Many FLIC clients have very poor physical health, with a number suffering from chronic long-term conditions that have rarely received consistent medical treatment. Some have also had acute illnesses requiring emergency treatment and hospital admission. With the average age of death for people experiencing homelessness currently at 47 for men and 43 for women, improving access to physical health services for people with multiple needs is a clear priority.

FLIC is exploring ways in which the system can intervene earlier and more effectively to ensure that our clients are better able to access healthcare – and whether in doing so, the costs both to the individual and the system can be reduced. We also want to improve the expertise and skillset of client-facing workers in these services so they are better equipped to meet the physical health needs of people experiencing multiple disadvantage.

"If you had not picked me up two and half years ago I would not be here now, I know that for sure." - William  

To inform our system change work we are undertaking an in-depth evaluation of our clients' health at key stages of their engagement with FLIC, in order to see if an intensive outreach approach improves health outcomes.

Better access to primary care

As part of Camden Homeless Health Network, facilitated by Camden CCG, we are working with health providers and local agencies in the borough to discuss the challenges of meeting the health needs of homeless clients.

To identify more effective ways to improve access to primary care, we are working in partnership with Camden CCG, Public Health, local GPs and voluntary sector health and homelessness support providers in Camden to deliver a physical health demonstration pilot. The pilot is focusing on:

• An enhanced wound-care service for clients in the South of Camden: This is a weekly wound clinic at the local homelessness GP Practice, Camden Health Improvement Practice. Practice Nurses from five local GP practices have received training which has enabled them to offer this service in their own clinics, thereby increasing the capacity of local GPs to address this issue.

• Access to nursing in the Camden Hostels Pathway: Clients with multiple, co-occurring needs often do not access medical care until the situation is very grave. Access to additional nursing input across the pathways is providing much needed clinical advice and guidance for staff, and increasing the capacity of the sector. FLIC have funded and are evaluating the impact of a nurse practitioner piloting in-reach into three local hostels.

• Building the capacity and awareness of client-facing staff and medical practitioners: FLIC is supporting the development of a programme of training and health awareness for both hostel staff and GPs to improve understanding of the health needs of clients experiencing multiple disadvantage.