The Forums Health Review

Read the Forums Homeless Health Review 2015

Healthwatch Gloucestershire Report - Report on access to health and social care services  by marginalised and vulnerable people in Gloucester. It was heartening to read, in the HWG Report, that the feedback about the Homeless Healthcare Team (HHT) was particularly positive and should be used as a model of Best Practice. Read the article in the Citizen here.

Charter For Homeless Health.

We support St Mungo's Health Matters Campaign. One of our recomendations in our Review, includes encouraging Gloucestershires Health & Wellbeing Board to sign up St Mungo's Charter for Homeless Health. 42 H&WB Boards around England had signed up, that's more than 1 in 4! A number of Boards had signed up jointly with their respective Clinical Commisioning Groups.

We are really pleased that Gloucestershire's H&WB Board has now signed up.

The County Council 'Joint Strategic Needs Assessment' (JSNA),  unfortunately does not include homeless healthcare. We recognise the JSNA as a strategic document and at present there is an important omission, sadly we are told Homeless Health was not a priority. We are working with the Director of Public Health and her team on taking this forward. Click HERE to read about JSNA's. Click here for the subsequent 'JSNA Briefing Paper' for the Forums meeting on the 15th June, Agenda Item 4.

Our Homeless Health Review encouraged Gloucestershires Health & Wellbeing Board to sign up St Mungo's Charter for Homeless Health. At the time 42 H&WB Boards around England had signed up. Gloucestershire's H&WB Board HAS signed up as at JULY 2016. We had a meeting with the CCG and Gloucestershire Care Services, see notes of meeting in members area, (other minutes) and the CCG kindly offered to liaise with the H&WB to take this forward on behalf of the Forum, ....we thank everyone involved.

Great News. On the 19th July the GHWB adopted the Homeless Health Charter. A big thank you to the CCG, Board Members, Commisioners, Sarah Scott and officers. Looking back, on the 24th May the Gloucestershire Health and Wellbeing Board (GHWB) approved a policy that describes an approach to ensure the Board signs up to charters and policies relevant to its function. The Homeless Health Charter had been assessed using the policy and there was recommendation to the Board at their next meeting on the 19th July, click HERE for agenda papers, minutes.., that they adopt the charter. This is really important for the health care of our homeless and vulnerable as it should now be a trigger for the JSNA. Forum members were encouraged to attend the meeting and support the GHWB as it was open to the public. Director of Public Health is  planning to meet with the relevant officers in the County Council and the Clinical Commissioning Group to discuss how to implement the charter and will be in contact with us in due course. Helpful GHWB Relationship Chart.


St Mungo's Homeless Health Matters - campaign impact October 2015


Service Users & Clients of the Day Centre and Homeless Health Team

The Forum was very concerned following closure of the Vaughan Day Centre on the 3rd January 2015 and the future of the Homeless Health Team. It was apparent that there had been no consutation with clients or service users by the appropriate authority's and there was a lack of any feedback. This lack of data collection or evidence to help improve service delivery, was a big concern.

Another of the Review recomendations was to talk to Healthwatch to see if they would undertake investigations and have conversations with clients and service users. A meeting was held with Healthwatch and we were really pleased that they agreed to carry out visits to faith weekly outreach provisions to find out what had been the impact of the closure. These visits were undertaken and Healthwatch updated the forum at our meetings until the County Council re tendered the Healthwatch contract and this once again broke up links and negatively affected consistency/effectiveness. 


The Homeless Health Team (HHT) - link for details

The Forum followed up concerns re the future of the HHT with the CCG and Gloucestershire Care Services. We were really pleased with their joint committment and full support of the HHT. Full Notes of our meeting are in the members area in 'Other Minutes'; extracts are as follows:

.........grave concerns about the present and future of the effective and award winning HHT who have been strongly negatively affected by the closure of the GEAR Day Centre as detailed in our Discussion Document, such as loss of GEAR support staff and loss of crucial work of patient advocacy and social support, loss of humanitarian services such as personal hygiene, washing facility’s, safeguarding, good nutrition, etc. Concerns that the service had to be reduced from a very effective ‘drop in’ to an ‘appointment only’ service...........

...........recognised the real importance of this specialist health care provision to the homeless. Dr Helen Miller, Clinical Chair of the CCG, and Ingrid Barker, Chair of GCS fully supports the HHT and homeless services and is particularly keen to help reduce inequalities, especially for the more vulnerable people in the community such as the homeless, the chaotic and those with complex needs, who find it hard to advocate for themselves..........


Helpful Information.

Homelessness and health research (extract from Homelesslink)

In 2010, Homeless Link first published national data looking at the health of homeless people in England. Our latest research looks at how health and the support available have changed since then. 

Latest findings

Based on 2,590 responses from people using services in 19 areas across England, the unhealthy state of homelessness highlights the extent to which homeless people experience some of the worst health problems in society.

Widespread ill health

  • 73% of homeless people reported physical health problems. 41% said this was a long term problem. 
  • 80% of respondents reported some form of mental health issue, 45% had been diagnosed with a mental health issue.
  • 39% said they take drugs or are recovering from a drug problem, while 27% have or are recovering from an alcohol problem.
  • 35% had been to A&E  and  26% had been admitted to hospital over the past six months.  

Worse than the general public

  • 41% of homeless people reported a long-term physical health problem (compared to just 28% of the general population).
  • 45% had been diagnosed with a mental health problem (25%).
  • 36% had taken drugs in the past six months (5%).

Unhealthy lifestyles

  • 35% do not eat at least two meals a day.
  • Two-thirds consume more than the recommended amount of alcohol each time they drink.
  • 77% smoke.

Not enough help

  • 15% of respondents with physical health needs reported not receiving help.
  • 17.5% of those with mental health issues and 16.7% with alcohol issues would like support but are not receiving it.
  • 7% have been denied access to a dentist or GP. 

Signs of progress

There is evidence of improvements in a number of areas since our 2010 report. According to the latest data 36% of homeless people admitted to hospital report being discharged onto the streets with nowhere to go.  In 2010, this issue was reported by 73% of respondents admitted to hospital. 

Following Homelss Link and St Mungo's research in 2012, the Department of Health announced £10m of funding for 52 projects to improve hospital discharge procedure for homeless people.

Our evaluation of this project shows that results can be greatly improved when housing and health are jointly commissioned. In projects containing NHS and housing staff, 93% of patients were discharged to suitable accommodation.   

Where next?

The homeless hospital discharge evaluation reiterates our call for homelessness to be considered a health issue, and for the housing and health sectors to work more closely. However, this is only possible with investment and commissioning of the right services.