South West London (SWL) Homeless Health Programme
Constituting boroughs Croydon, Kingston, Merton, Richmond, Sutton, and Wandsworth, the SWL Homeless Health Programme aims to reduce health inequalities and support vulnerable populations through an inclusive and innovative care approach. The programme includes initiatives such as mobilizing pathway teams, improving primary care access, developing mental health services, and enhancing collaboration among stakeholders to better serve homeless patients.
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South West London (SWL) Homeless Health Programme PLUS Project Event on Integrated Care Systems 11 Nov 2021 1
South West London (SWL) Integrated Care System Constituent boroughs are Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth Population of 1,585,000 with high deprivation in Croydon and Wandsworth; and affluence other parts SWL Strengthening Communities Programme commitment s include : (a) Reduce Health Inequalities and (b) Supporting Vulnerable people We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk 2
SWL Homeless Health (HH) Programme People experiencing homelessness are among the most vulnerable people in the society and experience significant health inequalities SWL HH Programme s core objective is for homeless people in SWL to experience a significant reduction in health inequalities as result of increased engagement with services and partnership working between agencies The SWL Homeless Health Steering Group defines the goals and provides strategic oversight for the programme Membership of the group includes representatives from voluntary sector (SPEAR), public health, local authority (LA) housing, primary care commissioners, social care, LA Rough sleeping/homelessness teams, Mental health trust, GP Clinical Leads and HH Programme Lead We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk 3
21/22 Q2 Q3 22/23 - SWL HH Programme Plan Mobilise 2 x Pathway teams at Croydon Hospital and St Georges Hospital Out of hospital aftercare strategy/plan in place for Homeless patients Mobilise Short stay stepdown accommodation for 2x Pathway teams Move on strategy/plan in place for patients stepped down Delivery of the SWL Homeless Out of Hospital Care Model Primary Care education and awareness to increase homeless patients registration Development of SWL of primary care homeless health offer and primary care network- Safer Surgeries Sign up promotion; and uptake increase by at least 30% Specialist Homeless practice and champions in each borough Equality of primary care access for people experiencing homelessness Development of SWL Homeless Mental health service model and improved, Drug, alcohol and substance misuse Mental health service model and Drug, alcohol and substance misuse offer in all boroughs Improve collaboration and coordination of MH and drug & alcohol offer for homeless patients MH Champions for homeless patients in each borough Data: MDT working and data sharing/capture processes Key stakeholders: Improved integrated working with voluntary sector and Public Health. Services available: Directory of services mapping & minimum standards for discharge Promoting independence: Reablement, housing and income support. Enablers We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk
Delivering the SWL HH Programme Objectives Three priority workstreams are (a) Improving Primary Care Access via GP registration; (b) Mental Health offer and (c) mobilisation of 2 X Pathway teams pilot at Croydon and St Georges Hospitals Task and Finish Groups aligned to the Primary Care Access and Mental Health workstreams to ensure that operational stakeholders are sufficiently involved and engaged to make the required improvements and impact Voluntary Sector representation from the charity, SPEAR, on Steering Group and Task & Finish Groups offers advocacy input and intelligence/expertise from working with people experiencing homelessness Mapping exercise underway to inform the development of a directory of services for people experiencing homeless irrespective of their immigration status We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk 5
Expected Outcome Better health outcomes for people experiencing homelessness due to strengthened multi-agency partnership working People experiencing homelessness receive high quality, timely and co- ordinated care including end of life Improved primary care access for homeless patients Improved data recording and sharing that enhances the safety of people experiencing homelessness, best practice and facilitates outcome based commissioning People experiencing homelessness are able to access timely MH assessment, treatment and continuity of care Improved admission avoidance and discharge process for homeless patients We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk
The End We believe in an inclusive and innovative approach to care. www.swlondon.nhs.uk
