Health and Homelessness
Effective interactions
Lesley Dewhurst
Chief Executive
Oxford Homeless
Pathways
Homelessness is BAD for health!
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80% have one or more physical health
problem
70% have at least one mental health problem
40% will end up in A&E in any six month
period, and nearly a third will be admitted to
hospital
Yet health care is NOT prioritised by most
homeless people
So, what works?
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Services must be accessible
Emphasis on preventative services
(screening and immunisation)
There must be a coherent network of
services across health, social care and
housing
Homelessness issues should be part of core
training for health professionals
Luther Street Medical Centre
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Makes a huge difference to delivery of
effective health care to homeless people
Located in the heart of homeless services
Holistic approach, including:
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Podiatry
Dentistry
Mental health
Substance misuse services
LSMC continued……….
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Full health checks, including BBVs
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Immunisation – Hep A and B, Flu
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Periodic TB screening
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Training module for medics
Partnership work
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O’Hanlon House – staff encourage
registration on entry
Daily liaison with LSMC staff
Interaction with Street Services Outreach
team
PATHS project – enabling patients to attend
hospital and other medical appointments
Needle exchange at O’Hanlon House
Case study – Lizzie
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Mid 30’s
Previous history of long term drug use – now on
Subutex script
Excessive alcohol use – liver problems
Brain injury – affecting vision and short term memory
Epilepsy
In and out of prison all her life.
Very chaotic
Lizzie……how partnership worked
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Slow but sure approach
Putting responsibility back onto Lizzie
Presenting options and highlighting risks
Liaising with LSMC
Being there at the right time - DETOX
Coordination of hospital admission and discharge
Still doing well in Simon House – clean and dry
Recent research (Homeless Link) tells
us…
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Oversight of local H & WB Board is essential
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H & WB Board must work with housing and
related support agencies – integration not
competition
Some practical steps
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Homeless people’s needs should be included
in every JSNA, H&WB strategy and
commissioning plans (Health Needs Audit
Toolkit)
Service users can be involved in this process
(Homelessness and Health Peer Activity
Toolkit)
Final message
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Homeless people can
be very expensive if
problems are not
nipped in the bud
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Keep us involved! We
want to help with the
planning and delivery of
health services