Health Commissioning for Excluded Groups

This module is part of a digital training package on health inequality and the social determinants of health. It will take around 1:30 – 2:00 hours to complete.  The case studies will require an additional 1:30, plus reflection time.

This module provides health service commissioners and policy-makers with strategic and practical information to influence local decision-making to support homeless and excluded people.  It provides opportunities to hear about key issues impacting on the health of marginalised groups living with multiple morbidity .

The material focuses upon a shift from risk-based to person-centred and preventative approaches, transforming primary care in deprived areas, acute trusts’ potential contributions to Inclusion Health and meeting complex needs through integrated health, social care and housing.

The module includes regional case studies with models of transferable learning, as examples of what can be achieved through creative and inclusive approaches to delivering health services for homeless people, and vulnerable migrants amongst others.

Additional units to supplement this learning are listed in the side bar.

Caring Commissioning

Professor Aidan Halligan calls upon people working with vulnerable groups to come first from a place of caring, and to call for action.

Professor Aidan Halligan – Homelessness, Social Exclusion and Health Inequalities

Inclusive, Person-Centred and Prevention Oriented Commissioning

Julian Corner is the Chief Executive of Lankelly Chase Foundation, an independent funder aiming to fundamentally shift the way society supports people who face severe and multiple disadvantages. Julian was previously Head of Strategy for Crime and Policing at the Home Office and Chief Executive of Revolving Doors Agency.

His presentation makes a compelling case for shifting to inclusive, person-centred and prevention oriented approaches to commissioning and delivering services.  The presentation examines the individual and societal cost of locality-based and risk-management approaches to decisions about service entitlement and provision for people with complex needs.

Julian Corner – Homelessness, Social Exclusion and Health Inequalities

General Practitioners at the Deep End

Professor Graham Watt is Professor of General Practice at the University of Glasgow and Co-ordinator of GPs at the Deep End.  Based on detailed research, including work with GPs in deprived areas in Scotland, Graham presents evidence of the inverse care law, patterns of multi-morbidity and deprivation, and their impact on health.  He calls on the NHS and Public Health community to consider the relevance of these challenges to their core business.

GPs at the Deep End demonstrates the realities of providing primary care to meet complex needs in the face of resource constraints, highlighting practical changes in approach which can be applied to transform primary care, with a focus on relationships, genuine integration, and local leadership.

Professor Graham Watt – Transforming Primary Care: the experience of Scottish GPs in deprived areas.

Inclusion Health from an Acute Trust Perspective

Toby Lewis, Chief Executive of the Sandwell & West Birmingham Hospitals NHS Trust draws on his senior NHS experience and his involvement in homeless healthcare provision to make the case for acute sector engagement in Inclusion Health initiatives.  He demonstrates the importance of hospitals playing a key role, and provides practical examples of what’s possible, sharing experience from the community-engagement approaches adopted by the acute trust he has led since 2013.

Toby Lewis – Inclusion Health from an Acute Trust Perspective

From Exclusion to Access

The NHS England Health Inequalities team (Ranjit Senhera, Christina Marriot, Haib Naqvi and Hanna Rees) offer a package of presentations on inclusion health and equality.  Their presentations focus on national policies, resources and priorities and their implications for local action.  They explore health inequalities, parity of esteem between physical and mental health, and a range of other issues related to improving access to high quality healthcare to those with the greatest need. There are 30 minutes of optional questions from delegates at the end of the seminar.

Ranjit Senhera, Christina Marriot, Haib Naqvi and Hanna Rees – From Exclusion to Access.

Case Studies

Transforming Primary Care

Experience and lessons from 25 years of specialist provision to homeless people, from Dr Sally Reynolds, GP, Luther Street Medical Centre, Oxford.

Specialised Services for Homeless People

The Safetynet Network of services in Dublin, with Dr Austin O’Carroll, GP Mountjoy Street Family Practice, Dublin.

GP-Led Outreach

The health team for homeless people in Copenhagen, Denmark, lead by Henrik Thiesen, Manager and Senior Physician.

Street Medicine

Lessons from the USA Street Medicine Institute and other international examples, with Jim Withers MD, Medical Director and Founder, The Street Medicine Institute.

Transforming Local Service Provision for Vulnerable Migrants

Experiences from services in Harrow, based on a new Mind / Doctors of the World resource for commissioners – Josie Hinton, Bridging Cultures, Senior Worker, MIND.
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The information in this e-learning resource has been collated by The Faculty for Homeless and Inclusion Health to support learning, collaboration and good practice. This has been sponsored by Public Health England as part of its commitment to sharing evidence and promoting the development of effective local leadership and good practice.