Homeless But Not Voiceless: Improving Access to Care for People Experiencing Homelessness and Dual Diagnosis

Healthwatch Lambeth also worked in collaboration with local organisations supporting people experiencing homelessness, speaking to 14 clinical and non-clinical staff.

Key findings

What worked well

Trusted homeless organisations provided crucial support with positive impact. Regular GP or psychiatric visits in temporary accommodation made care more consistent and easier to access. Individuals also received support from key workers and nurses to book and attend appointments and chase prescriptions. 

Some addiction support services were praised for actively re-engaging clients and not requiring them to start over if they missed an appointment.

Many individuals expressed hope for the future, including getting housing, returning to work, building skills, or volunteering to live more independently.

Areas for improvement

Despite NHS guidelines, barriers to GP registration persisted for individuals experiencing homelessness. Lack of digital technology and/or skills meant that many struggled to book appointments. 

Individuals reported feeling judged, dismissed, and not taken seriously by some healthcare professionals. Many also felt frustrated by short appointments and a lack of continuity of care. 

Mental health and addiction services often operated separately, leaving individuals without adequate support for both.

Recommendations

Whilst we recognise the hard work healthcare professionals and community support staff do to provide care and support to individuals experiencing homelessness with complex health needs, our findings also show some room for improvement. Some of our recommendations include:

• Flexible access to primary care, with GP surgeries, supported housing and/or homeless centres offering drop-in appointments, longer consultations and digital support.
• Improved knowledge on patient registration rights and understanding of homelessness and dual diagnosis, through training and reminders for primary care staff.
• Integrated support, through a dual diagnosis care pathway combining mental health and addiction support, GP surgeries, and supported accommodation.
• Life skills training, provided by supported accommodations to help residents manage their health and daily life independently.

See below to read the full report and the responses from the Associate Director of Primary and Community Care – South East London Integrated Care Board (Lambeth) and the Lead Commissioner for Substance Misuse – Lambeth Council.