GPs need to do more to help health of homeless, says report

Croydon’s family doctors need to do more to help the homeless, according to report published this week by Healthwatch Croydon.

The study, Experiences of Homeless People Using Health Services, recorded the experiences of homeless people who were referred by the council into support hostels in November 2017. It found that adult homeless, particularly those with complex needs, were not supported by GP practices as well as younger homeless in similar accommodation.

There are nearly 2,300 people in Croydon either homeless or in temporary housing, according to council figures. Healthwatch Croydon, the local champion for better health and social care, focused on those who are homeless but are in support hostels.

Working with Evolve, the homelessness support charity based in Croydon, they spoke to 78 of their service users, which they describe as customers, about their barriers to accessing healthcare and equitable treatment. This represented 27 per cent of their customers.

What they told Healthwatch Croydon raised the following issues:

Registration: A quarter of those asked had difficulty getting registered with a GP or did not get registered.

“I was living in a tent and I needed ID proof of address, they wouldn’t let me register without,” was the Catch 22 experience of one of the people surveyed.

It was primarily adult homeless who experienced the most difficulties, particularly if they had complex mental health needs.

Access to services: More than one-third of those asked could not say they had got access to services. Adult homeless are less likely to be able to gain access to services compared with young homeless people. This increases significantly if adult homeless have a complex range of mental health issues as well.

Being listened to: Two-thirds of those asked did feel that they were heard, but the remainder said that they were not listened to, or gave an alternative answer, which the report’s authors suggests that they were only partially listened to.

Involvement in decision-making: There was a significant number who wished to have more involvement in decision-making. Many younger customers felt they had been listened to and did not need more involvement in their care. However, a significantly number of adults with more complex needs felt not listened to and wanted more involvement with care decisions.

The report makes the following areas for consideration by GP providers:

  1. Stronger relationship between hostels and nearest GPs: With youth homeless services, local GPs were supportive in registration and service. This best practice needs to be carried on to adult homeless and particularly those with complex needs.
  2. Training with working with homeless: GP surgeries based near of hostels could benefit from working with local homeless organisations to better understand client needs and train staff accordingly, including registration.
  3. Effective signposting on GP registration: All hostels, GP surgeries, GP hubs and hospitals to have adequate information about rights of registration with staff able to signpost to relevant services at point of use.

Croydon Healthwatch’s Jai Jayaraman: wants better GP services for adult homeless

Jai Jayaraman, Healthwatch Croydon’s chief executive, said: “This report is a snapshot of the experiences of some of the hard-to-reach and unheard people. We are encourged to see good practice in terms of services for younger homeless. We would like to see this reflected in services for adult homeless, particularly those who have complex needs, as they report that they are not experiencing the same standard of care.

“Simple standard processes, such as registering homeless at GPs, training health professionals about working with homeless patients and encouraging the homeless to register for GP services would make a big difference to the care they receive.”

Dr Tom Chan, the medical director of NHS Croydon Clinical Commissioning Group, the body which funds and oversees the GP practices in the borough, said: “We are committed to meeting the healthcare needs of this vulnerable group of people and will highlight the findings of this report to local GPs. We will ensure that GPs have access to the resources and guidance available to them produced by Healthy London Partnership’s Homeless Programme.

“The Healthy London Partnership is CCG-funded and has, to date, delivered thousands of cards to shelters, day centres, food banks, drop-in centres and other organisations across London reminding those who find themselves homeless that they have the right to GP services.”

To read Healthwatch Croydon’s report in full, click here

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