Voiceless, unheard and socially excluded: Accessing health and care while homeless or vulnerably housed

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Summary of report content

Healthwatch Dorset wanted to find out first-hand about the barriers and challenges faced by people experiencing homelessness and those who are vulnerably housed when they try to access  health and care services in Bournemouth, Christchurch and Poole (BCP), including primary, secondary, social and community care.

Over a 10-week period during January to March 2024 staff spoke to people in the surroundings where they feel comfortable and safe. This was 26 people who are currently experiencing homelessness or in vulnerable housing; all were aged 18 and over. Healthwatch also spoke to seven health professionals and support workers.

Key findings

 People are still being refused access to GP services because they do not have a fixed address or ID.

 People are unable to complete an eConsult form online as they are digitally excluded. They have limited or no access to the technology or credit required, and/or some people lack the knowledge or confidence to use online systems. 

People are unable to access GP services by phone because the waiting time in the queue is so long and they don’t have enough credit on their phone. 

Many of the people who participated in the research have infected leg ulcers and are unable to walk to a GP surgery. 

People are unable to get to hospital or a GP because they don’t have the bus fare and it is too far for them to walk.

People who are in active addiction often live chaotic lives and have no means of writing an appointment in a diary or calendar, so appointments get missed. 

People feel like they are being judged in health care settings. They are conscious of their appearance and hygiene, so sitting in a waiting room feels uncomfortable. 

The withdrawal symptoms from drugs or alcohol are often poorly managed, so people end up discharging themselves from hospital. There is a common misconception that if you are on a methadone script then you don’t need pain relief. 

People are not having their legs dressed regularly enough because community nurses will only do leg reviews in a GP surgery or at Rossmore Leisure Centre. 

Many of the people in the research have poor mental health but are unable to access community mental health services because they are in active addiction, or they are not six months clean. Healthwatch were also told that trying to access a Community Psychiatric Nurse (CPN) is virtually impossible. 

Access to NHS dental treatment is very challenging. Healthwatch spoke to one person who got to the point where the pain was so intense that they pulled out two of their own teeth.

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General details

Local Healthwatch
Healthwatch Dorset
Publication date
Date evidence capture began
Date evidence capture finished
Key themes
Access to services
Accessibility and reasonable adjustments
Caring, kindness, respect and dignity
Health inequality
Lifestyle and wellbeing; wider determinants of health
Medication, prescriptions and dispensing
Parking and transport
Remote appointments and digital services
Service organisation, delivery, change and closure
Waiting for appointments or treatment; waiting lists for treatment

Methodology and approach

Was the work undertaken in partnership with another organisation?
No
Primary research method used
Interviews
If an Enter and View methodology was applied, was the visit announced or unannounced?
N/A

Details of health and care services included in the report

Details of health and care services included in the report
Community Mental Health Team (CMHT) and specialist MH services
Dentist
General Practice (GP)
Hospital services- not stated
Services for people with drug, alcohol and other addictions
Urgent primary care, including Urgent Treatment Centres, walk-in care, out of hours GP services, minor injury and treatment centres

Details of people who shared their views

Number of people who shared their views
33
Types of disabilities
Physical or mobility impairment
Seldom heard groups
Homeless people
People on low incomes
People with or recovering from addictions
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