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Carol Elliott, manager of the SeaFit Programme explains how taking health services to the quayside and working in partnership with the NHS and other health providers has helped to increase access to healthcare for fishermen and their families in coastal areas around the UK.
This might sound like a cliché, but I love my job, it has offered me a unique role in bringing health and wellbeing organisations together to support fishermen and their families.
Although standing on the beach at Cromer in January, with a howling wind chilling every bone, waiting to meet Dr Bola Owolabi – Director for Healthcare Inequalities Improvement at NHS England and NHS Improvement, some might question why! That is until someone comes along and tells you they’ve not visited a dentist in years, they struggle to make appointments, are terrified of needles, or have been pulling their own teeth out because the pain is unbearable.
Despite the appalling weather conditions, we were delighted to welcome Bola and her team along to our first health event of 2022. The SeaFit Programme is a joint initiative run by the Fishermen’s Mission (TFM) and Seafarers Hospital Society (SHS). We work in partnership to provide asset-based quayside services to improve the health and wellbeing of fishermen and their families.
Fishing remains one of the UK’s most dangerous professions taking a toll on the physical and mental health of those in the industry. SeaFit was set up having identified that fishermen find it difficult to make and keep pre-booked health appointments. They can’t plan for time off because the weather, tides, and fish locations dictate when they need to be out at sea. If they are not at sea, they are not earning a living.
There is also a traditional expectation to be strong and resilient which means many won’t seek out medical help. I’ve had many fishermen tell me that it was their wife or partner who kept on that them to get help.
SeaFit includes a range of initiatives in addition to the mobile health events. We have Healthy Lifestyle Advisors from Healthy Cornwall based in Newlyn, Health trainers from the Humber Teaching NHS Foundation Trust on the Yorkshire Coast, and support from LiveLife Aberdeenshire. They provide free NHS Health Checks and other support such as stopping smoking, reducing alcohol, weight management and much more. Several fishermen have been fast-tracked for urgent referrals to their GP for high blood pressure readings, thanks to this support.
We also provide access to mental health and wellbeing support in Cornwall, Norfolk and Suffolk and have a network of physiotherapists trained to meet the specific needs of fishermen.
The mobile health events use an assets-based model of flexible healthcare, taking services to the quayside, delivered and adapted to the local environment. We’ve provided free dental checks and immediate treatment through Dentaid Charity and Smile Together. There have also been free liver checks with the Eastern Liver Network and again several referrals made to GPs for non-diagnosed liver conditions. We invite existing local services to provide health information, for example: Macmillan Cancer Support, Seafood Cornwall Training, Oddballs Testicular Cancer, Prostate Cancer UK, etc.
Fishermen can be reluctant to talk, but they know and trust the SeaFit brand and local TFM Port Staff. Spending time on the quayside has been vital in getting to the know the fishermen’s needs. The constant walking around, being visible and having informal chats helps with engagement.
Even the Covid-19 pandemic provided additional opportunities for engagement in a way that could never have been foreseen. Migrant fishermen in particular, who were not registered with a GP, were not being invited for vaccinations and yet working closely alongside their UK crewmates. Working as the connecting influence between the fishermen, large boat owners and the NHS, TFM Port Staff and SeaFit Healthy Lifestyle Advisers helped set up various appointments and drop-in based methods, from quayside pop-ups to reserving block appointments at vaccine centres.
This led to the take up of almost 2000 vaccinations, and contacts made with fishermen to offer further support.
And what of the future? Over the next five years you will still find us standing on cold blustery quaysides as the SeaFit brand becomes the main delivery vehicle for the fishing community’s health welfare.
We hope work with Bola through the Core20PLUS5 approach will initiate more cooperative partnerships with PCNs, ICS, CCGs and PH authorities and be in a position to connect sustainable services and narrow the health inequalities gap for these under-served coastal communities.