine, and they see that, you know, we really want to make a difference. And that's from the sort of management committee down to the managers to the staff. And the volunteers that have supported us over the years, you know, we couldn't have done it without them. It's very much a partnership approach and everyone working together to address the inequalities to improve women's health and, and strengthen that support that we give to our service users, by joining up and working together and shaping ideas. And it's been great that we don't just do the delivery, we've been sitting on various strategic groups. So we're able then to make an impact and have a voice for for those women that we're supporting and voice for 'BAME' users or women in general. Though, whether it's the Maternity Services Liaison Committee, MVP, or Healthwatch, or what, or the Marmot partnership group, or various groups that we've been sort of part of, it's really about providing that voice to represent those communities as much as we can, and providing a voice for them. Also, I've been really fortunate to be able to offer the bespoke training as well, which has been really brilliant throughout the years, and I've been invited to share our experiences with student midwives that come to university. So for many years, I used to go there and do part of a module and just really share our experiences and have discussions around you know, difficulties that communities have and how to address the need, etc. And I've been really fortunate to be able to still go into the learning events for UHCW, the midwives there. And we recently did a bit of commissioning work, around scoping Warwickshire. So, what are the needs for the BAME communities there, particularly about perinatal mental health, and providing that, that cultural diversity training, professional training. So that's been really great to be a part of that as well. So, you know, there's just so many different ventures that we've been able to work on over the years. And we've been really privileged to be able to have done that.

 Noreen Bukhari  35:11
I just suddenly got this vision of you know, Anna Geyer, our fabulous graphic artist who's done the visual recording of our various Whose Shoes events in Coventry and indeed across the country. I think we need to ask Anna to draw a web of all the different things that you've mentioned during this podcast. 

 Noreen Bukhari  38:59
Wow!

Gill Phillips  39:00
And then it probably needs ... and I'm probably pushing my luck now, to be 3D because it's got so much depth as well in terms of how, how far back these links go. And the relationships and the trust that sits behind it.

Noreen Bukhari  39:15
Oh wow, that would be amazing. I mean, I've seen her work and it's absolutely brilliant. Having a 3D version. Wow.

 Gill Phillips  39:23
So if you're listening, if you're listening, Anna and if you've got a free rainy Sunday one time when you don't want to switch off from work and you fancy taking on that challenge ... 

Noreen Bukhari  39:35
That'd be excellent. Yeah. And that visual. I've seen, you know, when she's sitting, when we'll be sitting in some of those Whose Shoes workshops. And what she creates from just a few of the post its that she gets or from the conversations that she hears, and what she's able to create on paper. It's just such a visual masterpiece really, to be able to do that and we ... Obviously, when I was chairing the Maternity Engagement Group, we kept that as a source of, really, our themes for our action plan. And it was always a privilege to be able to look at it. And it was just amazing what she was able to capture. Very talented. 

Gill Phillips  40:15
And it's it was wonderful to hear that - that at best, ideally, that is an action plan. It's what the people who came to that session said and talked about, and were open and transparent in terms of things that were good, things that needed to improve, and to be able to revisit that and think, "Well, what's happening about that? What can we do about that?" is absolutely lovely to hear that.  

Noreen Bukhari  40:37
Yeah, absolutely. And, you know, the Whose Shoes events have been absolutely instrumental, the last couple of times, for the action plans that we've been working on locally, because just a great, a great session, and a great way to capture pertinent topics, you know, the fact that we're able to talk about difficult topics, and everyone's open and honest about, you know, their table discussions, or can really sort of get to the root of what the issues are. And the common themes have always been communication and things like information sharing, I think that's always been something that we need to generally look at. And it is how people are spoken to and what they remember, and everyone's very different. And even with some of the the Maternity Engagement Group meetings that we used to have, it was around how people perceive it as well at the time. So that's really interesting that it came up as a theme again this year. But it was always about trying to improve the care and support that we give to the families and ensuring that we're meeting the needs and things change year by year. But, you know, I think with the work that we do, particularly FWT, I think it's really around early intervention and prevention work. It's really about trying to support women and families to try and improve people's health before it gets to a stage where they have adverse health issues. And it's about empowerment, it's about trying to give people knowledge. It's around, addressing the needs the gaps, partnership working, trying to be innovative. And being able to have that flexibility of working with the community, but also be able to work on research programmes, and we've got that flexibility, those of us who are trained to be able to do that. But it's really about having that agenda, being really strong and passionate about - this is our agenda, this is our specialism. We are women only, we support women in Coventry, in the city and we know what their needs are, we want to be their voice and to be able to be diverse, and flex our services depending on the need. But I think particularly for the BAME services that we offer, the project is around addressing those particular needs, and being able to have the platforms to raise issues to mainstream audiences when we have them. And sharing that good practice and you know, to have an impact on reducing inequality. And we've been fortunate to be able to have the opportunity to be able to do that, you know, it's hard work. And unfortunately, with third sector, you know, we do need funding, and it's about ensuring that we've got that to be able to carry on doing that back at work.  So we're able to have the staff. 

 Gill Phillips  43:09
Of course.

Noreen Bukhari  43:10
And it's very, I mean ... in comparison to, so I would say statutory bodies, it's a lot cheaper with regards to running costs, etc. But the long term impacts are massive, because in the end we're saving, for example, the NHS or whatever, money in the long run, because we've got those interventions, those early intervention programmes right in the beginning.

Gill Phillips  43:33
So you've mentioned that your ability to be flexible, and to focus on things like early intervention and prevention, some of those things are hard to measure in money. But oh, boy, don't we know that they have effects on people's lives and long-term effects on families, and obviously, in the longer term, saving money to get it right. And to save all that hardship and suffering and misery in the meantime.

 Noreen Bukhari  43:58
Absolutely. Absolutely. And I think there also needs to be a budget, really for that. And really, even though we, we are overstretched, we know we know that the NHS at the moment with regards to some of the the acute services, we've got a long, long waiting list. There's lots of issues going on, particularly because of the COVID pandemic, the impact that has had on everything else. We all need to invest in prevention as well, because obviously there are people out there that with that prevention and early intervention will really benefit and they won't have long term adverse effects if they don't get that information and, and, you know, our job, I suppose, in a way is to ensure that this appropriately is timely. So that's always been our focus, really, and I hope that the funders and commissioners are always going to be investing in these type of programmes, really, because it's so important.  

Gill Phillips  44:48
I would hope that's being better understood. Now, obviously, there's not enough money for anything and everything. But I think people are starting to realise ... I think the work of people About the King's Fund has been very, very instrumental in terms of - you can't just put more money into the NHS or social care, or third sector organisations, it's all got to kind of fit together. The other thing I  wanted to mention was in terms of ... we've talked a bit about the various Whose Shoes work that we've done. So we're, we're not just starting, it's been the last couple of years now to do some more bespoke work, working with women from black and ethnic minority communities. And there's been a fabulous young leader who was one of the Darzi fellows. So Rosie Murphy did her Darzi placement around health inequalities in maternity at Croydon hospital. And last year, we were privileged to run a workshop together. I think it was at the local Asian centre. And within the short time that Rosie got, because time limited projects, like you're saying about funding and the ability to do something in the timescale that ideally, you want to and you can't always do that. I think the work that Rosie did in terms of building relationships and trust in a very short period of time, which is always difficult, was phenomenal. And the ripples are going very, very strongly from that. And there's somebody amazing called Leila Howe, who came along to the workshop, who's a local, I don't know whether you call her an activist, you know, you don't know how to 'label' people if you like, but just a fantastic woman, working in her community and beyond. And nationally, I think making some extraordinary things happen. So I think, I suppose it's what I'm trying to do through my work, you just put some feelers out there and try and do something within the budget or the opportunity that you've got. And you know, that's what you're doing ... you're just taking whatever opportunities come. And the fact that it's a one year project or a three year project, or may or may not be extended, will be the best use of that money it can be. And let's just ask whoever's listening to fund groups like yours, rather than always look through formal channels who can spend a lot of money rather quickly, you know, sometimes ...! 

Noreen Bukhari  47:10
Oh, thank you so much, Gill, and, you know, it sounds brilliant workshop you've got involved in. And it's great that you were able to do that. And that funding was available. And absolutely, I think, I think sometimes when we go for certain types of funding, there's always a caveat about innovation. And I always say that if there's something that works, keep it going. If there's something that doesn't work, or there's gaps that have been identified, you know, that's where we need to look at innovation. So it's really about ensuring that we've got that flexibility within certain funding models that are out there. So that we're able to fund existing programmes as well, because a lot of the third sector organisations in the country probably do some fantastic work locally, and they build ... it takes a long time to build a project up and build up trusting relationships, even trained staff, and then obviously, have a services that are set up. And then after a year or two, all that hard work is done. And then the funding finishes, and then why not sort of continue those programmes that are working? Well, I think one of the things that always comes up for funding bids is about sustainability, how can we sustain this going forward? I look at the lessons learned. But as you know, that can't always be embedded into mainstream services because of capacity issues and various other things. And also, I think there are specialists that can do that work. For example, there are universal services that are available to everybody. But there are some areas that need that specialist support that we talked about earlier, you know about the specialists in the third sector or the voluntary sector, it should be considered as a strong partner. And you know, I suppose in Coventry we've been really lucky that we've had that, you know, that trust from the practitioners and also the service uses, our partners, to be able to be part of an integrated health programme and a model. And that's been through 20 years of hard work and working together with those partners and building that. 

Gill Phillips  49:02
I think people also need to understand that it's people's ... this one of my hobby horses, really, it's people's lives involved. So one of my, as I say, hobby horses is, and if you're doing a project, and I can think of very specific examples from my own experience, and perhaps you're taking people who haven't had that support before, and you're doing something very special with them, and you're building them up and helping them move on with their lives. If that stops them for those individuals, you've got to be very, very sure of where that leaves them and how they move on from that new experience, new opportunity that they've had. Because otherwise it to me, it could be so damaging, that you've actually offered something and then that is ripped away from under them. Where does that leave people? 

Noreen Bukhari  49:49
Absolutely, absolutely. And I think their lives are better now. I mean, they're more empowered. They have the information that they need. It has a better impact on them. I mean, we focus on women; women and their families. It's not just them as an individual, it has a sort of ripple effect on everybody that's around them. They're more empowered, more confident to be able to do other things. So I think one of the things that we try and do at FWT is we don't hold on to any particular woman once we've supported her, given her, you know, so if she comes to MAMTA we've given her the support around pregnancy and positive outcomes for her baby. It might be that she can't speak English, and she wants to be referred on to an English course, or she wants to find a dog, or she wants help with a CV, or it might be that she wants help with housing. So because we've got the various programmes within FWT, we would refer internally first. Within the organisation, we have different types of projects and programmes to support women holistically. So for example, around some ESOL, and English, maths, IT. Also, if anybody's got any issues around domestic violence, or if they've got an issues around say housing or debt, or any legal support they might need, we have a Coventry women's Partnership Programme at the centre and we link with all the women's organisations at Coventry. So we're able then to refer internally and support those women. So it's a wraparound service. And you know, various needs are met. So if you pull any one of those programmes, there's something that's missing for those women. But equally, we refer to all the agencies in Coventry. So not just our health partners, but anybody that will benefit that particular woman and her family. And we also like work with those programmes supporting refugees, and people that are new to the country as as a migrant, just to try and become more integrated, and more socially sort of inclusive, in the sense they're able to navigate their way around Coventry. So we have caseworkers that work around that. And all that support that they can offer those women is so important, from things like accessing the GP, to filling out forms for housing, ensuring that they understand certain letters that come through from the school. You know, there's lots of things that families do struggle with. So we're very fortunate that we've got the funding to be able to support those people as communities, and those women. And if it wasn't for that they wouldn't have that support, you know. 

Gill Phillips  52:25
Well, I think we probably better wind up soon Noreen because we definitely could talk all day. But I'd really like to thank you for offering a masterclass in integration and inclusion, because I think if people want to unpick this podcast in terms of all the different strands that you've mentioned, and I'll try and do a transcript that people can read as well. But I think the gems that you've brought in, I'm just seeing it as like a big jigsaw. And you said at the end if funding gets pulled on any part of it, then that's causing problems, isn't it, because you've got something in place that's working. And it's like having a jigsaw and taking random pieces out, and then suddenly, it doesn't work anymore. So I think there's so much richness, and I'm looking for lemon light bulbs in this series, and you've kind of lit the world up there. But people need to hear that. And to understand that, in terms of a formula, it's a very deep, rich formula that's genuinely been built, rather than something that you can just fly in with a bit of money for a couple of years and hope to get some really good outcomes, because it just doesn't work like that. 

Noreen Bukhari  53:36
No, absolutely. Thank you so much for that summary, Gill, very kind of you but you're absolutely right, that's the world as the third sector at the moment. And we do need the funding to be able to carry on with the fantastic work. And you're right about the fact that the relationships have taken time to build over 20 years, particularly from MAMTA. And it takes a lot of time and investment and hard work and passion to develop those links and those partnerships. So thank you for recognising that and it's really lovely to chat to you, Gill. It's always a pleasure. But thank you so much for taking time out to speak to me. 

Gill Phillips  54:14
And thank you, Noreen, for coming on the podcast. It's been brilliant. Thank you so much. 

Noreen Bukhari  54:18
Thank you. Thank you, take care.

 Gill Phillips  54:21
I hope you have enjoyed this episode. If so, please subscribe now to hear more of these fascinating conversations on your favourite podcast platform. And please leave a review. I tweet as @WhoseShoes. Thank you for being on this journey with me. And let's hope that together we can make a difference.