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The homeless community: breaking down the barriers to primary care

02 August 2017
Volume 7 · Issue 2


The number of homeless adults on our streets is increasing which, due to their associated health problems, is causing increasing demand and inefficiencies on the National Health Service (NHS). Currently the homeless are experiencing inequalities of healthcare due to a lack of access to primary care. As a consequence, there has been an increasing use of secondary care, which has become the preferred provider of healthcare for the homeless community. Homeless health is often complex involving tri morbidity and although legislation already exists to embrace these needs within current models of primary care, they are not being met. Innovative and specific healthcare models are needed in order to access this disengaged community. This project is focussed on delivering an accessible primary care clinic specifically for the homeless community. The project will deliver improved efficiencies and reduced costs for the NHS, including ambulance services, which will benefit the wider community and reduce the inequalities of health currently being experienced. It is hypothesised that this increased provision of primary care to the homeless demographic will result in reduced morbidity and mortality, improved health and a more efficient NHS which is vital in the current climate of austerity and uncertainty.

Being homeless and sleeping rough is sadly not a new phenomenon. The numbers of homeless people all across England have been increasing over recent years (Crisis, 2016; DCLG, 2016) and a research project carried out on behalf of ‘Crisis’ and the ‘Joseph Rowntree Foundation’ suggests that the numbers will continue to rise in the future (Crisis, 2017) In England, the estimated number of rough sleepers in 2010 was 1768 (Crisis, 2016), 3569 in 2015 and 4134 in autumn 2016 (DCLG, 2016). In Manchester the figure was estimated to be 7 in 2010 and 70 in 2015 (Crisis, 2016). In 2015 there had been a 62% increase in rough sleepers in Manchester from the previous year. This is much higher than the national average increase of 30%, which makes Manchester the fourth highest area of rough sleepers in the UK (DCLG, 2016; UVMP, 2016). The rapid increase in the numbers of homeless adults in Manchester has been attributed to the thriving night life and its associated opportunities to access street funds (UVMP, 2016). The Voluntary groups who often work closely with the homeless community believe that the figures produced by local government largely underestimate the true numbers of homeless in their areas (Crisis, 2017). The average age of death for the homeless is 47 years for men and 43 years for women (UVMP, 2016. DoH, 2010). Homelessness itself is a marker of morbidity and many of the homeless have a long-term mental, physical or addiction problem (Aspinall, 2014; Fazel et al, 2014). These health problems are then often left unattended due to the homeless community experiencing barriers to accessing primary care (Riley et al, 2003; Canavan et al, 2012; Aspinall, 2014).

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