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Croydon’s street homeless need better support from GPs

Croydon GP practices need to work better with street homeless people to deliver the care they need according to report, published today by Healthwatch Croydon.

The study, Street Homeless Experience of Health Services in Croydon, recorded the experiences of street homeless people who have become members of Crisis in Croydon. It found that many adults living on the street had a negative experience of using GPs, and 19% had not even registered even though that is the only way they could access services.

Croydon has a significant number of homeless people in the borough. In the Director of Public Health Report 2017, 2,285 people were described as homeless or in temporary housing. Healthwatch Croydon, the local champion for better health and social care, focused on those who are street homeless.

Working closely with Crisis, the nationwide homelessness charity based in Croydon, they spoke to 36 of their service users, which they describe as members, about how they accessed healthcare and the treatment they received. This represented approximately 50% of their membership.

What they told Healthwatch Croydon raised the following issues:

First place for support: Nearly half (47%) would consider GPs as the first place to go for support.

Registration: Nearly one in five (19%) had not registered with a GP, even though they have the right to do so.

Experience of services: Nearly half (47%) had a negative experience of using GP services.

Knowledge of referral: Very few found it difficult to be referred, but 33% had no experience of referral suggesting they were not aware that they could be referred.

Mental health support services: Over one in four (28%) did not receive the mental health services they felt they needed.

The report makes the following areas for consideration by GP providers:

  • Increase training with working with homeless in GP surgeries: All GP surgeries based near could benefit from working with local homeless organisations to better understand client needs and train staff accordingly, including registration. They could also access free e-learning training modules from the Healthy London Partnership.
  • Better information for GPs on services available: All hostels, GP surgeries, GP hubs and hospitals to have adequate information about rights of registration with staff able to signpost to relevant services at point of use. The Healthy London Partnership also have materials tailored for homeless people.

Gordon Kay, Healthwatch Croydon Manager said: “This report tells us the experiences of some of most vulnerable people in Croydon and shows GP surgeries as usually the first place of call for street homeless. Therefore, GPs need to be prepared to meet their specific needs, particularly concerning mental health. Following on from our previous report for hostel-based homeless, we note similar issues that need to be addressed. These includes each surgery respecting the right to access for people despite having no fixed address, as well as ensuring better information to support street homeless. This can help GPs be more effective, as homeless people can approach the right services in the best way, improving the care they can receive.”

Dr Tom Chan, Medical Director at NHS Croydon Clinical Commissioning Group and local GP said: “We welcome the report that Healthwatch and Crisis have produced, and we are pleased to see that over 80% of those interviewed were able to register with a GP. We are committed to providing the best possible services for all residents of Croydon and will work with GPs and their practice colleagues to support those without a fixed address to access and use health and care services.”

Janice Gunn, Director of Crisis Skylight Croydon: “The report is a good starting point, but clearly there needs to be further in-depth research into the barriers street homeless people have in accessing health services.”