Health for All – Universal Health Coverage

Homeless Heath

Homelessness is one of the biggest challenges of our time and an indictment on our society.   Tackling homelessness is one of the key priorities for the Nursing Now Northern Ireland Campaign.

There are increasing numbers of people who are experiencing homelessness across Northern Ireland.

These are people with a combination of mutually reinforcing challenges including homelessness, drug and alcohol misuse, offending behaviour, mental ill health, poor physical health, including sex workers.

People in these situations have often experienced childhood trauma, family breakdown, domestic abuse and other major life changing events.

The average life expectancy of a person experiencing homelessness is just 47 years, and unfortunately there have been a number of high profile deaths on our streets recently.

Despite the health issues faced, individuals who are homeless face real barriers in accessing health and social care services. 

Therefore in relation to improving health of Homeless people this was a key area for the campaign to focus.

In the video below Chief Nursing Officer Professor Charlotte McArdle outlines, to nurses and health officials, her key priorities to improve health inequalities, homelessness, drug and alcohol addiction, childhood obesity and mental health issues across NI.

Nursing has a key role to play in delivering care and support to homeless people.

Nursing is taking this opportunity to set out a definitive pathway which will improve the health and wellbeing of homeless people in the long-term. Nursing recognises that it will require input and buy-in across all professions and nursing will work closely with the voluntary and community sector, and our colleagues in other Departments and statutory bodies, to co-produce and deliver on a cohesive vision going forward.

Jim Dennison, Chief Executive of the Simon Community, Northern Ireland’s largest homelessness charity, said that in 2018, 36,198 households were on the Housing Executive’s waiting list for social housing with over 24,000 considered to be in housing stress. “Across Northern Ireland, it is further estimated that there are between 76,000 and 136,000 adults who can be considered as ‘Hidden Homeless’, and circa 370,000 individuals living in poverty.  Simon Community Image

“Homeless people face many difficulties with ill health, can be more vulnerable and at risk of early death and we would be supportive of any initiative that helps give homeless people better access to healthcare or removes any barriers they might face” said Mr Dennison.

Therefore, from a Nursing perspective a Homelessness Nursing working group has been established.

This group is tasked with scoping the current nursing provision for those experiencing Homelessness within each of your respective Trusts, comparing this to best practice, identifying gaps in existing provision, and developing service improvement initiatives.

The working group will report to the Nursing Now NI steering group.

There was a conference held in Derry on health, wellbeing and homelessness, ‘Ensuring no-one falls between the gaps’ in which approximately 120 delegates attended.

Opening the conference, Chief Medical Officer Dr Michael McBride, said: “People who are homeless experience extreme health inequalities and barriers to accessing mainstream healthcare. Homeless people are ten times more likely to die than those of a similar age in the general population. The average age of death is a shocking 30 years lower than those who are not homeless.

“Homelessness is not a choice, it is a symptom of a wider societal problem which requires a partnership approach to deal with it. This conference aims to raise awareness of the problems faced and to break down the barriers ensuring everyone has equal access to our health and social care system.”

Each Health and Social Care Trust is working to identify the areas where nursing is already succeeding in improving homeless health with the intention that best practice is shared and rolled out across the region.

It is widely recognised that the most effective solution to tackle Homelessness will be derived from a multidisciplinary and multiagency approach that includes Trust Staff, GP’s, and local voluntary and community organisations along with Hostel Managers and Housing Executive staff.

This collaborative approach has also allowed the working groups to identify areas where additional focus may be required to improve the help offered to the homeless population, such as:

  • BHSCT have an arrangement is in place to facilitate the GP Registration process – Ensuring individuals have timely access to the necessary medication and treatment.
  • Hospital discharge procedures – A small pilot group in NHSCT has been set up to look as improving discharge pathways and protocols within mental health.
  • WHSCT are developing a nursing post to coordinate services for those experiencing Homelessness.
  • Medication management procedures – There are often complex medications that require administration that cannot be supported by hostel staff. Additional training can be provided to improve this.

Focusing on these key areas will allow the Nursing Now campaign to ensure that the development of service improving initiatives continue, subsequently reducing the health issues that are experienced by the homeless population in NI.

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