Evaluation of the Homeless Health Peer Advocacy service.

Evaluation of the HHPA Service

Groundswell are working with a team of academic partners to conduct research exploring the impact of the Homeless Health Peer Advocacy service.
This research is conducted in collaboration with Kings College London, London School of Hygiene and Tropical Medicine and University College London. This research will involve both qualitative) and quantitative methods engaging community stakeholders, peer advocates and most importantly over 600 people affected by homelessness. The 3-year project is funded by the National Institute of Health Research (NIHR).

Health and homelessness.  People experiencing homelessness suffer extreme health inequalities.
• The life expectancy is 47 years for men and 43 years for women affected by homelessness
• Homeless people are between five-seven times more likely to die prematurely than the general population

Living on the streets, in unsafe or unstable accommodation means people are often more susceptible to poor physical and mental health. Compounding these health conditions are the various challenges homeless people face in accessing health services, for example fear of stigma, not being able to register with a GP and prioritising daily demands such as finding something to eat and somewhere to sleep before healthcare. As a result, accessing healthcare is often delayed until it is urgent. This causes potentially avoidable ill-health and distress, but also significant costs to the healthcare system. For instance, the health care costs of homeless people are estimated to be eight times higher than the general population.

Homeless Health Peer Advocacy (HHPA)
In order to combat this issue, we founded HHPA to improve people’s confidence in using health services and increase their ability to access healthcare independently. At the core of this service are peer advocates who have experience of homelessness themselves and provide one-to-one support to attend health care appointments. The support of a trusted advocate, with similar experience, to overcome some of these challenges, can significantly improve the health and wellbeing of people affected by homelessness.

Why the research is needed
While there is a lot of research on the influence of peer advocates on mental health and addiction, in the context of homelessness, there is limited understanding of how peer advocacy influences health and wellbeing of homeless people. In order to explore this in more depth, to understand its impact and the cost savings to the health service, National Institute for Health Research (NIHR) has funded an evaluation of our HHPA service. Our hope is to understand more about the shorter and longer-term impacts, identify what is working well and how the service can have a greater impact.