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Improving health for the homeless

  • Last modified date:
    26 April 2011
Pam Campbell

Pamela Campbell, Consultant Nurse in Homelessness and Health Inequalities, helps run a day centre for homeless people in Southampton.

An online learning package to support nurses working with homeless people is helping one nurse-led practice in Solent NHS Trust.

The ‘Improving Healthcare for Homeless People’ online resources were launched by the Queen’s Nursing Institute (QNI) to support nurses who are new to community nursing or working with homeless people.

‘The resources have been very helpful to us,’ says Pamela Campbell, Consultant Nurse in Homelessness and Health Inequalities. ‘It’s an informative tool that has helped us shift our practice.’

Pamela has 19 years experience of running nurse-led services for the homeless. Her 15-strong team of nurses, nurse prescribers, community health nurses, health visitors and GPs is based at Two Saints, a day centre for homeless people in Southampton.

‘We’re right at the hub of social care for homeless people,’ she says. ‘We have a suite of medical rooms here and we’re able to tailor care appropriately because we have an awareness of their needs. But we are also led by the health needs they express during the initial assessment.’

Health issues commonly experienced by homeless people, or those in temporary shelter, include substance abuse, blood-borne viruses, abscesses, mental illness and self-harm.

‘Homeless people mostly access healthcare in moments of crisis – for example, when they’ve run out of insulin, or they need an inhaler,’ explains Pamela. ‘When you’re thinking about your next meal or staying out of the rain, it’s difficult to anticipate your health needs and remember to turn up for a GP appointment at the allotted time.

‘Our work is about being opportunistic; by providing inhalers or making sure someone regularly takes their medication, we can prevent someone from turning up at the Emergency Department in crisis, which is better for them and leads to better use of NHS resources.’

The team works in partnership with other agencies, including the Street Homeless Prevention team, which provides an outreach service, and Solent NHS Trust. It has also formed a regional coalition of nurses and health visitors who work together to help homeless people or those who are vulnerably housed – for example, women fleeing domestic violence and living in hostels.

‘Inter-agency working is crucial because it means more pairs of eyes are monitoring aspects of the general health and wellbeing of rough sleepers and hostel dwellers, and alerting us to declines in physical or mental health,’ says Pamela.

In addition to the online learning resources, Pamela’s team has received support from the QNI’s Homeless Health Initiative (HHI), which was launched over three years ago to help community nurses who are working with the homeless. On behalf of the trust, the Institute has also piloted an alcohol day de-toxification programme, developed for homeless people across the whole PCT.

‘HHI project staff visited the day centre to see our services, and we have since benefited from a small fund to conduct focus groups on the programme,’ says Pamela. ‘Patient satisfaction and input to service provision are essential in directing services and the QNI helped devise questionnaires to gauge the opinions of service users.

‘They are also helping us with future strategic planning by working on a health needs assessment for homeless people that was started by the DH. This feeds in to the local Joint Strategic Needs Assessment to make sure the needs of homeless people are at the centre of future funding cycles.’

QNI launched a new project at the start of this year called Opening Doors, which builds on the work done by the HHI and is aimed, in particular, at homeless families and those with substance misuse issues.

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