Homeless Health Project Funding
This funding programme is part of the QNI’s Fund for Innovation and Leadership programme, supported by Oak Foundation.
The QNI selected and funded ten community-based nurses to lead innovation projects in the field of homeless and inclusion health. These projects are based in different parts of the country – Birkenhead, Birmingham, Blackburn, Brighton, Bristol, Croydon, Newham, Southwark, Surrey and Weston-Super-Mare.
Each project received up to £5000 to develop and deliver an innovative approach to caring for vulnerable groups. Each project focused on a specific cohort of patients within homeless and inclusion health. This included people in prison, people sleeping rough, families in Traveller communities and people in temporary homelessness accommodation.
Nurses’ ideas ranged from TB testing and education in prison to Hepatitis C testing in homeless day centres, to developing kits to avoid infection following self-harm, wellbeing workshops, and child oral health outreach.
The QNI project management team visited all ten projects during 2018 to observe each project in action, talk to the lead nurse and to offer constructive support to help overcome challenges and develop solutions.
Each project has completed an interim report, to share progress after the first 5 months and to review the potential of the intervention to achieve better health outcomes for people who are experiencing homelessness.
Download our report that summarises the information provided by the project leaders.
If you wish to find out more about the projects or programme of work, please contact [email protected].
Summary of projects
Self-Harm Awareness Group
Project Lead: Kelly Smith Job title: Community Matron Outreach Team Location: Weston-Super-Mare
This project will provide a regular self-harm support group, in a safe, non-judgemental environment. Their goal is to cover all aspects of self-harm including emotional, physical and psychological, provide health education on harm reduction, reducing infection and signposting to other agencies. The group is planning to give out emergency first aid kits with supporting information and identifying those at high risk.
LEAP AHEAD Project
Project Lead: Julia Mullaney Job title: Advanced Nurse Practitioner Location: Darwen, Blackburn
The project’s aim is to reduce inequalities and improve the access to general practice for individuals at the James Street Project – a supported housing scheme for single homeless individuals with low to moderate support needs aged 16-65. It will reduce barriers to engage with healthcare to provide safe effective and appropriate care and identify health priorities for the individual. It is hoped that the project will increase uptake of flu, pneumococcal, MMR and meningitis immunisations, reduce smoking rates, and reduce the risk of diabetes and heart disease through targeted education.
Latent TB Screening and TB Awareness at HMP Birmingham
Project Lead: Julie McLoughlin Job title: TB Clinical Nurse Specialist Location: Birmingham
The project is focused on offering screening and treatment for latent tuberculosis as a pilot project to a designated cohort of identified prisoners at HMP Birmingham. Prisoners who have a positive IGRA result will undergo assessment and will be offered chemoprophylaxis treatment for latent TB infection in a nurse led clinic at the prison. This will improve the health outcomes of a vulnerable population who often have a history of homelessness, drug or alcohol misuse, are a high-risk group for developing TB disease following exposure, and often present late to TB services. TB prevention, control and its eventual elimination would result in savings to the NHS, CCGs and public health, from avoidable costs associated with diagnosis and treatment of drug-sensitive and resistant forms of TB.
Five Ways to Wellbeing
Project Lead: Claire O’Connell Job title: Primary Care Nurse Location: Bristol
This project aims to improve the emotional and mental wellbeing of homeless people, who access their services, by 20%, using the ‘Five Ways to Wellbeing’ approach, (National Economic Forum, 2008). They plan to present this approach in an innovative way, to support clients to experience the five ways to wellbeing for themselves by regularly taking part in five aspects of life; ‘connect’, ‘be active’, ‘learn’, ‘take notice’ and ‘give’ which can improve their wellbeing.
Improving Skin Conditions and Respiratory Health of Rough Sleepers and Asylum Seekers
Project Lead: Paul Coleman Job title: Clinical Lead/ Advanced Nurse Practitioner Location: Croydon
The project aims to ensure timely treatment of scabies and infestations by improving access to for dermatological support for complete treatment cycle. This will include new clothing provision. Many of the homeless and refugee patients do not have access to clean clothes. Asylum Seekers often only have the clothes that they arrive in; rough sleepers have no access to laundry facilities, and are therefore unable to eradicate scabies from their clothing. Because many of our refugee clients have had scabies for many weeks, and in some cases months, without treatment, they often end up with skin cysts which require onward referral to Dermatology. This project includes creating a seamless pathway to the local Dermatology Department. It also aims to treat rough sleepers with skin or respiratory conditions (rashes and infections) by providing new underwear, socks and shoes and other clothing, as part of the treatment, with the aim to measure and improve conditions more effectively than usual care.
Touch Base Clinic
Project Lead: Margaret O’Sullivan Job title: Community Viral Hepatitis Nurse Specialist Location: Brighton
First Base is an established homeless drop-in centre in Brighton where 1,200 street homeless people attend yearly for provision of food, showers and support. The project aims to provide point of contact Hepatitis C testing by staff supported and trained by Margaret. The project will have a clear fast track pathway for linkage to specialist services if Hepatitis C positive. The project will identify volunteers who will provide support to attend appointments and support client travel expenses. The overall aim is to increase testing for Hepatitis C, improve linkage to care to reduce morbidity and mortality for this vulnerable cohort.
Project Lead: Kendra Schneller Job title: Nurse Practitioner Location: London
This project aims to meet a specific need of targeted homeless, rough sleeping clients who are not currently accessing primary health care services. HIT Plus hopes to have an increase in the number of clients who are able to access and register permanently with a General Practitioner, access and use nursing services to address any acute concerns, be screened for blood borne viruses and vaccinated against influenza, pneumonia, hepatitis A+B and any other suitable vaccinations.
Drop in and NHS Health Check Outreach Clinic
Project Lead: Patsy Dodd Job title: Advanced Nurse Practitioner Location: Wirral
This project will develop a nurse-led clinic which is able to provide primary care to Wirral Ark residents and non-residents on the Wirral. The overall project aims are to reduce attendance at A&E, walk in centres and GP and reduce inequality of access to health care for homeless people. These aims will be achieved by providing a two-fold service: NHS Health checks to all Wirral Ark residents aged 40-75 years and drop-in services to homeless people who are non-residents.
The Health Bus
Project Lead: Lisa Gavin Job title: Lead, Homeless Health Location: Surrey
The aim of the project is to use an underused community resource (the Playbus) to deliver key health promotion messages to the local Gypsy, Roma and Traveller communities, in face-to-face contacts, using culturally appropriate tools and styles of delivery. They also aim to use basic screening to enable the community to identify their own risks of targeted conditions, including diabetes, heart disease and strokes and mental health, including male suicide and to support them with signposting and engagement, where risks are identified. The health benefits include offering early intervention for previously undiagnosed diabetes and persons at risk of heart disease and strokes by offering culturally accessible and acceptable health promotion, frontline screening and referrals to GP and other services.
Health Champions for the Homeless
Project Lead: Sihle Malapela Job title: Nurse Practitioner Location: London
The aim of this project is to establish a peer support group for the homeless population residing within Newham to act as health champions. The health champions will have a particular focus on the better management of diabetes, mental health and respiratory conditions. These are all high priority areas both locally and nationally.
The health champions will be empowered to deal with health related issues through a structured health development programme. The group will also act as a resource for fellow homeless people living within Newham and will sign-post peers to appropriate health services and promote self-management. This is an effective approach to improving health outcomes for people who are homeless, as they are more likely to trust peers with a similar background.