Lesley Dewhurst, Oxhop

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………. 

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     

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… 

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 

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