The Health Inclusion Team (HIT) is a multidisciplinary team of nurses, case workers, doctors, Occupational Therapists, Health Visitors, High Intensity User leads (who work with frequent attenders to hospital) and other support workers.
The primary aim of the team is to offer immediate health care to vulnerable adults, and to facilitate and support them to access mainstream services.
We work with people experiencing homelessness, refugees and asylum seekers, and clients with addictions. Our service for people experiencing homelessness is commissioned across the 3 boroughs of Lambeth, Southwark and Lewisham, all other services are commissioned for Lambeth and Southwark.
We offer advanced assessment and case management interventions, chronic disease management, minor aliment treatments, sexual health screening, contraception (LARC), vaccination schedules, advanced tissue viability treatments, and facilitate people into accessing main stream services.
The team is doing a huge push this year for flu vaccinations. Our goal is to reduce flu transmission, in a client group that is at high risk of severe outcomes related to influenza and COVID 19.
Our team of nurses use a Patient Group Directive (PGD) to administer vaccines. PGDs allow medicines to be given to a pre-defined group of people, based on a list of criteria, without a prescription. The criteria can include directions related to age, pre-existing illnesses, allergies, and potential interactions, but also related to individual vulnerabilities or the settings in which they live or work. In London in 2020 all people experiencing homelessness are included in the criteria for giving the vaccine
An outreach flu clinic looks slightly different than a clinic that is run in a general practice treatment room or pharmacy. Our clinic needs to be held somewhere that we can maintain infection control procedures, client privacy and store the medication correctly, such as in a fridge or cool bag.
This clinic was held at Ace of Clubs day centre (AoC http://aceofclubs.org.uk/) on St Alphonsus Road, in Clapham. AoC is a day centre that offers hot meals, groceries, amenities, showers, welfare advice and much more to people experiencing homelessness, and other vulnerable or marginalized people in the community. They have had to partially close their doors due to the pandemic, but have still been able to maintain a hot lunch service and advice by appointment.
We set up a table and a tent (with a heater!) in the day centre car park, and invited people to form a socially distanced queue to receive their vaccination. Clients came into the tent 1 by 1. We offered advice on the flu vaccination, gathered basic information and did the vaccination then and there. Between clients we cleaned all work surfaces, sanitized hands and changed PPE. The advice we found we were giving most frequently was that the flu vaccine is not ‘live’, and as such it cannot actually give a person the flu.
Helping to bring in clients and keep the clinic running safely, was the amazing Groundswell Team (https://groundswell.org.uk/#). Two members of the Groundswell Homeless Health Peer Advocacy team walked up and down the queue, armed with information and their experience, and reassured people, and encouraged clients to access the service. The volunteers were extremely valuable as they were able to use their personal experience to speak to clients, address concerns, and keep the queue moving safely. We also worked with the local outreach teams to get word out in the community that we would be available on the day.
The clinic was an amazing success. We successfully vaccinated 30 people – every vaccine brought to site was used. The positives of the clinic were the location and excellent support from the day centre and Groundswell. It was easily accessible for people, and in a comfortable, known atmosphere. The HIT team was also able to identify some people who had slipped through the cracks of mainstream health care, who were not linked in with a GP service, and those who had untreated health conditions and vulnerabilities. These individuals were invited back for an assessment to the weekly nurse clinic held on site at AoC.
For more information please contact:
Megan Griffiths
Community Nurse Specialist
megan.griffiths@gstt.nhs.uk
Three Boroughs Health Inclusion Team – Vulnerable Adults & Prevention Services
Integrated Local Services
2-8 Gracefield Gardens
London SW16 2ST
020 3049 4700
Guys & St Thomas Twitter: @GSTTnhs
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