• 12Sep

    Healthcare & information needs of homeless people and their healthcare workers

    The Homeless Health Network is a network of over 700 community nurses and other health professionals interested in better healthcare for people experiencing homelessness. The network is co-ordinated by The Queen’s Nursing Institute (QNI).

    They have published a summary report on their 2014 survey looking at the challenges faced by homeless patients accessing healthcare, and the essential development and structural needs for the homeless health sector.

    There were 184 respondents to the survey covering a wide diversity of job roles in community nursing, general practice and public health across England, Wales and Northern Ireland.

    On average respondents encountered 128 patients every month. This figure may indicate the high number of repeat appointments, part-time working in the sector, longer than average appointment times, or the nature of drop-in clinics where attendance is not guaranteed. If this figure translated evenly across the Homeless Health Network there would be 1,021,500 patient contacts per year, 94% of which were classified as homeless.

    The survey reported a range of patient’s backgrounds and circumstances:

    • 166 respondents (90%) worked with drug and alcohol dependent patients
    • 108 respondents (73%) worked with patients who had committed a criminal offence
    • 97 respondents (66%) worked with Asylum Seekers and Refugees
    • 90 respondents (61%) worked with patients who had engaged in Sex Work
    • 89 respondents (60%) worked with people with learning disabilities
    • 43 respondents (29%) worked with Gypsy and Traveller Communities
    • 43 respondents (29%) worked with those trafficked for work or sexual exploitation

    The current living conditions reported were:

    • 34% of patients were staying in a B&B or Hostel
    • 11% were rough sleeping
    • 11% were sofa surfing
    • 5% were staying in a Wet House
    • 4% were staying in a Refuge
    •  3% were in a Bail Hostel
    • 2% were in squats, 2% were in a rehabilitation unit, 2% were in an immigration unit
    • 1% were in prison, 1% were in a young offender’s institute, 1% on a traveller’s site
    • 12% were listed as ‘other’

    The Homeless Health Network reported the big challenges faced by people experiencing homelessness when trying to access health care services. The biggest access barrier reported was inaccessible services. This included:

    • Services located outside of city centres
    • Long waiting times for appointments
    • Telephone or online-only appointment booking systems

    29% felt that lack of service was a top problem, including:

    • Not enough flexible or out of hours care
    • Over subscription to services so patients cannot get an appointment
    • No specialised services at all

    25% felt that the patients’ own attitudes could prevent them from accessing services, including:

    • Fear of professional organisations
    • How they might be treated
    • Negative past experiences
    • Not prioritising health over addictions
    • Being aggressive or non-compliant
    • Mental health issues that prevent patients from being in the right frame of mind to access services or engage with services once they were there.

    They survey also identified areas the network wanted more information on the following areas.


    Public Health and Self-Care

    The top 5 conditions the network wanted to know more on were:

    1. Substance Misuse (including alcohol withdrawal)
    2. Mental Health
    3. Alcohol-Related Dementia
    4. Blood Borne Viruses
    5. Nutrition

    Screening and Prevention

    The top 5 conditions the network wanted to know more on were:

    1. Alcohol-Related Dementia
    2. Substance Misuse (Inc. managing alcohol withdrawal)
    3. Mental Health
    4. Blood Borne Viruses
    5. Tuberculosis

    After Care Following Treatment

    The top 5 conditions the network wanted to know more on were:

    1. Alcohol-Related Dementia
    2. End of Life Planning
    3. Long Term Conditions (e.g. Diabetes, Hypertension)
    4. Substance Misuse (Inc. managing alcohol withdrawal)
    5. Blood Borne Viruses

    Widening Access to Services

    The top 5 conditions the network wanted to know more on were:

    1. Cancers
    2. Alcohol-Related Dementia
    3. Immunisations
    4. End of Life Planning
    5. Blood Borne Viruses

    The summary report can be read here.