Mapping of specialist primary health care services in England for people who are homeless. Summary of findings and considerations for health service commissioners and providers

Homelessness has been a growing problem in many towns and cities across England since 2010. It can have a serious adverse impact on a person’s health and well-being. People who are homeless and sleeping rough or staying in hostels and shelters have significantly higher levels of physical and mental health problems than the general population. They also have higher rates of problematic drug and alcohol use (Wright and Tompkins, 2006).
There are challenges in meeting the health needs of people who are homeless. Many neglect their health, and their unsettled lifestyle and sometimes chaotic behaviour reduce their likelihood of completing treatment programmes. At the same time, many people who are homeless face barriers in accessing health services, including the inflexibility of services and appointment systems, negative attitudes from some health staff, and the difficulties that services have in treating people with complex and multiple needs.
This summary report presents key findings from a systematic mapping exercise across England of specialist primary health care services for single people who are homeless. It raises questions for consideration by health service commissioners and providers about the provision of primary health care services for this patient group. The mapping exercise was part of a larger study in progress which is examining the integration, effectiveness and cost-effectiveness of different models of delivering primary health care to people who are homeless (HEARTH study).
The HEARTH study is funded by the Health Services and Delivery Research Programme of the National Institute for Health Research, and is being conducted at the Social Care Workforce Research Unit, within the Policy Institute at King’s College London, and at the University of Surrey. Ethical approval for the study was obtained from London Bloomsbury Research Ethics Committee (Reference 15/LO/1382).