Produced by St Mungo’s Broadway and Homeless Link this 2014 audit of Health and Wellbeing Boards looks at whether the health needs of homeless people are being included in the planning and commissioning of healthcare services.
Homelessness and health campaign
Poor health is widespread amongst homeless people. Our latest research showed that 73% suffered from a physical health problem, and 80% a mental health problem. 39% said they took drugs or were recovering from a drug problem, whilst 27% had, or were recovering from, an alcohol problem.
People living in dangerous conditions, such as squats or on the streets, are more likely to have unhealthy lifestyles which can cause long-term health problems or exacerbate existing issues. Data indicates that 77% of homeless people smoke, 35% do not eat at least two meals a day and two-thirds consume more than the recommended amount of alcohol each time they drink.
Despite high levels of GP registration, a significant number of homeless people are not receiving the help they need with their health issues. More than a quarter of those who are receiving some treatment said they would like more help.
Homeless people are heavy users of acute NHS services; the latest data indicates that the number of A&E visits and hospital admissions per homeless person is four times higher than for the general public. This is estimated to cost a minimum of £85m per year.
We have made a number of recommendations for action across the health system to tackle this homeless health inequality. We are calling for improvements in:
Homelessness services to support clients to register and engage with GP, dental and optician services.
The NHS to offer a full health check to anyone identified as homeless and a care plan to treat any mental or physical health conditions.
Primary care services to be more targeted to the specific needs of homeless patients, and housing and health are joined up as part of the same pathway.
Greater investment in the homelessness sector for approaches known to improve the way homeless people engage with the health system.
NHS England and Public Health England to publish a clearer set of actions about their plans to reduce the health inequalities of homeless people.
The Department of Health to continue coordinating the Inclusion Health work-stream at a national level.
Inspection and accountability
Public reports to be published on the assessment of the quality of services offered to homeless people and recommendations for improvement.
Clinical Commissioning Groups to state how far they have improved access to services and health outcomes for homeless people as part of their annual reporting requirements.
Homeless Link first conducted research into the health of homeless people in 2010 and there are signs that improvements have been made since then. According to the latest data, 36% of homeless people admitted to hospital report being discharged onto the streets with nowhere to go. In 2010, this issue was reported by 73% of respondents admitted to hospital.
We are continuing to work closely with our members, the NHS and Healthwatch England to implement the recommendations made in our report and improve the way homelessness and healthcare services work together to provide support.
We are currently working with our members and the Health and Wellbeing Alliance partners to influence the development of the NHS long-term plan. A discussion guide (also in an easy read version) is available to help stimulate ideas across three key themes – life stage, clinical priorities and enablers of improvement. Please contact Michaela Des Forges at Michaela.DesForges@homelesslink.org.uk or 0207 840 4475 by 24 September 2018 to share your views and inform our response.
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Head of policy and communications
Helen job shares her role with Caroline Bernard, jointly overseeing Homeless Link’s policy, research, information and communications team. Helen is currently on maternity leave.
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