Agenda item

The Board received a report from Sarah Hart, Senior Commissioning Manager Haringey CCG, which updated the Board on the work undertaken around health and homelessness. The task and finish group that was set up to look into this issue had previous identified three key issues in terms of health barriers facing homeless people in Haringey:

• The process of GP registration was not transparent which allowed some practices to ask for photo ID as part of the registration process.
• It was not clear what type of primary care model should be adopted for homeless people in Haringey.
• There was a homeless discharge pilot at the North Middlesex Hospital which had no links into Council or primary care services.

The Board noted that the following  progress had been achieved:

• Guidelines had been published on registering with a GP which were homeless friendly including some discretion that GP’s could use in terms of establishing place of residence.
• The Homeless Health Charter was signed by Cllr Morton on behalf of the Board.
• A multi-agency workshop including partners from across the spectrum was established.

The Board noted that in terms of the actions that are still unresolved, a key consideration was which model the Board wanted to adopt for primary care for homeless people. Ms. Hart noted that the workshop agreed that some form specialist primary care provision would be required and so a full JSNA would need to be undertaken. In addition, surveys would be undertaken amongst Haringey’s homeless population to ascertain need.

The Board also noted that feedback from the pilot at North Middlesex Hospital suggested that Haringey didn’t have a particular problem with homeless people without GP access. Ms. Hart advised that the workshop found this very hard to believe. The consensus from the workshop was that that the pilot was aimed towards indentifying a traditional Westminster rough sleeper; however this wasn’t reflective of Haringey. Haringey’s homeless population was characterised by a number of people who were vulnerably housed, including those either sofa surfing or who were housed in hostels. Hostels had fed back that a key issue was inappropriate discharge of patents from hospitals. It was recommended that the Board set up a small working group to look at what the local hospital discharge strategies were for the homeless population.

The Chair commented that he recently visited a St Mungo’s Broadway premises and emphasised the quality of care offered and the work that was done to put people back on their feet.  Ms Etheridge commended the report and noted that it was a very thorough comprehensive piece of work. Dr. Helen Pelendrides, Vice-Chair Haringey CCG, commented that there was a model adopted in Barnet that did not use a specialist service but had developed a GP who had become very interested in homeless service and had set up a separate service for homeless patients. Officers agreed to liaise with Barnet around this service, it was agreed that a key consideration was around capacity and the number of primary care practitioners required.

It was:

RESOLVED:

1. An expert group consisting of the Council and CCG homeless commissioners, providers, GP’s and Public Health be established to develop and complete the single homeless person needs assessment; and

A request that commissioners and providers adopt the cross government operational guidance; Hospital Admission and Discharge: People who are homeless or living in temporary or insecure accommodation – as part of the measure to ensure better integrated services for homeless people leaving hospital be agreed.