There needs to be a Homeless Healthcare Hub in Central Brighton
Tim Worthley: Transcript from his speech at the Action on Homes Conference
“Thank you very much for having me my name’s Tim Worthley I’m one of the GP’s at Arch Healthcare, which is a brighton-based not-for-profit specialist healthcare provider and our mission is to explore every opportunity to improve the health and well-being of people experiencing homelessness.”
“We hold a contract to do that until March 2023, but there are talks ongoing about that being extended so we hope to have good news for people soon. In 2019 we were awarded an outstanding CQC rating achieving outstanding in all five inspected areas. So we were one of the very few surgeries in the whole country to get that and what’s lovely about that is that we know that we are providing not just decent Healthcare to people who are experiencing homelessness, but some of the very best Healthcare in the country, which is I think very very important that we all Inspire for that sort of Excellence, It was a very proud moment for us just to go back.”
“I am sure you already know this, which is that people experiencing homelessness in general across the country attend A&E 6 times as often, they’re admitted to hospital four times as often and they stay in hospital for three times as long compared to the general population.”
“Being homeless is really bad for your health, we know that very often people become homeless because they have serious health problems and then they remain homeless, often because they have serious health problems and then if they didn’t have health problems when they became homeless, they often then develop health problems whilst they’re homeless or get more health problems, it’s a real health issue being homeless.”
“We can see they’re, fifty times more likely to have Hepatitis C, twelve times more likely to have epilepsy, six times more likely to have heart disease, five times more likely to have a stroke, two and a half times more likely to have asthma. People it’s just so bad for you and that’s one of the reasons that we’re doing a specialist Homeless Service, which is able to care for people who are developing all of these different conditions much younger than really they ought to be. Often when people are homeless we find that they have a combination of mental health problems physical health problems and submissive problems and that’s all in the context of very insecure housing and the stress that brings, just imagine how difficult that is to manage.”
Tim Worthley: Transcript from his speech at the Action on Homes Conference
“Really sadly the average age of death for a woman who’s homeless in this country is 43 and for a man who’s homeless in this country is 47 and consistently over the last 10 years as we’ve been monitoring stats and writing you find very similar ages and brightens by our best efforts and if you’re home and see what you are nine times more likely to commit suicide than if you aren’t.
So that’s all very depressing isn’t it um and again telling you things that you already know, so I just want to spend a couple minutes talking about what Arch do and then I think then we can get into questions later about what we would like to do in the future. Because I’ve hardly touched on it. earlier we heard that there is so much good, we feel that our organisation is all about organisations all of our efforts do, but we’re also always painfully aware how much more we could be doing and how much better things could be?”
“So at the moment if we look at the homeless Healthcare landscape in the city we have Arch Health, that that’s us and we provide a GP surgery, we have about 1300 patients at any one time we offer about 14, 000 appointments a year every year we get about 500 new people registered with us and about 500 leaves so we stay consistent at around the 13 or 1400 mark!
We get to know a lot of people every year and try and offer them the best care that we can in fact we see about 1300 different people every year on average people that registered with us we’ll see them about ten times, it keeps us very busy!”
“We have about 12 or 13 GP clinics a week 12 nurse clinics for healthcare assistant clinics, one physio clinic and some off-site sessions. So we squeeze a lot into that time but again we’re painfully aware of the fact that we would love to be offering much more and there are days where we do turn people away, sometimes in significant numbers, which is just the most horrible feeling for any healthcare provider and particularly for us.
We’re really lucky that as part of our contract we’re able to offer more than that as well, we have a health engagement team which is provided by Just Life, who are the most wonderful organisation and they will see over 150 people a year they will offer about 4,000 contacts and they’re primarily for people in emergency accommodation. but not just and they’re about helping look after them when they come out of Hospital, helping them connect with Health Services, helping them with other things as well and obviously just Life provide an awful lot beyond their health engagement work.”
“But they’ve made a huge impact in the city and what we found was offering that level of support ,then the people were far less likely to be readmitted Hospital once they come out. We also have a hospital in reach team as part of our contract which is provided by a doctor, Dr Chris Sargeant and a couple of nurses and a wonderful team leader and they troll the wards of the hospital finding anyone that’s been admitted who is experiencing homelessness. They provide extra special care and advice and support to the teams that admitted them and look after them and then they facilitate a much safer discharge and they work with over 300 people a year on the wards and provided truly Wonderful service.”
“So as well as that we provide Outreach clinics in the community we’re running it with YMCA we’re running a step-down bed project at the moment. So people can be discharged from hospital a bit sooner than the others would have been and we run conferences in the city and also we’ve been already involved in covid vaccination they’re just about to start another round of covid vaccinations with some other partners.
We also Run multi-agency Healthcare that’s what we do but then there’s some other wonderful homeless Services & Healthcare Services in the city such as the mental health homeless team, um such as the substance misuse service and all the others that we work alongside.”
“What we want for the city because we’re, as I say painfully aware of what we’re not doing, this is a map just to show where some of the different settings are in the city, for people who need to access health support and we find that in the average day someone might need to walk as many six miles just to get to a few different services. We believe very firmly that that’s not good enough, that it’s unfair that it’s introducing barriers and it makes trying to get out of homelessness, it makes that a full-time job and let alone all the other things you need to do just to stay alive and to stay safe.”
“What we would argue needs to happen and we can talk about this a bit more later, we think there needs to be a Homeless Healthcare Hub in Central Brighton that brings all of these teams together, that has a GP service, that has a mental health service, that has a community nursing service, sorry I didn’t mention the Sussex Community Foundation Trust Homeless Team.”
“Which is a wonderful group of nurses physios that go into hospitals and other settings and just do amazing work. So they would be with us we would want some misuse workers with us, the health engagement team and we’d like to host housing workers and benefits advisors and social workers and it could be a real Hub of activity. We could run courses, run classes, there’d be a Cafe there.
We think the city needs it, consistently we are the second highest cityin the country for levels of homelessness, we have exceptionally high levels of drug-related deaths and suicides and when is the city really going to get imaginative about how we can have a coordinated structured response to this, because the problem isn’t going away and it’s not going to go away until we do things differently and we believe this is one the ways things that could be done differently and I will stop talkingthere.” [Applause]
Dr Tim Worthley Speech Concludes