The HHPA programme is an effective bridge to increased access of these services and is an effective form of increasing Patient Activation, which helps overcome many of the barriers to healthcare faced by those experiencing homelessness.
In 2015 Groundswell commissioned the Young Foundation to undertake a full external evaluation of our Homeless Health Peer Advocacy Service. The year-long study, funded by OAK Foundation, drew on a range of data sources including Groundswell appointment and demographic data, anonymized NHS data samples for known Groundswell clients and semi-structured interviews with current and former Peer Advocates. It also employed Peer Research to draw and reflect the participatory nature of Groundswell through undertaking in-depth interviews with HHPA clients, creating rich and insightful understandings of the impact of HHPA.
The findings revealed that HHPA not only reduces the health inequality that people experiencing homelessness face but also saves money for the NHS.
The evaluation shows that HHPA improves client health through:
- Increasing access to preventative and early stage health services through the support of a peer to overcome the multiple, and interconnected, barriers they face;
- Increasing the confidence, knowledge and motivation of clients to both seek appropriate healthcare and manage their health proactively in the future; and
- Decreasing the numbers of scheduled appointments that are missed by clients, thereby ensuring treatment is received.
Improved client health and changes in health related behaviour lead to cost savings for the NHS including:
- A 42 per cent reduction in unplanned care activity costs. Leading to an indicative saving of £2.43 for every £1 spent
- Between 50 and 70 per cent reduction in missed appointments bringing the number of appointments missed by homeless people supported by a Groundswell Peer Advocate down to the same as those missed by the general population and resulting in further cost savings;
- Potential future lifetime savings through better health leading to reduction in service use; and
Possible efficiency savings of supporting clients to access those services which are already available to them.
HHPA has a significant impact for Peer Advocates.
The peer component of the HHPA model is essential as it develops trusting relationships with clients through the shared experience of the Peer Advocate. This relationship and trust would not be developed without the mutual understanding of the peer, and therefore it is necessary to utilise Peer Advocates to act as a bridge between clients and the services available.
In the eighteen months from commencing volunteering, through developing employability and ‘soft’ skills whilst delivering support to clients, Peer Advocates transition from unstable accommodation and chaotic lifestyles to employment or training and more stable lives.