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‘It is time’ to tackle homeless health, say nurses

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Community nurses have called for more access to immunisation, testing and treatment for patients who are homeless.

A “major statement” on the need to improve access to healthcare for vulnerable patients living on the street has been made by nurses working with the homeless, according to the leader of a major programme on the issue.

“Nurses have made a major statement that it is now time for the health system to work as one to proactively immunise, screen and treat people who are homeless”

David Parker-Radford

David Parker-Radford is manager of the Homeless Health Project, run by the Queen’s Nursing Institute charity.

Speaking at a QNI conference last week, he said it was “now time for the health system to work as one” to proactively immunise, screen and treat homeless people to tackle the spread of diseases including HIV, hepatitis C, tuberculosis and influenza.

“Alongside harm reduction work around safer housing, drinking, smoking, drug use and sex, this work can save lives, save money in the longer term and help people to regain their health,” he said.

“We now have the tools to eradicate hepatitis C as a public health issue, and to reduce the situation where homeless people are 34 times more likely to have TB – we should all be working to ensure we achieve it,” he added.

Around 70 nurses and other healthcare professionals attended the QNI’s event in Cardiff on 15 October.

Dr Al Story, clinical lead from the “find and treat team” at University College London Hospitals highlighted that homeless people often experienced a complex range of comorbidities, which were “amplified” by poor respiratory health, malnourishment and drug use.

He said that service integration was vital if contagious diseases were to be brought under control, particularly when working with a vulnerable and mobile client group.

Queen's Nursing Institute

David Parker-Radford

For example, historically some 53% of people who were referred for treatment were subsequently lost to the system, he told delegates.

Dr Story also stressed the importance of earlier intervention in order to reduce the risk of infection spreading.

Liz Weeks, lead TB clinical nurse specialist, Cardiff and Vale University Health Board, also highlighted the positive impact of proactive nursing on the control and treatment of the disease among the homeless.

Meanwhile, Maxine Radcliffe, chair of the London Network of Nurses and Midwives Homelessness Group, discussed the importance of outreach work for the homeless population in the Soho area, which she said focused on HIV testing, treatment and prevention.

Currently around 20% of patients at the service in Great Chapel Street are migrants, and the remaining 80% are longer term rough sleepers, typically with alcohol dependence and other issues, she said.  

The QNI’s new Health Assessment Tool for community nurses working with homeless people was also launched at the event, as previously reported by Nursing Times.

The new tool, which is freely accessible on the QNI’s website, is intended to help community nurses to “cover all the bases with vulnerable people”. 

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