Homelessness2 - Kristinn Tan

Speaker key

IVInterviewer

KTKristinn Tan

KTI’m Kristinn Tan. I’m the lead GP at Camden Health Improvement Practice. We’re a specialist practice and we see single, homeless adults and other marginalised groups. The talk today was about homelessness in the Camden context and included hopefully useful advice and resources for the local GPs.

IVWhat is the definition of homelessness?

KTThe word home has both physical and psychological meanings. A home provides roots, identity, security and a sense of belonging. It’s a place of regeneration where warmth, stimulation and emotional wellbeing are normally found. Therefore homelessness can be very subjective. And certainly it covers those who are literally roofless, such as the rough sleepers, to those in temporary accommodation and impermanent tenures. And it could go all the way to those who are currently accommodated in households which are sharing accommodation but not wanting to, or those who indeed are split but would like to live together. What we work with on a day to day basis are the legal definitions of homelessness and those are the statutory homeless and the non-statutory homeless. The statutory homeless are those who have applied to a local authority for housing on the grounds of a priority need. And broadly speaking, these are the households with dependent children, pregnant women, and those with significant physical illness. The non-statutory homeless are everyone else and the data that are available in the main are on rough sleepers and hostel or bed and breakfast dwellers.

IVHow many people are homeless in Camden?

KTTo give some idea of the numbers of statutory homeless, in July to September 2014, there were 612 households who applied for and were accepted by Camden as being homeless. And if the numbers are roughly stable over the year, this would equate to about 2.5% of the total number of households in Camden. In terms of rough sleepers, the CHAIN data for Camden for the same period shows 191 rough sleepers. And an important point I think in the CHAIN data is that the trend is definitely upwards. There are also 500 homeless hostel beds in Camden and these are generally kept full. And so roughly in total there are about 600-700 homeless single adults in Camden, from the data that we have, at any given moment in time.

IVAre there any particular characteristics of the homeless in Camden?

KTIn Camden, like the rest of the UK, there’s roughly 80:20 male:female ratio in the single homeless adults. London is different from the rest of the UK in that it has an older single homeless population where nearly 60% are older than 40 years of age. The UK average age for a homeless adult is 35 years and this has implications for the disease profiles seen in London. The majority of single homeless adults are from the UK, and this is closely followed by the Europeans, who form about a third of the population. And again, unsurprisingly, London compared to the rest of the UK has a more ethnically mixed homeless population.

IVWhat is the aim of the LCS?

KTIn an ideal world, there would be no homelessness and so no need for the LCS and no need for Camden Health Improvement, otherwise known as CHIP, either. But the world is less than ideal and the LCS aims are laudable. And it aims to improve access, reduce inequalities and provide flexible, person-sensitive healthcare for this very hard to reach group. There’s a lot of stigma associated with being homeless and the homeless often have to endure very negative attitudes from society, including – sadly to say – the medical profession. And I’m very encouraged that the GPs in Camden are willing to undertake this work.

IVWhat services are there that they can access themselves?

KTThere are many services available to homeless people. In fact, there are far too many to be able to list in a handful of minutes and I would encourage GPs to have a look at the homeless directory which sits on the Camden CCG website. There is a leaflet there aimed at street homeless people, for starters and links to many of the services available in the borough.

IVAre there any services that they can only be referred to by a medical professional?

KTYes, there are. There are some that require referral. And again, these will be marked out on the Camden CCG website and, where required, we will do our best to ensure the referral forms are available.

IVWhat are the key messages from your presentation?

KTHomelessness has a significant deleterious impact on health and is an independent risk factor for premature death. The health sector plays an important role in facilitating the transition out of homelessness. It’s certainly not alone in its endeavours and there are many services available to the homeless and their GPs in Camden. Finally and most importantly when doing this challenging work, it’s to remember that people do leave the cycle of poverty and deprivation against seemingly insurmountable odds and it does take time. And I think part of what we do in general practice is to hold onto this potential until it can be realised. And I think it’s a worthy thing.

IVWhere can GPs find out more?

KTIf GPs go to the Camden CCG GP website and search for homeless or homelessness, they will find the homeless directory at the top of the results. It’s an online resource for GPs and it describes the services that are available to homeless people as well as links to professional networks, should they be interested. You can also contact myself and the team at .

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