RT Journal Article
SR Electronic
T1 Evaluating a specialist primary care service for patients experiencing homelessness: a qualitative study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen20X101049
DO 10.3399/bjgpopen20X101049
A1 Emily Clark
A1 Emily Player
A1 Tara Gillam
A1 Sarah Hanson
A1 Nicholas Steel
YR 2020
UL http://bjgpopen.org/content/early/2020/07/07/bjgpopen20X101049.abstract
AB Background People experiencing homelessness (PEH) often experience poor health, multimorbidity, and early mortality and experience barriers to accessing high quality health care. Little is known about how best to provide specialist primary care for these patients.Aim To evaluate the health care provided to patients experiencing homelessness who were seen in a specialist primary care service.Design & setting A qualitative evaluation of a city centre primary healthcare service for excluded and vulnerable people, such as rough sleepers, who find it difficult to visit mainstream GP services.Method Data on patient characteristics and service use were extracted from primary care records using electronic and free-text searches to provide context to the evaluation. Semi-structured interviews with 11 patients and four staff were used to explore attitudes and experiences.Results Patients had high needs compared with the general population. Patients valued continuity of care, ease of access, multidisciplinary care, and person-centred care. Staff were concerned that they lacked opportunities for reflection and learning, and that low clinical capacity affected service safety and quality. Staff also wanted more patient involvement in service planning.Conclusion PEH’s complex health and social problems benefited from a specialist primary care service, which is thought to reduce barriers to access, treat potentially challenging patients in a non-judgmental way, and provide personal continuity of care in order to develop trust.