Meet Jane – our Complex Case Manager

Meet Jane – our Complex Case Manager
07/03/2024 Nikki Dudley

We recently chatted to Jane, Complex Case Manager at Groundswell to learn more about her work. In this blog, she shares how important it is to get services to work together if we’re going to help people experiencing homelessness with the most complex health needs.

Hi Jane! Could you introduce yourself for everyone?  

“My name is Jane Cook and I joined Groundswell last summer as the charity’s first-ever Complex Case Manager. I started my career over 30 years ago as a nurse, and since then I’ve worked extensively in health and homelessness services. I’ve worked in hostels, day centres, prisons, temporary accommodation, hospitals, and on the streets.” 

It’s great to have you on the team. What does a Complex Case Manager do? 

“I work in Groundswell’s Homeless Health Peer Advocacy service (or HHPA for short). HHPA improves the health of people experiencing homelessness in London. The focus of my role is on people who have multiple health problems, which makes supporting them more complicated. I manage my own caseload of people, and I also advise the wider HHPA team on how to deal with other cases where there are complex issues involved.”  

What sort of people do you work with and what problems are they facing? 

“People I work with might be living in a homeless hostel, or temporary accommodation. They often have physical health conditions like asthma, diabetes, or chronic pain, as well as mental health issues and problems with addiction. They might also have mobility problems, be disabled, and have learning difficulties.  

There are usually lots of different services involved when someone has several health needs. The problem is, they often don’t work together well, and people don’t get the help they need – they are falling through the gaps. And there’s lots of stigma around people experiencing homelessness, especially those who struggle with addiction and mental health.”  

And how do you help people in that situation?  

“I listen to what the person needs – I put them first. I look at all the current problems, what services are involved, and what needs to happen. I advocate for the person and their priorities, and make sure improvements are made. That could be anything from getting someone the right mobility aids, to connecting people to specialists in certain conditions like cancer or diabetes. A lot of my job is about navigating all the different services involved and pulling them together, so the right care is provided. Our healthcare system is complicated, and even more so for people with complex physical and mental health problems. 

I push for services to integrate and work together properly. This is often done through multi-disciplinary team meetings where all the health professionals involved in someone’s care come together to make decisions. I make sure that these meetings consider the needs of the person experiencing homelessness first, and often I support the person to attend so their views are heard directly.” 

An important part of HHPA is ensuring people’s rights are met – what does that mean?  

“Everyone has the legal right to a certain level of health and social care. But many people don’t understand their rights and are failed by the services that are meant to help them. For example, people are entitled to a Care Act Assessment which looks at what package of social care support someone needs. However, these often aren’t carried out.”  

You also do a lot to promote best practice in homeless health, what does that involve? 

A big focus for me is unsafe discharge from hospital. It’s common for people experiencing homelessness to be discharged without their needs being considered – people are often released from hospital back into a hostel that doesn’t provide the right level of support. Their health needs won’t get met, and they end up back in hospital again or at crisis point. 

If I can raise awareness about this type of problem, improvements can be made to the healthcare system. Alongside my casework, I attend lots of meetings, help to develop training, and speak at conferences and events. We want people working in healthcare to improve their services and consider the needs of people experiencing homelessness.” 

Find out more

Groundswell offers Homeless Health Peer Advocacy for a range of physical and mental health issues. To find out what we can offer and how to refer,
read our HHPA London page or email [email protected].

We have partners operating HHPA services in various parts of the country. If you would like to explore having a similar service in your area you can find out on our information page.