Access to primary care for those with multiple needs

Healthwatch Stoke-on-Trent conducted a review into the experiences of people who have no fixed abode accessing primary care services. GP registration is key to accessing social care, mental health services and substance abuse services. Healthwatch Stoke-on-Trent worked in collaboration with other community organisations, VOICES and Expert Citizens, using a mixed methods approach. Case studies with three service users, staff at GP practices and testimonials from experts in the field were used to explore peoples’ experiences with registering with GP practices. In addition, the team conducted a mystery shopping exercise to find out how many GP practices were registering patients who were experiencing homelessness.

Their project found that nearly half of the GP practices said they were not able to register the person with no fixed abode. The ‘gatekeepers’, frontline staff such as receptionists, were found to not have a clear understanding on the current NHS England guidelines for registering patients and it was not clear how much autonomy they had when making these decisions. The team identified a number of barriers to accessing primary care, in addition to registration. The gatekeepers did not understand the needs of people who were homeless and people with no fixed abode experienced stigma both internally and externally.

Healthwatch Stoke-on-Trent made recommendations to improve people’s access and experience to primary care services. They recommended that all GP practices are to abide to NHS England practice for registering all patients, to communicate this guidance to practices and ensure that the gatekeeping staff receive training to understand the needs of patients who are homeless.

No response to the recommendations or other feedback has been received at the time of distribution of this report.