WIDER POLICIES
Commentary on Health Policy

A nationwide drive to increase the proportion of homeless people registered with a GP

It appears that a substantial proportion of homeless people are not registered with a GP.  The first conclusion is therefore that government in England, Scotland and Wales should consider a GP registration drive among homeless people.

Stimulating local health services focussed on homeless people

The national health organisations in England, Scotland and Wales all appear to have given substantial thought to the subject of health and homelessness.

In Scotland, there is a comprehensive framework which includes a set of national standards and the requirement that all Health Boards develop health and homelessness action plans.

England and Wales have established a variety of service models for improving healthcare to disadvantaged groups - including the homeless.  The issue here is whether, in practice, these models are actually implemented on the ground.  In particular, all three initiatives - Personalised Medical Services, The National Enhanced Service for Homeless People and Alternative Provider Medical Services - require a local health provider (GP, Primary Care Trust or specialist provider) to take the initiative, in terms of both the shape and - indeed - the very existence of the services to be provided.  If no local health provider takes the initiative in a particular geographic area, then there will be no health services specifically focussed on the homeless in that area.  In other words, current arrangements allow for - and indeed, encourage - the development of health services to meet the needs of homeless people.  But currently these arrangements guarantee neither the volume nor the quality of such provision.

• Homeless organisations should circulate authoritative material on the health needs of the homeless to all Primary Care Trusts and Health Boards:  The conclusion is that the major national voluntary organisations working with the homeless should put together some authoritative material on the health needs of the homeless and how these best be met, for circulation to all Primary Care Trusts (England) and Health Boards (Wales).  The aim would be to raise the awareness of Primary Care Trusts about the health needs of homeless people.  One particular subject that this material should address is, whether treatment for drug misuse among homeless people should simply be part of the mainstream drug treatment services or whether additional and specialised services (such as outreach services) are required. 
• Homeless organisations should take a lead in raising awareness about APMS initiatives:  The new Alternative Provider Medical Services initiative provides an additional opportunity, namely for voluntary organisations working with the homeless to take direct action themselves to ensure that their health needs are met.  The conclusion here is that the major national voluntary organisations working with the homeless should take a lead in this, raising awareness of the initiative amongst the voluntary sector and developing guidelines to help such organisations both initiate and run Alternative Provider Medical Services schemes.

Page last modified on 22/06/2006 at 12:11