The Homeless Health Service Shares Guidelines for Homeless Healthcare

Street outreach is an important element of homeless healthcare and is provided by many specialist services, but there has been no guidance on how to deliver it. In partnership with the LNNM and with funding from the Burdett Trust, The Homeless Health Service has developed national ‘Guidelines for health related street outreach to people experiencing homelessness’.

Rosa Ungpakorn

I’m an advanced nurse practitioner in the Homeless Health Service, Central London Community Healthcare NHS Trust. The service covers the boroughs of Westminster, Hammersmith and Fulham, and Wandsworth. We provide walk-in clinics in day centres, in-reach into hostels and other accommodation for people experiencing homelessness, and street outreach to people sleeping rough. I’ve been in this role for the last 8 years, and in 2020 I won the RCNi Advanced Nursing Practice Award for a street outreach project in Westminster. I’m also a member of the London Network of Nurses and Midwives Homelessness Group (LNNM), which provides support and continued professional development, and works to amplify the voices of inclusion health workers to influence policy from the frontline.

Our focus

Street outreach is an important element of homeless healthcare and is provided by many specialist services, but previously there has been no guidance on how to deliver it. In partnership with the LNNM I have developed national ‘Guidelines for health related street outreach to people experiencing homelessness’. The guidelines are based on qualitative research with participants with lived experience of sleeping rough, and on consultation with health and social care workers providing street outreach around the UK.

The importance

The aim of the guidelines is to assist services to plan new health related street outreach projects, or to review their existing street outreach. The guidelines focus on the reasons to provide street outreach and include practical advice on: the skills and training healthcare workers need; timings, locations and recommended approaches; safeguarding and personal wellbeing; and items to provide to patients. We have included quotes from the research participants so that the voices of people with lived experience can directly influence practice, and featured best practice exemplars and case studies from services in several different locations.

The impact

People experiencing homelessness face stark health inequalities. They are ten times more likely to die early than the general population and have a higher prevalence of chronic disease and frailty at a younger age. There are also multiple barriers to accessing healthcare, including refused GP registration, rigid appointment systems and the competing survival priorities that people experiencing homelessness must meet before addressing their health. Health related street outreach brings healthcare directly to the most underserved people and aims to reduce these health inequalities.

These guidelines are designed as a tool to support healthcare workers to provide high quality street outreach, implementing best practice and innovative ideas in their areas. By promoting service improvement and encouraging creation of new street outreach projects, the guidelines will have a positive impact on patients. As they are based on research with people with lived experience they will also ensure that street outreach is appropriate for, and acceptable to, the people it is aimed at.

The funding

We are very grateful for the funding provided by the Burdett Trust. This enabled me to take protected time outside of my full-time role to complete the guidelines. It also paid for Chris Torry, LNNM Network Development Manager, to co-author and to create the visual design of the guidelines. The funding has also allowed us to print copies of the guidelines, which we hope to distribute once COVID19 restrictions reduce and the LNNM is able to a host another conference.

Our launch event

The guidelines have been endorsed by Pathway, Queen’s Nursing Institute and Royal College of Nursing. They will be launched on the 20th January 2021 at a LNNM virtual event, which will be opened by Chief Nursing Officer for England, Ruth May. Speakers will include me, other healthcare workers featured in the guidelines, a safeguarding expert and representatives from the endorsing organisations. Chris and I are also currently working on an e-learning module based on the guidelines, which would provide healthcare workers new to street outreach with interactive training.

Everyone is welcome to attend the launch event on 20th January 2021, book a free ticket to join us.

Following the launch the guidelines will also be available on the LNNM website and the RCN endorsed resources page.

Homeless Health Service:
Website: http://homelesshealthnetwork.net/
Facebook: @LNNMHomeless
Twitter: @lnnmhomeless

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