Research into the barriers to accessing good health and social care services for homeless and vulnerable adults in Hackney

Healthwatch Hackney and the local CCG funded Peter Bedford Housing Association to explore whether homeless and vulnerable adults access good quality health and social care services. They spoke to 95 people.

Results showed most service users prefer to get information face to face or through direct communication such as letters or emails. Half of respondents do not use the internet. Very few use online health information sources such as iCare or NHS Choices.

Issues around identity — race, gender, disability, sexual orientation, and age — create barriers for many people. Money, transport, and a lack of clear information were also common issues. Many respondents do not feel listened to or feel misunderstood.

Many service users could not say whether services, such as mental health services, were easy or difficult to access. This includes those who have never tried to use them. This suggests more support is needed to improve access.

Only a third of respondents said mental health, sexual health, drug and alcohol, and physical activity and obesity services were easy to access. Many still face barriers, including unclear referral pathways. Dentistry was the exception, with nearly 60% saying it was easy to access.

Half of participants had lived in a hostel before or were currently living in one. Overall, the environment is not supportive of self-care. People in recovery often live alongside those still using drugs or alcohol. Not having a fixed address also limits access to healthcare. However, residents of St Mungo’s Broadway’s Mare Street hostel gave more positive feedback. Substance misuse remained an issue.

Communication strategies should encourage people to seek help. Service users should not be passive recipients of information. Although the research could not fully explore identity issues, these remain complex. There is a clear need for people to express their views and feel heard.