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GPs go forth

GPs have 'critical role' in homeless response to coronavirus, says NHS England

GPs have a ’critical role’ in providing healthcare to the homeless during the coronavirus (Covid-19) pandemic, NHS England has said.

Practices should ensure that homeless patients are registered and provide ‘initial holistic health assessments’ either remotely or face to face, NHS England lead for NHS health homelessness Covid-19 response Olivia Butterworth said.

She added that GPs should also ‘reach out’ and contact existing patients known to be homeless or in temporary accommodation that is ‘unlikely to be suitable’.

Practices should also identify those who are most vulnerable and should be on the shielding list so that they can continue to receive accommodation support from local Government, she said.

It comes as GPs were told in April that they should contact all of their patients who are shielding from coronavirus as a 'follow-up' to the NHS letter notifying them to stay at home for 12 weeks.

Speaking in a webinar on the 23 April, Ms Butterworth told GPs: ’General practice has a massively critical role to play in this and while we appreciate that everyone is busy, homeless people have a right to access primary care in the same way any other citizens do.’

Dr Caroline Shulman, a GP in homeless and inclusion health and honorary senior lecturer at UCL, added that GPs should have a similar level of involvement in hostels for the homeless as they do in care homes.

She said: ‘There’s a huge opportunity here for primary care getting more involved and really trying to stop major outbreaks within the hostels. They’re very similar in lots of ways to care homes and yet they don’t get the same degree of health input as care homes do.

‘We obviously want to try and prevent the same sorts of outbreaks as we’re getting in care homes.'

Similar health assessments should be carried out for those accommodated both in hostels and temporarily in hotels during the pandemic, Dr Shulman added.

Speaking in the webinar, Dr Shulman and Ms Butterworth said GPs should: 

  • Register those who are currently unregistered, either as a temporary registration or accepting them onto the permanent practice list.
  • Provide 'initial holistic health assessments, either virtually or in person as appropriate', for newly-registered patients and ensuring that referrals are made to mental health and substance use services 'where necessary'.
  • Contact patients known to be homeless or in temporary accommodation 'where practically possible' and provide remote health advice 'where necessary'.
  • Support local authority and VCSE partners who are providing accommodation for homeless people to make decisions about Covid-19 symptoms and potential referral to acute care using existing protocols.
  • Provide prescribing and medicines management including liaison with mental health and substance use services.
  • Identify those in the ‘extremely vulnerable’ group and ‘plan for ongoing care’.
  • Provide 'support and advice' to accommodation providers such as closing communal areas, regular cleaning, contingency plans in case of infection outbreak and liaison with local authority for alternative accommodation where necessary.
  • Provide advice and guidance to hostel staff to do daily symptom screening and support with new and on-going health needs including palliative care.

It comes as GPs have been told to continue registering new patients as registration regulations were relaxed to allow the digital delivery of applications to practices.

The advice said practices should ‘agree how they can most effectively connect and support’ locations that accommodate people who are homeless. 

Readers' comments (4)

  • Thank goodness NHSE has such great thinkers. Off to town now to round up a few of the homeless to register them for remote consultation services. Genius

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  • Clearly neither of these two has any idea of the GP contract or what is meant by Essential Services.

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  • I'm afraid to say that there seems to be an ever growing disconnect here. The idea and concept is laudable but entirely unrealistic. homeless healthcare ought to be a fully funded, stand alone pillar as part of the new joint working and needs to be properly resourced at a PCN level. our colleagues cannot be expected to take this on as well.

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  • its a nice wish list - i will put it in the pile with all the other ones and once i get some free time I will have a look at them. hopefully before i retire but can't guarantee it. depends how long covid goes on for and if i am still alive by then.

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