Improving Health Outcomes for People Experiencing Homelessness

Emily Rosenorn-Lanng
Professor Mel Hughes
24th March 2023

Homelessness is a complex and multifaceted issue that affects thousands of people in the UK. People experiencing homelessness face many barriers to accessing health and social care services, and often have poorer health outcomes than the general population. According to the latest official statistics, there were 271,000 people experiencing homelessness on a given night in 2022, with 10,432 of them in the South West region and 1,095 in the BCP conurbation. However, these figures may not capture the true extent of homelessness, as many people may be hidden or not counted by official sources.

That’s why the HealthBus Trust has developed an innovative and integrated model of health care for people experiencing homelessness in the BCP conurbation. The HealthBus Trust is a charity that provides a mobile health clinic that operates four days a week, offering primary care, mental health, substance misuse, and dental services to people experiencing homelessness. The HealthBus Trust also works in partnership with other agencies, such as housing, social care, and voluntary sector organisations, to provide holistic and person-centred support to people experiencing homelessness.

The HealthBus Trust has been evaluated by an independent research team from Bournemouth University, who analysed the data and feedback from the HealthBus patients, staff, and partners about their experiences and views of the HealthBus service. The evaluation report provides a detailed analysis of the impact and effectiveness of the HealthBus service, as well as recommendations for future development.

The evaluation report highlights some of the positive aspects of the HealthBus service, such as:

  • The HealthBus service aligns with the NICE guidance on integrated health and social care for people experiencing homelessness, especially in terms of planning and commissioning, improving access and engagement, and long-term support.
  • The HealthBus service completed 1902 appointments between April 2021-March 2022, treating 456 patients and registering 194 new patients during this period, which equates to 42% of the total estimated homeless population of BCP. Only 262 of them were registered with a GP (57%); none were accessing primary care and therefore not subject to any level of preventative care. The HealthBus Trust vaccinated 257 homeless people with the COVID vaccine.
  • The HealthBus service reduced emergency admissions and A&E attendances for its patients, providing both technical and allocative value. Applying this reduction to the recorded number of HealthBus clients this could represent a cost reduction for admissions of between £81k – £201k, based on the reduction of 80 emergency admissions during a 12-month period across the entire HealthBus user population.
  • The HealthBus service received positive feedback from its patients, who rated the quality of the care they received as 4.7 out of 5, most frequently rating their experience as the highest possible rating of 5.
  • The HealthBus service received positive feedback from its partners, who valued the service provided and the effectiveness of communication. 63% of them indicated they contact the HealthBus Team at least once a week, indicating significant demand from partner agencies.

The evaluation report also identifies some of the challenges and areas for development of the HealthBus service, such as:

  • The HealthBus service could be utilised to underpin and evidence the development of a template model of outreach which could be applied over comparative populations.
  • Potential cost reductions incurred due to a decrease in demand on acute services should be explored in more detail and economically quantified, where possible, with greater emphasis being placed on the return of investment of secondary prevention.
  • The HealthBus service should be supported to act as a pathway for the integration of the underserved homeless community into mainstream care pathways.

The evaluation report also acknowledges some limitations of the research, such as the short time frame, the use of secondary data sources, and the need for more in-depth research into the HealthBus model.

If you are interested in reading more about this evaluation report, you will find more information on the aims, methods, findings, and recommendations of this research project.

If you are a health professional working with people experiencing homelessness or a related area, or if you are involved in supporting or assessing health care services for this population, you may find this report useful and relevant for your own practice development. You may also want to consider supporting or collaborating with the HealthBus Trust for future cohorts. This service offers a unique opportunity to improve health outcomes for people experiencing homelessness, and to reduce health inequalities within this population.

Meet the author(s)

Emily Rosenorn-Lanng

Researcher
Emily Rosenorn-Lanng is a researcher and project manager at the National Centre for Cross Disciplinary Social Work (NCCDSW) at Bournemouth University. She has over 19 years of experience in conducting and managing various research projects in health and social care, local government, tourism and heritage sectors. She specialises in quantitative research methods, game-based learning, generative AI, cybersecurity, and accessibility. She is also pursuing a part-time PhD in game-based learning in Cyber Security education. She has published several research papers and reports on topics such as mental capacity, cyber fraud, child mortality, leadership development, and more. She has also participated in the InnovateUK cyberasap program, a pre-accelerator for cyber security start-ups.
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Professor Mel Hughes

Director of the National Centre for Cross-Disciplinary Social Work
Dr Mel Hughes is Associate Professor in Social Work at Bournemouth University (BU). Mel champions lived experience expertise through her roles as Academic Lead for the PIER (Public Involvement in Education and Research) partnership and Deputy Director of the Research Centre for Seldom Heard Voices. Mel is committed to ensuring that those who are most affected by social, economic and health inequalities have a voice in shaping and informing research, education and practice.
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