In this section:
This year, why not enjoy a day out at a National Gardens Scheme garden - you'll be helping fund the QNI too!
Providing vital funding for projects that help improve patient care.
Visit our nursing heritage website, a celebration of District Nursing around the world since 1859.
You may equate St John Ambulance with first aid at football matches, concerts and other public events. But since 2003 St John Ambulance Homeless Service (SJAHS) has been operating a nurse-led healthcare service for homeless and vulnerably housed people in Hastings & St Leonards in response to local health inequalities and a lack of accessible healthcare facilities for homeless people. Despite being located in the relatively affluent county of East Sussex, Hastings is one of the most deprived towns in the country, on a par with many northern cities (English Indices of Deprivation, CLG 2010).
As well as delivering four nurse-led clinics per week at a day-centre (Seaview Project) for homeless and vulnerably housed people and a fortnightly session at a soup kitchen (Hope Kitchen), SJAHS has an arrangement with the Conquest Hospital, whereby all homeless patients are referred to the service for advocacy and support.
A SJAHS nurse will visit the patient on the ward within a day or two of receiving the referral, to assess the client and begin to help with discharge planning, to ensure the best possible discharge, with all the support and follow-up health care required in place, and with the patient rehoused if at all possible. Although SJAHS is not a housing service, we work closely with many other local voluntary and statutory agencies, have a very good working relationship with Hastings Borough Council Housing Services, and advocate on clients’ behalf, accompanying them to housing and health appointments after discharge.
The team’s Nurse Co-ordinator, Roger Nuttall, is a paid employee of St John Ambulance, who also employ a podiatrist for a weekly foot care clinic at Seaview, but the service depends on a team of volunteers, currently comprising 5 active nurses (including a midwife and a mental health nurse) and 9 general volunteers, who together deliver many of the clinics. One of the general volunteers also visits clients on the hospital wards to assist with the advocacy and support work there.
Although SJAHS is essentially a healthcare service, offering wound care, general health advice, nurse prescribing, health promotion provision of general social support is a core aspect of the service provided. Consultations at clinics are not limited to 10-minute slots, but volunteers and staff will spend time chatting and listening to clients, employing basic counselling skills to give clients a sense of dignity and self-worth.
Homeless people are 11 times more likely to suffer from depression and/or anxiety than the general population (Wendy Bines, 1994) and many have experienced a series of traumas and rejection. Being given acceptance, dignity, respect and time to talk can help instil a sense of self-belief and promote motivation to take whatever actions are needed to get rehoused / deal with dependencies and other issues.
Steve (not his real name) was admitted to hospital twice in quick succession with deliberate overdoses of painkillers. He admitted that these were not suicide attempts, but a plea for help to get housed.
With a very chequered housing history, and now street homeless, there were no agencies, landlords or family willing to house him. The Homeless Service supported Steve in hospital and after discharge, advocating to a number of agencies for support, while Steve maintained that he was intent on leaving his drug-centred (amphetamines) lifestyle behind him.
As a result Emmaus initially helped to fund temporary accommodation, while a local supported housing project assessed his motivation as to how genuine he was in wanting to change.
Eventually Steve was accepted and settled well into the supported housing project, engaging fully with the support offered there. During the 4 months (at time of writing) since his discharge from hospital, Steve has been working voluntarily almost every day with Emmaus, in their warehouse and delivering furniture, greatly enjoying it, has stayed ‘clean’ from drugs and is in hugely improved health.
For more information about St John Ambulance Homeless Service Hastings, please contact Nurse Co-ordinator, Roger Nuttall at: [email protected] or on 01424 435358, or visit: http://www.sja.org.uk/sja/counties/sussex/hastings-homeless-service.aspx
Communities and Local Government (CLG). 2011. The English Indices of Deprivation 2010. CLG. Available at: http://www.communities.gov.uk/publications/corporate/statistics/indices2010
Bines, W. 1994. The Health of Single Homeless People. York: Centre for Housing Policy, University of York. Available at: http://www.york.ac.uk/inst/chp/bines.pdf