Health care for the homeless – it’s a big issue

At Healthwatch Essex, we capture the voice of the people of Essex through a range of activities, including undertaking rigorous research to build up a detailed picture of people’s lived experience of health and care services.

We try to look at all sections of society and address the issues that are applicable to them, whether by condition, or age, or other factors that may impact on their ability to access and use the health and care services they may need.

Our latest research study has exposed the challenges facing homeless people in accessing health care services, recognising that homelessness is a growing problem. Across the UK, it is estimated that more than 250,000 people are homeless or lack a permanent place to live. From 2010 to 2016 rough sleeping increased by 134% (from 1,768 to 4,134 people).

Here in Essex we are not immune to the problem and indeed many of your readers may have noticed the problem increasing where they live. Certainly, it has been something that has struck me when I have visited some of our larger towns

Looking into the statistics, we were able to ascertain that it is estimated that there are currently around 3,000 people in Essex who are homeless or lacking a permanent place to live.

Accordingly, we felt it was time to speak to some of those people to understand the issues they face when it comes to their health and wellbeing. Evidence shows that homeless people are generally more likely to experience poor health and die younger and their interactions with health care services and professionals are often problematic.

The study we carried out involved 22 individuals who were in contact with homelessness services via the CHESS homeless charity in Chelmsford and Beacon House Ministries in Colchester. They were asked about their views and experiences of interacting with mainstream health care services, recording their contact over a six-month period.

The findings paint a fascinating picture of what it is to be homeless and look after your health and wellbeing needs. So, for example, the majority of participants reported that it was easy to access services for physical health problems, but a large proportion reported difficulties with accessing mental health care. A few participants reported that they had not received any mental health care despite experiencing serious issues.

Participants expressed a preference for health care professionals who were non-judgemental and able to offer practical advice. They also valued the ability to see the same GP, albeit that was seldom possible. Continuity of care was also reported as being problematic, particularly for people who moved across different levels (e.g. from GP to specialist care) and locations (from prison to community care).

As with all Healthwatch Essex reports, it is not just a series of findings based on the experience we were able to delve into, it also makes a number of recommendations to help healthcare professionals, service providers and NHS commissioners design services that are more accessible to homeless individuals.

For GPs, these include acknowledging concerns by explaining any actions that they intend to make and talking through how the individual is likely to experience personal and social problems that could have a negative impact on their physical, mental and psychological well-being.

Recommendations for NHS commissioners and service providers included supporting and promoting the delivery of flexible services for homeless individuals around opening hours, the length of clinical consultations and considering creating GP placements within homelessness services to facilitate access.

We also recommended that systems be improved to strengthen the way primary and secondary care exchange information so that participants experience better continuity of care. This was seen as particularly important in relation to those who required specialist care from mental health services.

Check out the report

Dr David Sollis, Chief Executive at Healthwatch Essex