1. How does this film make you feel?

2. What barriers to accessing care are highlighted in this film? Do similar barriers exist in your local services?

3. Are there any barriers to GP registration locally?

4. Are people in your services required to repeatedly retell their story? What impact might that have on them? What can be done about this?

5. What support is available for someone with language barriers?

6 Are there any ways in which services could be more inclusive to specific groups (e.g. vulnerable migrants, people experiencing homelessness, people leaving prison, Gypsy, Roma, Traveller populations)

To find out about ways you can support people inclusion health groups to register with a GP:

NHS Learning Hub – Supporting GP registration for people experiencing homelessness 

Groundswell – My Rights to Access Healthcare Cards 

Doctors of the World – Safe surgeries toolkit 

Homeless Friendly project 

Friends, Families and Travellers – Finding Healthcare 

1. How might psychological trauma affect people’s behaviour, communication, and engagement with services?
2. Have you ever felt overwhelmed or reacted strongly in a healthcare or waiting environment? How might someone who has experienced trauma feel in a similar situation?
3. How welcoming and accessible are your service environments? How could the physical environment (e.g. waiting areas, layout, privacy) be improved?
4. How could services welcome and support people who have previously felt judged or stigmatised?
5. What do you think of the Zero tolerance policy in the NHS, and how does it fit with trauma informed care?

To undertake free online training to help you support people who have experienced psychological trauma: 

NHS Learning Hub – Trauma Informed Care 

Thrive – Trauma Informed Practice 

To learn about the reasonable adjustments for people with physical and mental health impairments: 

NHS Reasonable Adjustments 

1. How might adverse childhood experiences (e.g. family support, finances, trauma) effect their adult lives?
2. What factors might influence a person’s ability to make choices about homelessness and/or addiction?
3. Do you think there is enough support to prevent people getting into homelessness and/or addiction. What does this look in your area?
4. Could something like this have happened to you or someone you know under different circumstances?
5. Where do you think the line is between “choice” and “lack of control” in addiction? Do you think different practitioners differ in their views, and what problems could this create?

You can read responses of key agencies to the Suella Braverman ‘Lifestyle Choice’ claim here:  

Shelter: Homelessness is not a lifestyle choice 

Crisis and other key organisations: Open letter to Home Secretary Suella Braverman on Government proposals to criminalise the use of tents by people sleeping rough 

You may also wish to watch another short film on the same topic: 

A Lifestyle Choice 

Finally, the notion of ‘lifestyle choice’ often features in decisions about whether to intervene when people are known to be self-neglecting. This is a complex area. To find out more on this topic go to: 

University of Bristol – Mental Capacity, Self-Neglect, and Adult Safeguarding Practices: Evidence Synthesis and Agenda for Change 

You can also listen to this 10 min presentation from Jess Harris at Kings College London which discusses the complexities of the notion of lifestyle choice. 

Safeguarding for people experiencing homelessness and self-neglect 

1. Why did you enter a caring profession? How does your day-to-day practice reflect those values?
2. How do you explore what matters most to the service user?
3. Do you think you are able to deliver person-centred care in your role? If there are challenges to this, what are these, and how could you begin to overcome them in the current financial environment?
4. How would you know if your care was being experienced as person-centred?
5. How does your service gather feedback from patients/service users?
6. Does your service act on the feedback it receives?

The NHS vision for personalised care encompasses six, evidence-based approaches, each of which are defined by a standard set of practices.  

These are: 

1. Shared decision making 

2. Personalised care and support planning 

3. Enabling choice, including legal rights to choice 

4. Social prescribing and community-based support 

5. Supported self-management 

6. Personal health budgets and integrated personal budgets 

Head to the NHS ‘Comprehensive model of personalised care’ webpage to find out more. 

1. What stands out to you about the recovery journeys described in the film?
2. What are the key stages or turning points in these journeys? What helps people move from crisis to recovery?
3. What role does “one person” (trusted relationship) play in recovery? How can you be that person in your practice without crossing boundaries or becoming overwhelmed?
4. What support systems or opportunities helped people progress in this film? How can your service better enable these opportunities?
5. Julian highlighted that many of his health problems were attributed directly to addiction, rather than other causes (this is called diagnostic overshadowing – focusing on one issue and missing others). Do you think you have seen this happen, and how can this be overcome?

All our films highlight many organisations as well as Pathway that support and aim to empower people with a lived experience of homelessness both during their recovery journey and after they leave homelessness. 

These include: 

Groundswell: A dedicated homeless health charity that operates as a community of people with lived experience. They run a Homeless Health Peer Advocacy team, where people with personal experience of homelessness support others to attend health appointments. They also undertake many peer led research projects. 

Museum of Homelessness: A social justice museum and community day-centre co-run by those with lived experience, delivering direct support, art programmes, and campaigns rooted in firsthand perspectives. 

Lived Experience Advisory Forum Oxford: LEAF raises the voices of Experts Through Experience to help improve service delivery and achieve better outcomes for all across Oxfordshire and nationally, whilst also offering forum members new opportunities, connections, and room for growth. 

The People’s Recovery Project: This community works primarily with rough sleepers with addictions problems and supports then over the longer term make transformational recovery journeys. 

Crisis: The national youth and single homelessness charity uses an Experts by Experience Panel to co-produce strategies, inform service delivery, and guide public education, and supports people to access further opportunities to get involved. 

Many major charities also have Lived Experience Advisory Panels that people with a lived experience of homelessness can get involved with. 

Examples include: 

Single Homeless Project (SHP): Has a peer mentoring programme and supports co-production, and client voice initiatives driven by people with lived experience.  

Housing Justice: Coordinates a London-based Lived Experience Group meeting regularly to advise staff on project development and host schemes.  

The Passage: Features a Lived Experience Assembly (LEA) whose members engage directly in governance and strategic decision-making based on their personal histories of rough sleeping. 

1. What does meaningful involvement of people with lived experience look like? How do you avoid tokenism?
2. Why is lived experience important in service design and delivery? What difference does it make?
3. What volunteer and paid opportunities exist for people with a lived experience of homelessness in your organisation?
4. At what levels do those opportunities exist (frontline, advisory, leadership)? Are there pathways into senior roles and leadership positions?
5. What support do you think might be needed to enable people with a lived experience to succeed in roles like these? How could reasonable adjustments and ongoing support be put in place?

Groundswell is an organisation that supports people with a lived experience of homelessness to become Homeless Health Peer Advocates. 

Organizations such as St Mungo’s, Thames Reach, Single Homeless Project, and The Passage routinely value lived experience in frontline recruitment.  

NHS organisations can employ people with a lived experience of homelessness in a variety of roles. To support more NHS organisations to do this Pathway contributed to the production of the: 

NHS Employers Toolkit: Recruiting people with experience of homelessness toolkit 

This report accompanied the project: 

Access to Employment in NHS Health Care Support Worker Roles for People with Lived Experience of Homelessness: Programme Evaluation Final Report