Many homeless people face barriers when try to access health services. This means that they are more likely to suffer from poor health which in time costs the NHS more.

The issue

Often health services are not set up to respond to the needs of homeless people. For example, many mental health services will not treat people until they have sorted out their drug and or alcohol problem. Homeless people can often be trapped in a vicious circle of dependency. They try to alleviate the symptoms of their mental health problems through the consumption of drugs and alcohol which means that their mental health problems go untreated.

Although many homeless people are registered with healthcare services (92% according to Homeless Link, Health Audit), many will not be using them. This could be because they have moved away from the area where they are registered with a GP. Or because they have had a bad experience of using heath care services either through treatment or how they were discharged.

A substantial number of homeless people use hospital A+E departments for treatment instead of going to see a GP.

When people are discharged following a hospital admission, many will have nowhere stable to convalesce. With no support, they return to rough sleeping or sofa surfing which won't aid their recovery.

The solution

We include medical facilities within many of our services. For example doctors, dentists, optometrists and podiatrists volunteer at our Crisis at Christmas centres to run clinics. In our London Skylight we have optician and dental services. Our new service in Croydon has a medical room for our members to be seen by specialist homeless health team.

To improve access to health services, the Homeless Charity Groundswell has developed a Homeless Health Peer Advocacy programme which offers one-to-one support for people experiencing homelessness to make and attend health appointments. The use of peer advocates reduces the use of A+E which saves the NHS money.

From September 2013 to March 2014, 52 projects received a shared of £10 million from the Department of Health to pilot projects to improve hospital discharge procedures for homeless patients. Evaluation of the Homeless Hospital Discharge Fund (2015) found that the success of projects was largely dependent on a multi-agency approach.

Read more about healthcare for homeless people from sector-specialists Pathways.