NFA Primary health Care service for the Homeless.

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NFA Primary health Care service for the
Homeless.

• Tracey Campbell
• Nurse Practitioner
• Clinical Lead

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• NFA team- overview of the service
• Challenges of homelessness within the city
• Service user involvement

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Overview of the service

• The NFA is a Primary Medical Service (PMS)
  commissioned and provided by Leeds Primary Care
  Trust (PCT) and sits within the Community Care
  Services Unit.
• We provide a range of clinical and social care to
  the Homeless population of Leeds.
• The service is city centre based and we cohabit
  building with both St. Annes resource centre and
  Harm reduction service.

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• Provide a holistic primary care service to
  homeless people in Leeds that facilitates
  empowerment and growth by offering choice,
  respect, flexibility and opportunity to those
  persons excluded from existing services as a
  result of their NFA status.
• Multidisciplinary approach to Physiological and
  Psychological care of individuals with complex
  health needs.
• Provision of drug treatment and harm reduction
  services to all homeless people using opiates,
  stimulants and alcohol in accordance with
  National Treatment Agency and Models of Care
  standards.
• Support Worker Service offering professional
  interventions with clients to aid positive
  changes and re-integration into their local
  community.
• Developing and maintaining collaborative working
  relationships with external agencies to aim
  towards mutual goals and vision.
• Accessible and culturally sensitive ethos.
• Ensuring robust Governance and fit for purpose
  in line with local and national strategy.

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• Acceptance Criteria
• Homeless people aged 16 years rough sleeping,
  in hostel accommodation, insecure accommodation
  (short tenancy, sleeping on friends floors)
• Patients are registered with the practice through
  application of GMS.
• Practice population demographics
• Our practice population averages around 650-1000
  patients per annum.
• Approximately 30 of practice population equates
  to asylum seekers/ destitute failed asylum
  seekers and refugees.
• Service Delivery
• Monday to Friday 9am - 4.30 pm (5 pm non clinical
  service).
• On day appointment system for clinical team.
• Pre booked appointments for dental services,
  mental health, addiction services and support
• Domiciliary visits to service users in temporary
  or short term accommodation non medical team
  only.
• Outreach hostel satellite clinics, street
  outreach
• Accompanying clients to health appointments,
  court cases, access to social support/housing/work
  and training.

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The team
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Management
Management forum Primary care service
manager Clinical Lead Practice coordinator GP Drug
service lead Senior mental health
therapist Senior support worker
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Governance
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Clinical supervision External individual 2
monthly Internally individual as per
need Internal peer group 2 weekly
Training PDP/ KSF Target Students Training
packages
Strategic influence NFA Team Steering
Group TAG NTA group Homeless Health
Initiative Personality Disorder Network Tissue
viability research group
Service development Annual away day Project
Board Risk working group Business plan
Audit QOF Models of care NTA/ TOPS NSF/
NICE Performance management
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Collaboration
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Challenges

• Complex health needs
• Poly drug use
• Asylum seekers health and social needs- resources
• Housing tenure
• Political agenda service restructuring
• Out of hours services
• Residential rehabilitation and detoxification

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Service user involvement

• Service users involvement is facilitated in a
  number of ways in the development, planning and
  ongoing review of service provision and delivery
  
• We have a dedicated service user notice board for
  information re service user issues.
• Service users are encouraged to give feedback on
  one to one basis.
• Service user questionnaires when we require
  structured anonymous feedback.
• service users are invited to become involved with
  specific projects or service development work
• redesign of practice leaflet
• production of quarterly service user newsletter
• co-facilitation of service user group
• drug services city wide strategy group.
• Equality- utilisation of skills and experience-
  short term commitments

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