Somerset’s Homeless Health Service – helping reduce health inequalities as temperatures drop across Somerset

As temperatures drop across the county, many people who experience homelessness can struggle even more with their health. People who are in temporary accommodation, or sleeping rough, face huge barriers to accessing healthcare, and as such, can potentially only live until their mid-40s – around 30 years younger than the general population.

The award-winning Somerset Homeless Health Service which started towards the end of 2021,  has already helped 1,286 people who live on the streets, in hostels, in tents and in vans access support with their physical and mental health.

Drug and alcohol disorders are common amongst the homeless population, and they are also more likely to struggle with their mental health. In fact, homeless people are more than nine times more likely to contemplate suicide.

GP Dr Laura Devlin is one of two inclusion GPs who goes out with the Homeless Health Team says:

“I have learned that my most important duty is advocating for my patients. Our team is passionate about social justice and strives to ensure that everyone is treated fairly and with respect. We aim to help excluded people navigate what can be a confusing healthcare system, and to give them the same high-quality care that any person would expect to receive in a GP or hospital setting”.

Somerset NHS Foundation Trust Clinical lead, for the Homeless and Rough Sleeper Nursing Service, Karen George explains:

“Whether it’s a park bench, a field, or one of the hostels across Somerset, we will deliver outreach nursing care to those who need it, wherever we can,” explains Karen. “There are hundreds of people in Somerset who are in difficult situations, and it’s important to remember that it’s not just people living on the streets that struggle. There are people living in hostels or sofa surfing, living in their cars and those who have just been released from prison amongst many more who don’t have a permanent home.

“When someone doesn’t have a fixed address, the barriers they face to accessing healthcare can be impossible to navigate. This often means they end up attending an emergency department (ED), when they don’t really need to be there, or sadly, simply not accessing healthcare at all.

“Our goal as a team is to reduce the gaps in healthcare, by working closely together with our partners across Somerset. We link in with our colleagues at Public Health, NHS Somerset, Somerset Drug and Alcohol Service (SDAS), homeless charities across Somerset and with other healthcare services. “

How the service works

The thirteen-person Homeless Health team which includes inclusion GPs, link workers, mental health nurses, peer support workers and nurses, provides a range of healthcare services, from general health assessments, wound care and dressings, help to access medical appointments, sexual health testing, mental health first aid and more.

The service is a collaboration between the NHS in Somerset (NHS Somerset and Somerset NHS Foundation Trust) and Somerset Council.

The service helps people overcome barriers to accessing mainstream healthcare services and provides high-quality healthcare at informal drop-in clinics and through outreach visits.

Nurse and inclusion GP led drop-in clinics are held in a variety of settings across Somerset, which are easily accessible to patients. Alongside drop-in centres, people are seen and treated in the community – whether that’s in a field, shop doorway, in a van or tent.

The team tries, wherever possible, to go to the person in need, visiting those who are sleeping rough or living in vans, hostels and other forms of temporary accommodation, staying on temporary and permanent traveller sites, or taking shelter in retreats and refuges.

Referrals are also received from Somerset Council teams, the Department of Work and Pensions, hostels, police, schools, charities, village agents, GP surgeries, hospital teams, and drug and alcohol services.

Professor Trudi Grant, Executive Director of Public and Population Health, joint appointment between NHS Somerset and Somerset Council said: “People who are homeless, or vulnerably housed, face huge barriers to accessing healthcare and experience some of the most severe health inequalities compared to the general population. 

“Working in this joined-up way is so important when it comes to working with vulnerable groups.  This approach has allowed us to deliver a vital health and wellbeing offer that is focused on prevention, early intervention and treatment.”