Pharmacist Prescribers Working With People Who Are Homeless

NHS Greater Glasgow & Clyde

"Addressing health inequalities is often cited as the NHS’s first priority. People experiencing homelessness, who are rough sleeping, are not only destitute, they also suffer from unprecedented levels of combinations of physical ill health, mental ill health and addiction problems. When you next see a person who is homeless, consider this: their average age is 43 years, but in terms of health status (their number of chronic conditions), it is equivalent to looking at a vulnerable 84 year old with no money or roof over their head."

- Richard Lowrie, Pharmacists for Homeless project spokesperson

Pharmacists for Homeless

The ihub’s Improvement fund awarded a grant of  to “Pharmacists for Homeless” - a partnership project run by pharmacists from NHS Greater Glasgow and Clyde and outreach workers from the Simon Community street team to support Glasgow’s rough sleeping population and make healthcare more accessible for people who are homeless.

The multi-discipline outreach team take time to ask patients about their heart, breathing, nutrition, mental health, addictions, medicines, blood borne viruses, feet, and other health problems known to affect this vulnerable group who don’t often access preventative healthcare.

Patient consultations can take place in a range of unconventional venues, where trust can be established and a lack of permanent accommodation / fixed address is one less barrier to receiving care.

Initial Results

To date, the project has had successful engagement with over 80 people, several of whom are rough sleepers who evidenced a range of physical and mental health needs – the complexity added to by the presence of addiction and disengagement from health services and treatment. These patients have expressed their gratitude for having their treatments re-started, and are now engaging in health services as a result of our intervention. The combination of expertise has ensured that for those who were rough sleeping they have been successful at obtaining accommodation.

We know that healthcare for people who are rough sleeping is best delivered by engaging with the person where they are at that time, whether that is on the street, engaging in services or within their accommodation. This is because patients who are homeless often live chaotic lives and the nature of this limits their capability to engage in our traditional health services. People who are homeless also describe numerous barriers and a feeling of exclusion when accessing healthcare.

Kate Stock, a clinical pharmacist working with Glasgow’s Simon Community Street Team is now going out to assess the health of people experiencing homelessness, and where possible refer or treat patients (the pharmacist can prescribe independently) in conjunction with the Homelessness Health Service in Glasgow. That means the pharmacist and Simon Community Street Team meet patients on the street, in the Simon Community Hub, Glasgow Winter Night Shelter, the Marie Trust (where they can get a hot meal, shower and welcome) or William Hunter House. Over 80 people who are homeless have received a health check so far, with several engaging in multiple follow up consultations.

The outreach team are building strong links with addiction services, blood borne virus teams, and the hospital homeless discharge liaison nurse team.

“The development of the “Pharmacists for Homeless” project with support from the ihub’s Improvement Fund offers a vital service to Scotland’s most vulnerable people. Having the capability, for our health services, to reach out and engage with people who are in chronic need is a real game changer. Engaging in health is particularly problematic when you are without the most basic of human needs, a home. Pharmacists offer a significant wealth of advice and access to services and their willingness to engage in this way is inspiring and will improve the health of these people for the better.”

- Ruth Robin, ihub Portfolio Lead, Place Home and Housing

Next Steps

Following this initial success, the pilot project is now looking share its experience with other partners and expand to Edinburgh to continue the development of this outreach service to some of the most vulnerable people living rough in Scotland’s capital city.

Those involved in the project hope to build on the success of the project and make a case for the continuation of funding for the pharmacist-street worker outreach service, beyond the life of this initial pilot and grant award.

The ihub is committed to sharing the learning from this project and to enable health and social care providers to adopt this approach, ultimately encouraging the spread of this model of outreach service to communities across Scotland, where homeless people can benefit from similar health check support.

For further information on this project please contact: