Case study

My Right to Healthcare

Groundswell and the LHHP have produced ‘My Right to Healthcare’ cards which explain to GP surgeries the rights of homeless people to register for primary care.

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Summary

People who experience homelessness in England are 60 times more likely to visit A&E in a year compared with the general population. This is largely due to the difficulty they have in registering at a GP surgery, with people often wrongly turned away due to lack of proof of address or identification.

To help address this, Groundswell and the London Homeless Health Programme (LHHP) have produced ‘My Right to Healthcare’ cards for people experiencing homelessness which explain that this population have a right to register with GP surgeries.

Background

Research has found that access to GP surgeries for people experiencing homelessness is a frequent difficulty. This leads to limited access to preventative primary care, a factor that is thought to be contributing to the heavy use of A&E.

Groundswell is a charity that exists to enable people experiencing homelessness to take more control of their lives, have a greater influence on services and have a full role in our community. Groundswell carried out peer-led research for the LHHP into people experiencing homelessness.

The consultation revealed that a leading barrier to gaining access to primary care via a GP for people experiencing homelessness was difficulty with registering at a GP practice. The consultation found that in most cases, registration wrongly required a fixed address, identification and a UK status. It also highlighted a lack of knowledge among GPs, the practices’ staff, the people experiencing homelessness themselves and those supporting them about their rights regarding accessing healthcare.

What was involved

Groundswell and LHHP set out to address this stark inequality by reinforcing the message that being denied access to GP surgeries is not acceptable.

They did this by producing ‘My Right to Healthcare’ cards with the input of their Homeless Health Peer Advocates. These are small, plastic, credit card-style cards emphasising that when registering with a GP:

  • you do not need a fixed address
  • you do not need identification
  • your immigration status does not matter

The cards are distributed to hostels, night shelters, day centres and food banks, and are handed out to people experiencing homelessness. NHS London approved the use of the NHS logo and brand on the card to add influence to the cards, and Healthwatch England’s details feature too, encouraging people to report any issues they face when using the cards or accessing GPs so that any issues can be addressed with the providers.

What went well

To date, over 75,000 cards have been distributed across London through Groundswell, as well as various partners in the homelessness and housing sector. Evaluation of the cards demonstrated that 92% found the cards ‘very useful’ in supporting people to register, and 92% also ‘agreed’ or ‘strongly agreed’ that the cards ‘increase awareness of the rules around registering with a GP’.

Doctors of the World UK (DOTW) run clinics and advocacy programmes which provide basic medical care, information and practical support to people facing multiple vulnerabilities. The DOTW staff have fed back that the cards are a useful tool for overcoming the barriers to GP access for people experiencing homelessness, and that as an advocacy tool they “really help service users to help themselves”.

Groundswell won an award for the healthcare cards under ‘Communicating for Change’ at the Homeless Link Excellence Awards. This award celebrates the impact communications can have to engage, change behaviour and improve lives.

Next Steps

Groundswell have been working with NHS England as part of a consultation with people experiencing homelessness across the country.

NHS England have committed to rolling the cards out nationally in 2020, ensuring more people can register with a GP and intervene early around health concerns.

Find out more at www.groundswell.org.uk

Published 11 February 2020