“People often share this information once a trusting relationship has been formed”
My name is Mark Leonard, and I am a Homeless Health Caseworker for Groundswell. Using a peer support approach, I support people experiencing homelessness to access healthcare and overcome health inequalities. This includes taking people to health appointments and advocating for them if needed. I also work with the UCLH Find & Treat team.
I attended a conference in Glasgow with the International Network on Health and Hepatitis in Substance Users (INHSU) and we shared information about the UCLH Find & Treat team, who visit people experiencing homelessness in London hostels and day centres. The team focus on blood-borne viruses which include Hepatitis C, Hepatitis B and HIV, and sexually transmitted infections such as Syphilis, Gonorrhoea, Chlamydia and Trichomonas. This is important because people experiencing homelessness have a higher prevalence rate and are at higher risk of infection with lower treatment rates.
If a patient tests positive, we can link them into treatment and offer peer support with collecting medication, transport costs and providing refreshments and lunch which helps to build the relationship and trust. See the poster for more information about all of the screening services we provide, we created this for the conference.
We go to the patients themselves to provide screening and treatment which removes some of the barriers and stigma of having to go to a clinic or a hospital. We can also refer people to the liver clinic for further screening or treatment where needed.
This is important because people experiencing homelessness have higher rates of liver morbidity and other complex health conditions. Patients with liver damage need to be monitored to ensure the condition doesn’t deteriorate or develop into certain cancers.
We work closely with the NHS and GP’s to ensure our patients receive ongoing treatment and support wherever they are based in the UK. Sometimes people move to a new borough or area and their treatment may not be followed up and any support can end.
We will contact the patient for consent to link them in with all the relevant services to ensure that services are aware of the patients ongoing treatment needs.
We also try to find peer support for the person in their new area as we know this emotional and practical support is really important. We never assume that a patient has a substance misuse issue, but people often share this information once a trusting relationship has been formed. We can refer patients to drug and alcohol services where requested and sometimes people need support to re-engage with local health and drug/alcohol services.
Some of the challenges we face include:
- People losing phone/losing contact.
- People moving to a new area.
- People being unaware of their diagnosis.
- Lack of support with ongoing treatment.
How to refer (London only)
If you work in a London hostel setting and would like the Find & Treat team to provide screening at your service, or if you have any questions, just email: [email protected]