Ten new community nurse-led projects will benefit from a year-long programme of financial and professional support, the Queen’s Nursing Institute (QNI) has announced.
The projects – all led by community nurses – will take place in London and the southeast, Birmingham, the northwest and the southwest. They will support homeless people as well as those living in vulnerable or temporary housing, including recent migrants, people in custody, and Gypsy, Roma and Traveller populations.
The project leaders will be given six days of training sessions with the QNI professional team and ongoing support throughout the year, as well as £5,000 in financial support.
The QNI is currently working in partnership with its funder, Oak Foundation, which is supporting its Homeless Health Programme for three years.
This is the first time that the QNI’s Fund for Innovation and Leadership has focused specifically on projects that work with the homeless population.
David Parker-Radford, the QNI’s homeless health programme manager, said: ‘These projects represent the vital role that community nurses have to play in supporting some of the most vulnerable groups in society, by engaging with them on the streets through outreach and treatment work, where more traditional models of care are not effective.
‘The health and social problems related to homelessness are acute and the number of people who are street homeless has increased substantially in recent years in recent years. Community nurses are at the forefront of delivering compassionate and effective healthcare to people who may otherwise simply be invisible to the system, with terrible costs to them as individuals and to society as a whole.’
1. Latent TB screening and TB awareness – HMP Birmingham
HMP Birmingham is the largest prison in the West Midlands, with a huge turnover with 5,500 admissions annually.
In Birmingham, if someone is new to the country the GP will offer a latent TB blood test. However, those new to the country and in prison do not get tested.
This project will provide education sessions and symptom awareness to prisoners, prison staff and nurses. The nurse-run clinic within the prison will offer testing and treatment to prisoners under 65 with a history of homelessness, substance misuse, or those who are new to the country in the past five years.
Patients who test positive can be isolated in a ward, as someone can remain infectious even eight weeks after starting treatment.
2. Five Ways to Wellbeing – Bristol
This project seeks to improve the emotional and mental wellbeing of homeless people in Bristol who access the service.
‘Five ways to wellbeing’ is a document provided by New Economics Forum. The five ways are: connect, be active, keep learning, give to others, and take notice.
The project will run five courses through the year, linking to one of the five actions. The sessions will follow the structure of activity, discussion, reflection and one-to-one support and also measure outcomes.
3. Community outreach self-harm awareness group – Weston-super-Mare
Acute mental health services lack low-level mental health support and first aid and support for self-harmers. This project will provide a support group to cater for emotional wellbeing, physical health and psychological effects. It will also provide education on first aid, harm reduction, distraction techniques and personal safety plans, which will be uploaded to EMIS for other health professionals.
The healthcare will be provided in a soup kitchen, as a one-stop-shop in a familiar place. New clients will be offered a ‘hook’ to participate eg a new sleeping bag, food, clean bedding etc.
4. Primary care services for homeless asylum seekers (The Rainbow Centre, Croydon) – London
This project seeks to improve skin conditions and respiratory health for rough sleepers and asylum seekers.
The service was part of the PCT but has now merged with the acute trust. As a result funding has been lost but through funding bids as commissioning has been achieved on a five-year basis.
The Rainbow Centre is nurse-led. Nurses hold the budget and therefore ‘hold the power’. A GP is employed for 15 hours by the service and the CCG employs the GP for a further eight hours. They work collaboratively with voluntary organisations like Turning Point, Crisis and the Salvation Army.
The project will develop pathways for people with scabies and respiratory illnesses and give them access to new clothing following treatment for both conditions.
5. Drop in and NHS health check outreach clinic (Wirral Ark) – Birkenhead
Wirral Ark charity provides accommodation for the homeless under the MainStay framework, as well as providing support and guidance for individuals to secure permanent accommodation.
This nurse-led project seeks to address serious and life-threatening obstacles to health services that homeless people face in getting appropriate health care by providing them with nursing care through the charity.
6. Leap Ahead Project (The James Street Project) – Darwen
The James Street Project is a supported housing scheme for single homeless people, with low to moderate support needs, aged 16-65.
In cooperation with James Street, this nursing project seeks to reduce inequalities and improve access to general practice for homeless individuals.
The project focuses on lifestyle, education, advice, promotion, airways and diabetes.
The project will reach clients who can be hard to reach by providing healthcare clinics in the clients’ own environment, through group consultations on prevention and one individual session per week.
They will also provide training for hostel staff in health to ensure that care is provided at the right time in the right place to the right person to reduce health complications and prevent hospital admissions.
7. HIT plus targeted street outreach for rough sleepers in Southwark – London
The purpose of this project is to target rough sleepers who are not accessing primary health care services by signposting rough sleepers to day centres and primary health care services.
The project works in conjunction with Southwark’s Street Population Outreach Team charity and Melbourne Grove practice in East Dulwich to provide health education, promotion and assessments.
The service runs once a month, but clinics can be cancelled due to staff shortages. Data collection will generate information to secure funding to commission a new post.
8. Touch Base – collaborative service to improve testing and treatment of hepatitis C – Brighton and Hove
This profect will improve hepatitis C testing at homeless day centres by frontline staff and give staff and volunteers education and training on liver disease, hepatitis C and testing. The project aims to improve collaborative working.
9. Health Champions for the Homeless, Newham – London
The project will establish peer support group for the homeless by recruiting 10-12 health champions. The service will provide education and awareness sessions on diabetes, mental health, and respiratory conditions for health champions who take this information back to soup kitchens. The service will accept anyone.
10. The Health Bus – Surrey
The project will concentrate on health promotion, screening for diabetes/heart disease and signposting with the Gypsy, Roma and Traveller (GRT) population.