As recently as July this year, watchdogs criticised providers for creating barriers to good healthcare for homeless people, that included making it difficult for them to access GPs and dentists and even stigmatising patients who were without a permanent address.
Research by Homeless Link also showed that 15% of rough sleepers had not received adequate healthcare support when they needed it. Similar numbers also said that although they would like help with mental health and alcohol issues, they were simply not getting it.
Given that homeless people face desperate health issues including everything from susceptibility to heart attacks to being amongst the highest risk suicide groups in society, plus having a life expectancy of just 47 years-of-age, we at Beacon GP CARE were determined to do something to change this situation. And so with the support of ten Greater Manchester surgeries plus an out-of-hours emergency healthcare provider called BARDOC, we created Homeless-Friendly.
A growing problem
You may argue that specialist services for the homeless already exist – in particular, voluntary sector organisations situated in city centres. And you may also add that the NHS is a long way from being the least compassionate organisation when it comes to the vulnerable. All of which is correct; but homelessness is a growing problem, that is morphing away from city centres and we believe that as a caring concern in the heart of our communities, general practice can play a unique role in caring for the neediest in our society.
The programme calls on us all to make a cultural shift. It asks that we look at our policies and procedures to ensure that they are homeless-friendly. If practice staff need support and training, Beacon GP CARE can provide that.
Fundamentally, we remind staff that there should be no obstruction to homeless people getting the same quality healthcare the rest of society enjoys. If we can remind all practices of the NHS England guidelines that: 'A homeless patient cannot be refused registration on the basis of where they reside because they are not in settled accommodation', then we will have done our job.
With a commitment to joining-up health and social care, Homeless-Friendly will also signpost patients to organisations that can assist them. They might include local charities that can help house them or organisations that might train them for work.
For young people, we might reference Centrepoint or Childline, and as healthcarers we really should be working with our colleagues in the public and voluntary sector to help homeless people overcome the addictions that may have caused their difficulties.
The scheme has already attracted quite a lot of attention. Organisations including The Salvation Army have come on-board and what a pleasure it is to see them working day-to-day with our surgeries, sharing knowledge often from a community we don’t see beyond our surgery door, in our common goal of helping the homeless. Manchester is also fortunate enough to have a newly elected Mayor in Andy Burnham, who has made a commitment to eradicating homelessness in his city by the year 2020.
But homelessness is no longer just a metropolitan problem. And it not just about rough sleepers in doorways, either. Communities may have high numbers of people in B&Bs. Sofa surfing – sleeping on friends floors – may be more prevalent in areas with a younger population. And as the BBC recently reported on its Countryfile programme, rural homelessness is on the rise.
Our dream is to change attitudes to homelessness for ever and remind those without a home that they are still a pivotal part of our society. As with the wonderful Dementia Friendly Communities programme, we want Homeless-Friendly to be adopted by everyone from NHS foundation trusts to banks and businesses.
But that journey can only begin in a place that is still the hub of our neighbourhoods. A place where compassion is evident and the desire to embrace positive change obvious. And that’s at the general practice – where being homeless-friendly should be a way of life.
Make a commitment to becoming Homeless-Friendly by visiting www.beacongpcare.org
- Dr Zahid Chauhan works for Beacon GP Care, a not-for-profit social enterprise helping communities overcome healthcare inequalities and enabling surgeries to bring best care to all.