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An initiative to tackle health inequalities for people who are homeless

An initiative to tackle health inequalities for people who are homeless

An initiative to tackle health inequalities for people who are homeless

Monday, May 21, 2018

As a GP and passionate campaigner against health inequalities, I find it abhorrent that anyone in our society should be refused medical care, especially when that person comes from one of the most unsupported groups who need it the most – people experiencing Homelessness. This crosses a barrier and calls for all of us in health and social care to address what is clearly unjust.

The research tells us that the numbers of homeless people being denied treatment on the grounds of not being able to produce a permanent address is relatively small – just 7% according to Homeless Link. But, working on the front line as we do, we know that there are a range of complex issues behind why everyone from rough sleepers to sofa suffers don’t present themselves at a general practice. Or else why would they only ever turn up at A&E in case of a dire emergency? Or be tragically found dead on our streets? Those reasons include inaccessibility to services, total disengagement with the state, chaotic lives, a fear of discovery and a mistrust of authority.

These are big problems to solve, even for willing medics and their compassionate teams! In creating Homeless-Friendly, I aim to counter the received wisdom that no proof of address means no access to healthcare treatment. NHS guidelines actually state that if a patient is homeless they can be registered to the surgery address and be seen by a doctor. To tackle this issue, we included information about this in a training pack we provided externally. This included educating staff on the scope of stigma people experiencing homelessness face on a daily basis as well as encouraging staff to act as a link; providing information to enable people to access housing, training and addiction support services/ advice. This has led to us establishing direct lines to organisations such as the Citizen’s Advice and going forward, we are planning to run food banks in our surgeries.

Currently we are largely North West based, participants in the programme have publicly pledged to be Homeless Friendly and proudly display this to their communities.

With the co-operation of Bury Council and local out-of-hours service BARDOC, we have recently gone one stage further; providing homeless people with a 24/7 phone number, which they can call and be referred to a guaranteed healthcare service. We want this scheme to be replicated across the country and see a closer relationship between Local Authorities and healthcare providers, to heal and raise-up people experiencing homelessness.

The need is paramount. The problems of addiction, hunger and hypothermia are known; but as medics, we encounter everything from dental to mental health problems, plus a propensity for falls and the easy spread of viral and bacterial infections on the streets. The hidden homeless also experience issues such as anxiety and severe bronchial problems caused by damp and squalid temporary accommodation. I am always minded that the average life expectancy of a rough sleeper is just 47-years-of-age.

Homeless-Friendly may be in its formative moments, but I have been greatly encouraged by the support from across society to make sure people who are currently experiencing homelessness receive access to the same quality services as everyone else. I hope you can spread the message about our work and encourage key stakeholders in your area to take a similar approach.

Dr Zahid Chauhan is a GP, national health campaigner and the founder of Homeless-Friendly. Learn more about the programme and how to make a pledge to support those who are homeless here.

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