Drink and Drugs News DDN July 2018 - Page 10

healthcare Seeking healthcare can be daunting for homeless people. DDN visits a practice in north London that takes every opportunity to engage foot door A in the ‘W e haven’t touched the sides of the people sleeping on the streets around here. Everybody comes to Camden, they come to Euston train station, they come to Kings Cross, there are millions of tourists marching up and down Euston Road all the time. So if you want to beg, it’s a good place to be.’ Paul Daly is the practice manager at Camden Health Improvement Practice (CHIP), an NHS service run by Turning Point which provides health services to homeless people. Walking from St Pancras and past Euston on the way to CHIP means navigating through people of all ages and nationalities, sitting on the street and in doorways. As a drop-in health practice, CHIP welcomes all of them without any need for ID. If you are homeless you can make your way to 108 Hampstead Road and join the morning queue. At 9.20am doors open and the first nine patients are seen by the doctor. ‘That doesn’t sound like a lot, but they tend to be very complex,’ says Daly. If you have an emergency you can fill out a form and they will squeeze you in; otherwise you will need to turn up again the next day. Appointment slots are supposed to be 20 minutes per patient, but often run way beyond that. ‘We don’t restrict patients to one problem, but there’s a limit to what you can do,’ he says. ‘Some of the patients don’t present very often, so they’ve stored up a whole set of issues and we can’t manage them all.’ The practice has 800 patients at the moment – an increase of 25 per cent in the last two years. An important routine for each new arrival is the comprehensive health check, lasting around 45 minutes, which includes tests for HIV and hepatitis B and C. This is seen as a golden opportunity to engage, explains Daly. ‘A lot of these patients don’t go to a GP at all – they let themselves get so ill they go straight to hospital and it’s an endless cycle. So at least if they’re coming in here and getting their primary care managed, they have a better chance of stopping that from happening.’ The small team has one and a half doctors and two full-time nurses. They feel very lucky to have the support of a volunteer GP who used to work at the practice and comes back twice a week to do medical reports. In common with everywhere else, budgets (and space) have been squeezed. There’s no longer room for the 10 | drinkanddrugsnews | July/August 2018 clothing store, apart from some socks and gloves. Strong partnerships with local hostels and drop-in centres have become more important than ever. A doctor from CHIP goes out on his bike twice a week to visit the hostels and find ‘the really entrenched people’ who won’t come to the centre, maybe offering a prescription as an incentive to engage. Five or six years ago they were more of an outreach service, running a clinic at each hostel once a week. But it was an expensive way to run the service, needing double the staff and a lot more kit – and no guarantee that patients would be in the right place at the right time to see the clinicians. The current model allows hostels to send their residents over to CHIP for treatment and holistic care – and the support works both ways. The area has built up a network of specialist support through its drop-ins and day centres, so there are places to refer young people, sex workers, and arrivals from other countries who might need all kinds of help. Peer support is also close at hand through the charity Groundswell, who will take people to appointments – invaluable help since funding is no longer available for the team’s in-house ‘navigator’ post. www.drinkanddrugsnews.com