Talking with the homeless community in Waltham Forest

Healthwatch Waltham Forest undertook research on the experiences of homeless people using health and social care services in the borough. They spoke to 50 people across two focus groups held in April 2015, exploring experiences of GP services, A&E, mental health services, pharmacies, dentists, opticians and ambulance services.

Participants reported significant difficulties accessing GP services. Many were not registered with a GP and described barriers relating to proof of address and identification requirements. Those who were registered frequently reported problems obtaining appointments, long waits on the telephone and feeling that staff lacked understanding of the challenges associated with homelessness, mental health problems and substance misuse. Positive experiences were reported at some practices, particularly where staff were described as compassionate, supportive and responsive to individual needs. 

Experiences of A&E services were mixed. Participants generally felt that clinical care at Whipps Cross Hospital was good once they were seen, but many described long waiting times, poor follow-up care and a lack of coordination between physical health, mental health and substance misuse services. Concerns were also raised about stigma and judgement from some healthcare staff. Dental health was a major issue, with many participants reporting poor oral health, difficulties accessing NHS dental services and anxiety about seeking treatment. Pharmacy services were viewed more positively, although some people called for greater privacy and better information about medications. 

Healthwatch Waltham Forest recommended improving access to GP registration and appointments for homeless people, increasing awareness and understanding of homelessness among healthcare staff, strengthening coordination between services, improving access to dental care, and expanding targeted healthcare provision in locations already used by the homeless community. The report highlighted the importance of clear information, respectful treatment and better integration of services to improve health outcomes for this vulnerable group.