Some patients and groups are always going to be hard to reach in terms of providing care.
It may be that they are unlikely to come into contact with services through traditional routes or are perhaps unlikely to try to use them of their own volition – either due to circumstance, tradition or uncertainty.
But these reasons should not stop service providers from proactively seeking to help them. I want to champion two nurse-led initiatives that are seeking to reach two different groups who are often categorised as hard to reach – namely homeless people and the Gypsy or Traveller community.
First, this month, a new nurse-led pilot has been launched to provide rough sleepers in the Ipswich and Suffolk Coastal areas with mental health assessment and short-term interventions.
It will see senior mental health practitioner Jonathan Dickson engage with rough sleepers in the area, with the hope of getting them help to address underlying mental health conditions.
Norfolk and Suffolk Foundation Trust began the year-long initiative at the start of July, with the overall aim to reduce the numbers of rough sleepers and decrease their flow to the streets.
Meanwhile, a ground-breaking project that has seen a community outreach nurse work closely with Gypsy and Traveller people in Yorkshire is to be extended, after an evaluation found it had boosted health and wellbeing among this marginalised group.
Under the pioneering partnership scheme, Queen’s Nurse Liz Keat has successfully forged trusting relationships and supported people to access mainstream health and care services.
Her role was created as part of the joint project between the Leeds Community Healthcare Trust, Leeds Clinical Commissioning Group and Leeds Gypsy and Traveller Advocacy Group.
It was devised in response to concern about the welfare of the area’s Gypsies and Travellers, who have an average life expectancy of about 50 years, compared with 78 in the city’s settled population.
“These are great examples of nurses involved in prevention work”
These projects are great examples of nurses involved in prevention work that, if successful, should help reduce pressure on other services run by colleagues further down the pipeline.
Both are also examples of services that we are constantly being told that the NHS should be aspiring to provide, namely those in community settings and those involving integrated networks.
But such work requires funding to be set up in the first place and to then be properly established or even extended. It also requires the right people with the right skills in the right place to lead it. Neither funding nor people are easy to find and keep, especially when it comes to making services sustainable.
Both Mr Dickson and Ms Keat are so valuable simply because they are not doing the norm and are hopefully leading change that others can also use to positive effect elsewhere. However, almost inevitably, initiatives like these are often most at risk from cuts, particularly since the groups they serve are less likely to be in a position to complain if they disappear.
By writing about the work of Ms Keat and Mr Dickson in their respective areas, I hope Nursing Times can help shine a light on their vital and innovative roles. They should be treasured by their local communities.
If you know of other such services that need shouting about, then let me know.