The document discusses the problem of homeless people's access to healthcare and the high costs associated with it. Homeless individuals use acute healthcare services 4 times more and inpatient services 8 times more than the general population, staying in hospitals 3 times longer. To address this issue, a peer approach was developed involving recruiting and training homeless individuals as peer advocates to support clients in attending health appointments. Data shows this approach increased screening uptake by 45-75% and helped 5 advocates gain employment. The program expanded successfully from 2010 to 2012 in multiple cities due to partnerships, champion support from NHS staff, and its low-cost, targeted design.

1. The problem and its cost
 Barriers – health is relative, self esteem, other
priorities, drugs/alcohol
 The problem – homeless peoples’ access to
NHS care, prevention, appropriate use
 Cost = Financial and moral;
– Homeless people use 4 times more acute services than the
general population
– 8 times more inpatient services
– Stay in hospital 3 times longer (due to complexity of illness
not discharge)
– 33% A&E episodes vs 4% gen pop

2. The Innovation – a Peer Approach
 TB van – 45% -75% s cre e ning u p take
 R e cru it & train p e op le with e xp e rie nce of
h om e le s s ne s s – 5 into e m p loym e nt
 P e e r Ad vocate s s u p p ort h om e le s s clie nts to
atte nd h e alth ap p ointm e nts
 An ad vocacy ap p roach – e nab ling th e clie nt to
ch oos e h ow to ad d re s s h e alth is s u e
 D ata colle ction to e vid e nce cos t s aving

3. Diffusion and adoption
• We s tm ins te r – 201 0 5 ad vocate s s u p p orte d 57 clie nts
to 200 ap p ointm e nts
•We s tm ins te r & H &F – 201 1 , 1 2 ad vocate s s u p p orte d
95 p e op le to 400 ap p ointm e nts
•E xp ans ion into C am d e n 201 2
volu ntary s e ctor p artne rs h ip s
ch am p ions – frontline N H S s taff
m u tu al b e ne fits
 S im p licity & targe te d – e .g. j nior d octors
u
b e th @ grou nd s we ll.org.u k 020 7976 01 1 1