HEALTH & HOMELESSNESS Jane Gray Director & Consultant - - PowerPoint PPT Presentation

HEALTH & HOMELESSNESS

Jane Gray Director & Consultant Nurse Inclusion Healthcare Social Enterprise CIC Ltd.

HOMELESSNESS

Rough sleeping is the most obvious sign of homelessness but much is hidden Average life expectancy for a rough sleeper is

• nly 42yrs, national averages 77.9 (m) 82 (F)

42 years is less than some African countries where investment in health service provision is much less

HOMELESSNESS

• There have been national initiatives to reduce

rough sleeping since 1990 & numbers had fallen ~ these are now increasing & Leicester has the highest figures outside of London?

• Homelessness is a multiple & complex issue

requiring a multidisciplinary co-ordinated approach by health, housing, social care, criminal justice teams & other organisations

IMPACT ON THE HEALTH OF ADULTS

• Mental health problems
• Skin diseases
• Chronic Gastrointestinal

problems

• Respiratory diseases
• Musculo-skeletal problems
• Antenatal and postnatal

problems

• Substance misuse problems

(alcohol/drugs)

• Dental problems
• Loss of self esteem
• Loss of confidence
• Institutionalised

Multiple needs relate to:

• Low income
• Inadequate housing
• Poor health than general

population

• Reduced life expectancy
• Loss of opportunities

IMPACT ON THE HEALTH OF CHILDREN

• Respiratory diseases
• Skin problems
• Dental problems
• High rates of infectious

diseases

• High rates of mental

health problems

• Developmental delay
• Delay in speaking &

walking

• Bed-wetting
• Poor sleep and

aggressive behaviour

• Increased rates of

hospital admission

• Low rates of

immunisation

ACCESS TO HEALTH CARE

Homeless people may have difficulty registering with a GP on either a temporary or permanent basis though the BMA has advised for many years that homelessness should not be a barrier Upto 40% may not be registered at all or not in the area where they currently are Many use walk in or emergency dept. facilities which are not equipped to manage primary care

NATIONAL MODELS OF GOOD PRACTICE

• Variety of dedicated services around the country

ranging from lone health workers (e.g. nurse or health visitor to full teams in GP surgeries

• Some provision may be under threat with changes in

the way health services are commissioned

• Needs to be a co-ordinated multidisciplinary

approach

• Needs to be sensitive to your populations needs

NATIONAL MODELS OF GOOD PRACTICE

• Queen’s Nursing Institute (QNI) developed a 3

year “Homeless Health Initiative” (2007/2010) to provide expert support to health professionals working in the community looking after homeless people. 600 members.

• Now have a 2 year “Opening Doors” initiative

focussing on health needs of homeless families & substance misuse

INCLUSION HEALTHCARE

Previously known as “Leicester Homeless Healthcare Service”, a service for single homeless people, run by PCT 2000 to 2010 We became “Inclusion Healthcare” 1st Sept 2010 & are jointly run by a Nurse & Doctor. Ensures service can continue with changing landscape in NHS & commissioning. Our staff are the shareholders.

INCLUSION HEALTHCARE

• Work from multiagency

“Dawn Centre” & do

• utreach clinics too
• LCC building with 44

place hostel, YMCA drop-in centre & fully equipped health suite

• GPs, general &

psychiatric nurses, drug & alcohol workers

INCLUSION HEALTHCARE

• Patients can fully register
• 24/7 healthcare so access to primary care at

all times including “out of hours” at BH & W/E

• Full range of services delivered by GPs,

general nurses, psychiatric nurses, practice therapist, drug workers, alcohol practitioner

INCLUSION HEALTHCARE

• Visiting services from specialist Midwife,

Podiatrist, Optometrist, Complimentary Therapist

• Since becoming a SE we have been able to

fund podiatry (including issue of shoes/socks) & complimentary therapy from our surpluses after our grant funding was lost

INCLUSION HEALTHCARE

• “New service” ~ Hepatitis C treatment &

monitoring clinic

• The Future ~ fully integrated healthcare

service for ALL homeless people?

CONTACT DETAILS

• Jane Gray, Director & Consultant Nurse
• Tel: 0116 221 2780
• Email: Jane.Gray@GP-C82670.nhs.uk
• www.inclusion-healthcare.co.uk
• www.qni.org.uk