Case study: Supporting the health of homeless communities across Hampshire
In Hampshire, health and housing partners, local authorities and the police have been working together to meet both the housing and health needs of people experiencing homelessness.
Based on feedback following engagement with the community and providers of hostel services, a specially designed primary care service was set up in larger hostels across the county.
Health professionals visit the hostels regularly, providing consistent care and making a real difference to the community. We are now seeing appropriate hospital admissions from clients who have, in the past, failed to engage with statutory services as well as preventable admissions.
People experiencing homelessness suffer significantly more long-term physical and mental health issues than the general population. Those who are sleeping rough, have slept rough and/or are living in hostels and night shelters also have significantly higher levels of premature mortality.
Across Hampshire and Isle of Wight, between 2020 and 2021, around 1700 households were in temporary accommodation and being assisted to more secure accommodation. Within Hampshire commissioned hostels and supported accommodation:
- approximately 40% of people have significant underlying physical health conditions
- 77% have mental health issues
- 80% misuse substances
- 61% have co-occurring mental health and substance misuse.
There is an inconsistent homeless health care offer across our area. 88% of settings do not have a linked GP practice and although many people are registered with a GP, engagement with services can be challenging with many unmet health needs.
As part of the system-wide homelessness workstream, a small working group was established that included housing leads, hostels, local authority and health partners. The intention was to look specifically at the primary care needs of those people living in hostels.
Following engagement with service users and providers of homelessness services it was clear that proactive outreach into the hostels and across rough sleeping sites by local primary care providers would ensure that the health inequalities present in the homeless population are addressed and do not remain hidden.
The service aims to deliver a health outreach intervention (which alleviates the ongoing associated risks of homelessness and rough sleeping) by bringing GPs and/or nurses closer to people at risk of rough sleeping through weekly surgeries at a nominated homeless hostel or external site, building relationships with hostel staff and clients and providing consistency of care for patients who have complex needs.
“If it was not for Tracey I don’t think I would be alive. She gave me antibiotics and advised me to go to hospital 2 days later if I did not feel better. Luckily I got there just in time as blood clots had travelled to my lungs. She basically saved my life.” CJ
“It’s a benefit, I will keep going to Tracey. I will carry on seeing her.” RF - this feedback is from a client who hasn’t engaged with any services for over 10 years.