Homelessness is a marker of our increasingly unequal society. An investigation by Shelter found that 700 people were homeless in Plymouth in 2018 (Plymouth News, Nov 2018), and there are indications that homelessness is on the rise in the South West (ITV News, Feb 2020).
This is a health concern because the average age of death for people who die homeless in England and Wales, is around 46 years, and even less for women who are experiencing homelessness (ONS, 2019). Dying before your time is the ultimate social exclusion.
The Covid-19 pandemic has exacerbated a great many existing health inequalities, with a disproportionate impact on poorer and marginalised groups. In Plymouth, as elsewhere, there are a lot of wonderful people in many agencies doing what we can to improve the health of people experiencing homelessness and who have complex needs. Primary care is at the heart of this, and the homeless outreach service is based at Adelaide St surgery in Stonehouse – a Plymouth neighbourhood in the most deprived 1% in the country on IMD19 score.
Along with 19 other practices we have been running a Covid-19 vaccine hub for the general population, using a leisure centre and ice rink venue that has proved ideal. We have vaccinated more than 25,000 people in this facility.
Knowing that people experiencing homelessness and those with complex needs are vulnerable and have many difficulties in accessing services, we decided to run a dedicated vaccine session for them. We used our many contacts with other agencies and put the word out for Thursday 4th March – hoping for perhaps around 100 to come. The final tally was a wonderful 262 people, no-one was turned away.
We are incredibly well connected to all the agencies who work with people experiencing homelessness in Plymouth (because we run the medical outreach service in hostels etc) so absolutely everyone put the word out – and of course we all use social media too. Transport was provided from 2 of the bigger hostels, and the soup run team put on food which I am sure helped.
Many people offered to help. The team was made up of GPs and nurses who were paid, plus extra clinical staff from the hospital (Blood Borne Virus team), plus support staff from several agencies. Loads of volunteers helped with ushering, including several medical students from Peninsula Medical School, and other University students, staff from the Pavilions Leisure Centre and many more. We needed a great many people as marshals, Pinnacle data recorders, administration staff etc, and everyone pulled together.
At the event we not only had 5 vaccination bays run by local GPs but:
- Health promotion teams doing weights, BMI, BPs etc. Some very serious hypertension was picked up
- BBV team from Plymouth University Hospital Trust who performed 67 spot tests for Hepatitis C
- Dental team from Peninsula Dental School who registered over 70 patients, who will now go on to receive dental services
- Sexually Transmitted Infection (STI) screening done by our GP registrar who is currently working in the wonderful Plymouth SHiP sexual health service. More than 60 screens were issued.
- Support and information from our local ‘Livewell’ complex lives team
- Plymouth soup run volunteers – a fantastic service who take food out every day around the city, who provided hot drinks and food for this event
- Plymouth Access to Housing (PATH) who help all aspects of housing and have been instrumental in making the ‘everyone in’ campaign work in Plymouth. The rough sleepers team from Plymouth City Council were also very helpful. Everyone was able to get help with housing.
- Staff from our great Plymouth hostels, the George and Shekinah and support from the Salvation Army
- GP registration for those with no GP surgery
- Finally, Plymouth ‘street vet’ looked after the canine companions who are so important to many. All were checked, fed, given flea treatment and wormed.
It was a life-affirming event. We vaccinated a large number of people who are highly vulnerable and were able to offer a lot of other help at the same time.
Pro-active outreach like this has great potential to reach people, and doing this in such a collaborative way with so many agencies involved shows what General Practice can do if we all work together.
For more information please contact:
Dr Richard Ayres, GP Adelaide St Surgery / Senior Lecturer Peninsula Medical School
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