Health Heroes Against Homelessness

North-west professionals tackle homelessness & health

A group of passionate health professionals are coming together in Manchester next week to discuss the city’s worsening homelessness crisis.

The meeting, run by the Faculty for Homeless and Inclusion Health, will bring together doctors, nurses, mental health professionals, hostel workers and commissioners to look at new ways of providing support to people who are homeless who have mental health problems. Over 70% percent of people who are homeless have a physical or mental health problem. People who’ve lost their home are more likely to suffer depression, more likely to feel suicidal and are more likely to suffer from serious illnesses such as epilepsy, diabetes and emphysema.

Rachel Brennan, Manager of the Homeless Service at Urban Village Medical Practice in Manchester said:

“Every day we see patients who are struggling with homelessness and horrendous health problems. All of us need good healthcare, but it’s especially vital that patients who’ve fallen through the net can get the support they need to get back on their feet.”

Michael is a patient at Urban Village Medical Practice. He slept rough Manchester on and off for 4 years, until his health deteriorated and he was hospitalised. With the support of the hospital homeless service, Mpath, Michael got into a hostel and got healthcare and drug treatment at Urban Village Medical Practice. As his health and stability increased, he leapt at the chance to move into his own home. He now manages his health conditions with a local GP practice. Michael said:

“Without help from Urban Village and other supporting staff I think I would have died on the streets. Through the practice I’ve completed Hepatitis C treatment, come off alcohol and drugs and got my own place. I can’t thank everyone enough for their help.”

Alex Bax, CEO of Pathway, who host the Faculty of Homeless and Inclusion Health said:

“Good health services can change the lives of people who are homeless. The best services bring together health, housing and social care. Andy Burnham’s commitment to join up services across the city is an amazing opportunity for change.”

Close.

Pictures are available on request.

 

Contact

Cat Whitehouse, Communications Officer
cat.whitehouse@pathway.org.uk
020 3447 8780

 

Notes to Editors

  1. The Faculty for Homeless and Inclusion Health Regional meeting will take place on 26 July 2017, 17:00 – 19:30 at Urban Village Medical Practice, Ancoats Primary Care Centre, Old Mill Street, Ancoats, Manchester, M4 6EE.
  2. Inclusion health is a discipline focusing on the health needs of  people who are homeless, vulnerable migrants, gypsy and traveller communities and people who sell sex, groups that all struggle to access healthcare, but often have serious health problems.
  3. The Academy of Royal Medical Colleges has recently made a joint statement on inclusion health with The Faculty, committing all 24 of the UK and Ireland’s Medical Royal Colleges and Faculties to reducing inequality.

 

About The Faculty

The Faculty for Homeless and Inclusion Health is a network of over 1000 professionals working in inclusion health – a discipline supporting

  • People who are homeless
  • People who sell sex
  • People from gypsy and traveller communities
  • Migrants who are vulnerable

Members include doctors, dentists nurses, social workers, public health experts, support workers, researchers, commissioners and people with lived experience of exclusion. Faculty membership is free, and offers research and updates on inclusion health issues, a network of regional meetings and training events and consultation around the National Service Standards for Homeless and Inclusion Health, endorsed by the Royal College of Physicians. The Faculty is hosted by Pathway, a charity helping the NHS to support homeless people.

Homeless and Inclusion Health Symposium 2018 Call for Papers

Dr Arvind Madan addresses Homeless Health 2017

Homeless and Inclusion Health 2018 will take place in London on 7th – 8th March. We are seeking presentations of interest to our audience of professionals drawn from medicine, mental health, housing, public health, research and commissioning and Experts by Experience who have lived through exclusion.

Presentations should be 15 minutes long, followed by 15 minutes of discussion. Submissions will be assessed by a committee from the inclusion health field.  Areas of interest include academic papers, data describing services or clinical issues, interventions drawn from practice, evidence of service user involvement and the use of multidisciplinary approaches. Preference will be given to members of The Faculty of Homeless and Inclusion Health. The committee looks favourably upon submissions from people with lived experience of exclusion.

A 200 word abstract, made using the enclosed Excel template, should be sent to Katrina.Wright@neilstewartassociates.co.uk by Friday 11 August 2017, 10am.

Terms

Successful submissions will be offered one free ticket per paper for the lead speaker on the day of their workshop, and a reduced price ticket for the other day of the event. Additional speakers are eligible for a reduced fee for the day(s) of attendance.

All presentations at the conference may be recorded and/or filmed, all presenters must agree to this unless there are safety concerns in doing so.

The charity has limited resources and prioritises supporting Experts by Experience (EbE) to attend the symposium. As such we cannot pay travel and hotel costs for speakers unless they are part of the EbE programme and/or there are extenuating circumstances. If this applies to you please indicate this on your submission.

As a thank you for submitting your work, if your paper is not accepted then the Faculty will offer you the Early Bird Delegate Rate, even if this has expired.

Homeless Patients Are Dying Without Support

Research published today reveals that homeless people who are terminally ill are falling between cracks in services, and not able to access the same level of support as others.

Researchers from Pathway, Marie Curie Palliative Care Research Department at University College London (UCL), St Mungo’s and Coordinate My Care worked with homeless people and care professionals and found that many homeless people who may be approaching the end of their lives are living in homeless hostels.

The study is the largest of its kind and the first to describe the lack of appropriate services for homeless people in the UK, from the perspectives of homeless people and those supporting them.

It showed that hostel staff often end up caring for some of the sickest homeless people, despite not having the palliative care training or support to do so.  As a result, huge burdens are placed on hostel staff who do their best to manage with minimal support and very limited resources.

One hostel staff member commented:

“At least three times a shift we check she’s okay.  It’s hard … particularly on weekends and nights when we only have two staff … it’s a big hostel … you really can only do so much … this isn’t an appropriate environment, but it’s the best we have”

Dr Caroline Shulman, Pathway and Marie Curie Palliative Care Research Department, UCL, who led the research, said:

“Hostels provide temporary accommodation. They are not designed to meet the needs of seriously or terminally ill residents. Hostel staff often struggle to secure additional support from social services or palliative care services for their residents who have complex problems.”

Many homeless people die young from conditions such as advanced liver disease, often complicated by mental health problems and/or drug and alcohol issues. There are differences in the type and amount of support available for this group across London, with some innovative attempts to deal with this extremely challenging problem. However the researchers found that overall, homeless people with advanced ill health rarely receive adequate care and support in the community. This results in repeated unplanned and emergency hospital admissions in the last months, weeks or days of life, which can be very distressing.

One of the participants with experience of homelessness commented:

“There’s been a few guys that were in hospital, told they were dying …. They didn’t want to go to any hospice, they didn’t want to … stay in hospital, they wanted to die in the homeless hostel”

The research calls for urgent action to improve collaboration between health, housing, social services and the voluntary sector, with extra support for hostel staff. It also makes recommendations for a specialist health hostel, with staff that not only understand the complex needs of homeless people but can also offer adequate 24-hour support for people with serious illnesses, including those who are dying.

As one of the hostel residents observed: 

“You’ve got to walk past those people.  They half block the stairwell, you have to edge your way past.  It’s kind of … in your face.  Erm, yeah, it becomes part of the furniture.  But it disturbs me as a person…”

Professor Steve Field, Chief Inspector of General Practice at the Care Quality Commission, said: 

“As a GP I have seen how the lack of appropriate and sensitive services can mean that homeless people are denied the compassionate healthcare, dignity and respect that they deserve at the end of their lives.

“This research makes it clear that by working together, healthcare services and the wider system – such as housing, social services and the charity sector – have a vital role to play in improving the quality and co-ordination of care for homeless people as they reach the end of life. Everyone has the right to safe, high-quality, and compassionate health and social care. Through our inspections we have seen services that are providing outstanding care to people who do not have secure housing but it takes strong, responsive leadership and dedicated staff.

“In the coming months CQC will be publishing a detailed report making recommendations on how we as a society can meet our responsibility to the most vulnerable people in our communities who are currently being let down at a time when they need help and support the most.”

The research, published in the journal Palliative Medicine, was funded by the Oak Foundation and supported by Marie Curie, Pathway and Coordinate My Care.

Click here to download the paper from Palliative Medicine (free).

-Ends-

Notes to Editors

Case studies and interviews available on request.

Additional quotes:

Alex Bax, Chief Executive at Pathway, sad: “Pathway is delighted to support this ground breaking research. We knew that homeless people’s experience of care at the end of their lives was often poor, but this new study shows how all parts of the system working together could make things much, much better. The voices of homeless people and the staff who work with them come through loud and clear. Towards the end of life everyone wants to be treated with dignity, respect, kindness and compassion. And homeless people are no different.”

Simon Jones, Director of Policy and Public Affairs at Marie Curie, said: “The majority of people tell us that they wish to be cared for and die in comfort, where they normally live and surrounded by their loved ones. For most people, this means their own home. This important study highlights that for homeless people, home represents something completely different – a hostel, or on the street.  Everyone deserves compassionate care and a dignified death, regardless of where they normally live, or their personal circumstance.”

Niamh Brophy, Palliative Care Coordinator at homelessness charity St Mungo’s, worked on the research. She said: “People who are homeless do not gain access to palliative care until very late in their illness, if at all. Often their choices for care are limited, and their death is more likely to be perceived as sudden, untimely and undignified.

“In recognition of this complexity, St Mungo’s provides the unique service of having a dedicated Palliative Care Coordinator. My role centres around giving our residents with serious health concerns the opportunity to choose their treatment, the chance to reconnect with loved ones, and the possibility to die in a dignified, comfortable way in a place of their choosing.”

The Oak Foundation said: “We are pleased to support the research to improve end of life care for people who are homeless or vulnerably housed. This work is key to strengthening the links between the homelessness sector and health providers.”

 

About the research

  • Homelessness includes not only people who are sleeping on the streets, but also those in insecure or temporary accommodation such as hostels.
  • Participants were recruited across three London boroughs, Lambeth, Hackney and Westminster, selected for their high volume of both homeless people and homelessness services.  Frontline homelessness providers and health and social care professionals were recruited through the research’s team existing connections.
  • 127 participants took part. Over a third (n=39%) of the homeless participants had been homeless for more than five years; 86% reported having slept rough and 71% reported currently sleeping in hostels, most of the time.

recent CQC report acknowledged that people from certain groups in society, including homeless people, experience poorer quality care at the end of their lives and that more must to done to tackle the problem.

Key findings

  1. In London, appropriate services for homeless people with advanced ill-health are lacking. Facilities that can meet the physical and emotional needs of homeless people with advanced ill health, who may continue to misuse substances, are needed.
  2. There is currently a large emotional, and practical burden on hostel staff in supporting homeless people with advanced ill-health due to lack of appropriate alternatives. Homeless people, and those supporting them struggle to access the services required.
  3. There is a conflict between the recovery-focused nature of many services and the realities of health and illness for homeless people that creates a lack of comprehensive person centred care.
  4. Collaboration between health, housing and social services, the promotion of multidisciplinary working including hostel in-reach and greater training and support are urgently needed for professionals and those working with homeless people as their health deteriorates.

About the partners

Marie Curie – care and support through terminal illness

Please note – we are now called ‘Marie Curie’ (not Marie Curie Cancer Care)

Marie Curie is the UK’s leading charity for people with any terminal illness. The charity helps people living with a terminal illness and their families make the most of the time they have together by delivering expert hands-on care, emotional support, research and guidance.  Marie Curie employs more than 2,700 nurses, doctors and other healthcare professionals, and with its nine hospices around the UK, is the largest provider of hospice beds outside the NHS.

For more information visit www.mariecurie.org.uk
Like us at www.facebook.com/mariecurieuk
Follow us on www.twitter.com/mariecurieuk

The Marie Curie Palliative Care Research Department at UCL is an internationally recognised centre of research with a team of over 20 full-time researchers. The department receives core funding from Marie Curie and also undertakes research funded by the National Institute for Health Research (NIHR), the Alzheimer’s Society and other research funders. The department has particular research strengths in the areas of palliative care for people with dementia, prognostication in advanced cancer and the management of cancer-related fatigue.

Pathway

Pathway works to improve healthcare for homeless people. The charity has helped the NHS to create 11 homelessness teams in hospitals across England, supporting over 3000 patients every year. Pathway also develops models to facilitate improvements in patient care, carries out research in new and developing areas, provides training for healthcare professionals and supports specialist commissioning. Pathway hosts The Faculty for Homeless and Inclusion Health, a network of over 900 health and social care professionals providing support for homeless people, vulnerable migrants, gypsy and traveller communities and people in the sex industry.

St Mungo’s

St Mungo’s provides a bed and support to more than 2,600 people each night who are either homeless or at risk of homelessness. As a charity and housing association, we work to prevent homelessness, through more than 250 projects including emergency services, supported housing, specialist physical and mental health services and advice, skills and work services. We believe everyone should have a place to call home and be able to fulfil their hopes and ambitions. www.mungos.org

St Mungo’s Palliative Care Service started in 2007, and since then we have

  • Provided more than 190 residents with end of life care support including bereavement support
  • Delivered training about homelessness and end of life care to more than 300 staff
  • Developed an online Resource packaimed at supporting staff working with people who are homeless
  • Forged greater links and partnership working with services such as a multidisciplinary working group set up to identify earlier on those residents whose health may be deteriorating
  • Partnered on collaborative research and training development with UCL, Marie Curie and Pathway

Coordinate My Care (CMC) 

Coordinate My Care is an NHS urgent care clinical service developed from the concept of a multidisciplinary digital end of life care plan to an urgent care plan for all vulnerable patients. CMC was established in May 2012 to address the need for patients to have integrated, coordinated and quality care. The CMC service is implemented successfully across the 32 London CCGs where it has provided quality improvements and a reduction in unnecessary hospital admissions. As of June 2017, 41,565 care plans have been created.

Palliative Medicine

Palliative Medicine s a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. It reflects the multidisciplinary approach that is the hallmark of effective palliative care. http://journals.sagepub.com/home/pmj

Homelessness Training for GP Receptionists

A young woman behind a GP receptionist desk, smiling and looking helpful.

A new homelessness training package for GP receptionists will be launched this week at Homelessness and Health, the international symposium of Pathway and the Faculty for Homeless and Inclusion Health.

Over 70% of people who are homeless have physical health problems, yet many are wrongly turned away from surgeries at the front desk because they do not have proof of address. People who are homeless attend A&E five times more often than the general population.

Everyone in the UK has a right to register with a GP, and proof of address is not required. The new video and training package is based upon current NHS England Guidance.  It offers simple tips to support patients and shows how important a doctor can be for a person who has lost their home.

Pathway produced the package with Experts by Experience and actors from Cardboard Citizens, on behalf of the NHS Healthy London Partnership.

Click here to view the video and find out more

 

Learning Bursaries for Homeless and Inclusion Health

Lankelly Chase Foundation and Pathway are proud to announce a limited number of learning bursaries for The International Symposium on Homeless and Inclusion Health 2017.  The places are intended for:

  • Lower grade front line clinicians whose organisations cannot find funding to attend the event.
  • People with lived experience of homelessness.
  • Colleagues working in isolated services or settings. 

The funding includes the conference, lunches and teas, and and unlimited access to the online videos after the symposium.  It does not include travel or accommodation (which can be arranged for £100 B&B inc VAT at the conference hotel).

To apply for a place please email Katrina.wright@neilstewartassociates.co.uk and send a short request (100 words  or fewer) explaining why you want to attend the conference, and why you should receive a free place. Applications for free places must be received by Friday 2nd December at the latest.

The International Symposium on Homeless and Inclusion Health brings together 250 health and social care professionals, commissioners, researchers and Experts by Experience supporting healthcare for vulnerable and excluded patients. Details of the 5th event and videos from previous years can be found at www.HomelessnessandHealth.co.uk.  The next event will be held on Wednesday 1st and Thursday 2nd March 2017 in the ILEC Conference Centre, Earls Court, London.

 

Help Change the Face of Commissioning

As healthcare professionals we operate in a landscape shaped by commissioning. The Faculty of Homeless and Inclusion Health is seeking exceptional people to guide that process.

Five years ago the Faculty for Homeless and Inclusion Health published the first Inclusion Health Standards for Commissioners and Service Providers.  The document encapsulates the collected wisdom of Faculty members and provides a best practice guide to commissioning of health services for vulnerable groups. Later versions were endorsed by both the Royal College Physicians and the College of Medicine.

The next version of the standards will be published in Spring 2017. We are looking for frontline inclusion health practitioners in every area to volunteer to help update the standards.

If you would like to be involved in this work please review the current standards and contact us to find out more.

Pathway wins the Kate Granger Award

Kate Granger Awards 2016

We are delighted to announce that Pathway has won the 2016 Kate Granger award for compassionate care.

Chris Pointon, Kate Granger’s husband, read the result and we were presented with the award by NHS England Chief Executive Simon Stevens in front of an audience of health service colleagues at the NHS Expo in Manchester.

This is a huge honour for all the Pathway teams working day-in-day-out with homeless patients in hospital, and a recognition of their hard work and dedication to helping socially excluded people.

Click here to download our press release about the award

Image: Kate Granger Awards 2016 (l-r Chris Pointon, husband of Kate Granger; Samantha Dorney-Smith, Alex Bax and Stan Burridge, Pathway; Simon Stevens, Chief Executive NHS England)

Pathway Shortlisted for the Kate Granger Awards

Pathway Teams at the International Symposium for Homeless and Inclusion Health
Pathway Teams at the International Symposium for Homeless and Inclusion Health

Pathway and 11 homeless healthcare teams across the country are finalists in the Kate Granger Compassionate Care Awards 2016. The team faced competition from 135 other entries to become one of 9 shortlisted nominees.

Medical Director Dr Nigel Hewett OBE said:

“Pathway helps homeless people by bringing together professionals in hospitals. Over 3000 patients every year rely on the kindness, compassion and expertise of Pathway teams across the country. We are delighted that their hard work has been recognised”

Kate Granger was a Consultant Geriatrician and campaigner for better patient care. After being diagnosed with cancer she began the “#hellomynameis” campaign, encouraging healthcare staff to introduce themselves to patients before beginning treatment.

Sadly Kate died earlier this year, but before her death she chose the winners of the awards she helped to set up.

The awards will presented by Kate’s husband at the NHS Expo on 7th September.

National Homeless Health Symposium 2017

Early Bird Bookings Are Open!

Delegates at the 2016 Homeless Health SymposiumBooking is now open for the 5th International Symposium on Homeless and Inclusion Health. The event, taking place in London 1–2 March 2017, already has confirmed speakers from the CQC and the Academy of Medical Royal Colleges.

Discounts are available for members of The Faculty for Homeless and Inclusion Health, NHS staff, Local Authorities and charities.

Save up to £75 when you book before the end of September.

 

Call for Papers

For the first time the event will include opportunities for health and social care practitioners to submit data and papers for presentation. Get in touch if you’d like to present your team’s work.  One recent delegate said:

“Great meeting of minds, incredible networking opportunities and so much learning done!”

Book your tickets today

See pictures from the 2016 event

See videos of the plenary sessions

Listen to podcasts of the seminars

 

The International Symposium on Homeless and Inclusion Health

Challenging Healthcare, Changing Lives

Richard Wilkinson speaks at the International Symposium on Homeless and Inclusion Health
Keynote speaker Richard Wilkinson

Two rainy days in London in March 2016 brought together 300 doctors, nurses, mental health professionals, experts by experience, support workers, commissioners and researchers, united by a single passion: helping vulnerable patients.

The event attracted speakers from all over the world, including:

  • Jane Dacre, President of the Royal College of Physicians
  • Dennis Culhane, Professor of Social Policy at the University of Pennsylvania
  • Professor Richard Wilkinson Professor Emeritus of Social Epidemiology at the University of Nottingham Medical School.
  • Professor Sir Michael Marmot, Director of the Institute of Health Equity, President of the World Medical Association

Audiences in 5 locations across the UK and Ireland joined the debate through remote access. The programme included an impressive 16 unique workshops,  including the implications of novel psychoactive substances, work with gypsy and traveller communities, commissioning services and end of life care for homeless patients.

Our team of Experts by Experience co-chaired many of the sessions, offering unique insight from people who have lived through homelessness and exclusion. As one delegate said:

“Great meeting of minds, incredible networking opportunities and so much learning done!”

Early Bird Bookings 2017

Delegates at the 2016 International Symposium on Homeless and Inclusion Health

The 5th International Symposium on Homeless and Inclusion Health will take place on 1st – 2nd March 2017.  Early Bird bookings are open until the end of September!

For the first time this year’s event will include opportunities for health and social care practitioners to submit papers for presentation. Get in touch if you’d like to present your team’s work.

See pictures from the 2016 event

See videos of the plenary sessions

Listen to podcasts of the seminars