Interview with Zoe; NHS Homeless Health Nurse

(3 Min Read)

“From the NHS team we think this has been an amazing success, really impressed with what’s going on here.”

Zoe NHS Nurse

“The clients that we see here often find accessing healthcare extremely difficult. When you are sleeping rough your immediate priorities are: ‘where am I going to sleep tonight? ‘And where is my next meal coming from?’ Healthcare unfortunately never reaches the top of the priorities. Accessing healthcare as a rough sleeper or a homeless person can be really challenging. Services are ill equipped to deal with people who are sleeping rough. Often there are preconceptions in mainstream services around what a homeless person looks like, what a homeless person’s rights are and aren’t and unfortunately a lot of GP surgeries are extremely difficult for a lot of rough sleepers to access. There is a misunderstanding that you need an address to access a GP and that’s not the case but often that is used as a barrier. Often our clients maybe don’t have a mobile phone, have difficulty getting letters about next appointments and as a consequence their physical health becomes neglected. Rough sleepers are at much greater risk of long term conditions than the main stream population. Our role here at The Bridge is to try to offer everyone a health screening as they arrive to identify any untreated or unmanaged conditions. Checking blood pressure, managing drug and alcohol issues, tapping into long term conditions that aren’t being treated like diabetes, respiratory conditions. Ensuring people are vaccinated – flu and COVID. We have a relationship with Dean Street Sexual Health services – getting people screened for HIV or other STDs. We have a team from Imperial who do BBV screenings. Lot of our patients have Hepatitis C.

The stability of being indoors makes that treatment viable. Whereas if you are rough sleeping these sorts of treatments are not viable. People’s lives are too chaotic. We’ve seen a lot of success at The Bridge, thanks to the stability of having somewhere to sleep, having regular meals, people can start thinking about their health.

Every two weeks we have a multi-disciplinary team meeting lead by my colleague, working together with our clients and bringing together all the different services so we can start to build a plan for our patients.

The great thing about The Bridge is it’s the last chance saloon. They’ve been evicted from other places, whereas here it’s very much hands off, no pressure, we’re here if you need us. We’ve seen people here at The Bridge who’ve never managed in accommodation before. We’re able to offer them support with their health which has previously gone untreated. Often it’s quite a slow process, building relationships and trust. From the NHS team we think this has been an amazing success, really impressed with what’s going on here.

There has been some real wins from the pandemic. By removing that immediate need for housing and food, the basic needs, people can then start looking to the future and thinking about their health. Previously their lives are just too chaotic. We’ve seen some really impressive results and picked up things like untreated TB, untreated HIV, lots of hepatitis. For example, Hepatitis C; the nature of the treatment is quite complex and it’s just not possible to undergo whilst you’re sleeping rough. The stability has enabled us to initiate treatment that would not have happened pre accommodation.

We aim to offer total flexibility. We are here Tuesday and Friday and very happy to go with the flow. There are people we might see every Tuesday and Friday with leg dressings. For example I have just had a call to let us know someone will be down in half an hour. I make contact with people when they are here and if they are ready to come down, then they come down.

At the beginning of the pandemic I was working on outreach and treating people with COVID on benches, because there was nowhere for them to go. Literally nowhere. People with COVID – sleeping on benches outside of churches. Not sick enough to go to hospital. Pre accommodation we were treating people on the streets. There were several people with COVID that we were treating on the streets before there was any accommodation options. Everything in London shut down, there was literally nothing open. The toilets closed, the water fountains closed, people were thirsty, people were starving: there was literally nothing. So to be able to offer people accommodation has been lifesaving.