Closing the healthcare gap for the homeless

Last week Public Health Minister, Anna Sourby, announced that £10 million worth of funding will be made available to support hospital aftercare for the homeless. This is a much-needed cash boost and fantastic news for vulnerable adults and voluntary sector organisations, just like Spectrum Community Health, who provide invaluable and often life-saving support to these individuals.

According the it is estimated that 70% of homeless people are discharged from hospital back onto the streets without their health and housing problems being properly addressed. Through this funding, which supports voluntary organisations, it is hoped that homeless people will receive the best possible support and care after leaving hospital.

This is a fantastic step forward and one which supports our own vision and passion for providing services for the vulnerable. These are individuals who have complex and long-term health and social care needs but, due to the complex, chaotic and transient lives they often slip though the net and become hard to reach. With the help of partners, we have delivered a specific pilot project that supports ‘hard to engage’ groups including those that are homeless.

The Vulnerable Groups Health and Advocacy Support Pilot has been delivered in partnership with the local authority with a goal of improving the health and wellbeing outcomes of vulnerable adults, while also reducing the burden on health and social care services of urgent unplanned care. We are also gathering data about the needs of these vulnerable groups of people across the Wakefield District to allow us to review and manage the specific care that is required.

Despite the lack of in-depth national data about the needs of vulnerable groups, the pilot followed local anecdotal evidence; this highlighted that despite frequent outreach activity mainstream agencies in Wakefield have poor engagement with a small number of hard to reach people who have complex and long-term health and social care needs.

This means that they often disengage with their local hospital, GP surgeries and other healthcare providers. Issues with trust, physical and mental health problems, anxiety and depression often mean missed appointments and disengagement.

The pilot which is managed by the Senior Nurse practitioner at Spectrum is implemented primarily by the vulnerable Groups Health and Advocacy Support Worker who provides direct support to those experiencing chronic exclusion and chaotic lifestyles.

Our advocacy worker provides intensive support, building trusting relationships and offering help in navigating and accessing services that these individuals need in order to improve their overall wellbeing and better long-term health. Whilst our project can support those referred following hospital discharge our goal is also to reach these people before they reach hospital.

Although the pilot has been live for little over 15 months the results speak volumes and show how hands on advocacy support can have life-changing affects.

Those that engaged with this service between January 2012 and September 2012 were either homeless sleeping rough on the streets, homeless but sofa surfing  or at risk of being evicted. Each individual supported during this time has been provided with health assessments, wellbeing screening through to harm reduction advice, and anxiety and depression intervention. Alcohol detoxes, wound care and dentist treatment has also been provided alongside social support, referral to Vulnerable Adults Service and Housing and also engagement with family reconciliation processes.

Whilst this project is still on-going it is a great example of best practice and with additional government funding we hope to see more and more vulnerable people supported not only as they are discharged from hospital but also in reaching them before they require often unplanned and urgent care.

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