Arch Healthcare is Brighton’s only specialist homeless GP surgery. Arch currently looks after 1400 homeless patients - www.archhealthcare.uk
Below is some information we think might be helpful for clinicians caring for patients who are homeless or due to become homeless in the near future.
Brighton & Hove Hub & Spoke Model:
Over the last few years Brighton & Hove CCG have worked extensively to design a Hub & Spoke Model for the care of homeless and vulnerably housed patients in the city.
This model forms an integral part of the Integrated Homeless Health contract held by Arch since February 2017. Arch runs the specialist GP service, various outreach clinics, a hospital in-reach team and work with partners to deliver non-clinical health engagement work and is involved in a wide range of other health interventions in order to meet the health needs of homeless people in the city.
In addition, Arch hosts a fortnightly Multi Agency Homeless Health Meeting (MAHHM) where representatives from a range of services from across the city can discuss homeless patients who are causing the most concern to professionals and support workers. Referral of any qualifying patients to the MAHHM can be made via Arch’s Practice Manager.
Registering homeless patients
Arch Healthcare is a service commissioned to work solely with homeless and vulnerably housed people in the Brighton and Hove area. Patients may register with us if they live in Brighton & Hove and are:
Living in a van
Living in a hostel
Living in emergency accommodation
We support our patients in registering with mainstream surgeries if:
They have been housed in private rented accommodation for 6 months or more
They have been housed outside of the area of Brighton & Hove. (This includes placements by Brighton & Hove CC)
They have not been engaged with Arch Healthcare for a prolonged period of time
We are very happy to register any patients currently registered with local surgeries who have become homeless. However, it is not always in the patient’s best interest to change GP if they have become vulnerably housed, so we would encourage you to ask the patient what they think would be most helpful.
Please bear in mind, as per the links below, that people who are homeless have a right to be registered in mainstream GP surgeries. Our Practice Manager and Clinical Lead GP are willing to offer advice on individual cases if needed.
It is important to be aware that people who are homeless can not be refused registration on the basis of lack of ID or proof of address. Please see the below links for more information:
List of local homelessness services patients can be signposted to:
This website provides a list of local homelessness services patients can be signposted to: www.homelessinbrighton.org.uk
The Brighton Homeless Street Directory 2019 lists homeless services by type and day of the week: https://levity820317787.files.wordpress.com/2019/04/street-directory-2019.pdf
Particularly useful teams for clinicians might include:
First Base: First Base offers a range of services to support people who are sleeping rough or insecurely housed in the city, to get off the streets, start realising their aspirations through work, learning and leisure and find a place they can call home.
First Base is open every morning Monday-Friday. Arch provides nursing outreach clinics every Tuesday morning. Other outreach sessions are also provided by Podiatrists, St Johns Ambulance, the Mental Health Homeless Team and the SCFT Homeless Nursing Team.
Justlife: Justlife provide Health Engagement Workers who offer extensive non-clinical outreach to homeless patients with specific health needs; ensuring safe discharges from hospital, helping them to engage with health & care services and also providing a wide range of personal support with benefits, housing and general health and recovery. Referrals are made to this team from a range of services in the city including BSUH, Mill View Hospital, GPs, housing providers and other community providers. Patient care is designed through a weekly case meeting which is led by Arch Director and ANP Hannah Bishop.
Justlife also offers a weekly drop-in Thursdays 1.30-3 at Once Church Brighton, for people who are homeless. Arch offers nursing outreach from here once a month: https://www.justlife.org.uk/projects/brighton/brightontimetable/
2 Dyke Road, Brighton, BN1 3FE
0300 123 1550
Justlife Referral Form (downloadable link)
Pathway Hospital Homeless Persons Team
The homeless in-reach team at the Brighton & Sussex University Hospital (BSUH) follows the Pathway model and involves the identification, support and discharge planning for homeless people admitted to the hospital. The team consists of a part-time GP (Arch), nurse (SCTF), discharge and advocacy worker (Justlife). The team take referrals for all patients who are; rough sleeping, in a hostel, sofa-surfing, an asylum seeker, a traveller, in temporary (B&B) or hostel accommodation. Patients are assessed within 48 hours of referral (for Princess Royal Hospital the team only cover patients that are residents of/or applying to Brighton and Hove). When making a referral via the phone please leave a message with the name of the patient, D.O.B, ward they are on and hospital number. The team are available Monday to Friday 8am-4pm and have very limited cover at the weekends.
07884 195 417
Pathway Team Poster (downloadable link)
Sussex Community Foundation Trust Homeless Nursing Team:
The Homeless Team is a non-urgent community Healthcare service that is made up of nurses, occupational therapists, physiotherapists and a healthcare assistant.
Some people living in hostels and emergency accommodation can struggle to access standard NHS services and GP or nurse appointments. If you feel you are one of these people, we are able to visit you at home, to support you with various aspects of your health and wellbeing. The team includes: nurses, physios and OTs.
SCFT Homeless Nursing Team Referral Form (downloadable link)
SCFT Homeless Nursing Team Poster (downloadable link)
Mental Health Homeless Team: Located in the East Brighton Community Mental Health Centre. A Specialist service for people with mental health problems who are homeless or in unsupported emergency accommodation. Offers specialist advice and treatment and support on a range of issues and links people into services they would otherwise have difficulty accessing. Referral required.
SPFT Mental Health Homeless Team Referral Form (downloadable link)
0300 304 0098
St Mungos: Sussex Outreach Service (SOS) provides assertive outreach and support to rough sleepers. We work closely with StreetLink, the 24 hour rough sleeper referral line. Alongside the outreach service, we provide pop up hubs that offer rough sleepers a safe place for assessment away from the streets. The pop up hubs are not in fixed locations, meaning we can move them to areas where they are most needed. Referrals can be made via the Street Link app or by email including as much detail about the person and their sleep site as possible.
How Arch Healthcare can help
- Our Practice Manager and Clinical Lead GP are willing to offer advice on individual cases whenever that would be helpful
- We have attended surgeries to provide informal training particularly with regard to prescribing and managing complex patients with the combination of physical health problems, mental health problems, substance misuse problems and vulnerable housing. Please let us know if you think this would be of use to your team
- Arch hosts an Annual Homeless Health Conference each November (to fit with PLS training) this includes an afternoon session for local clinicians https://www.archhealthcic.uk/annual-health-and-homelessness-conference/
Prescribing for complex patients with tri-morbidity
Arch’s Prescribing Guidance Document (downloadable link)
Tips for managing complex patients with trimorbidity in a mainstream setting
Managing Complex Patients presentation Dr Tim Worthey Nov 2018 (downloadable link)
Arch Healthcare Contact Information
If you think Arch Healthcare can help with one of your patients, or you require more information from us, please contact our Practice Manager: 01273 003930 / BHCCG.firstname.lastname@example.org
Arch Healthcare opening times: 8am-5pm Monday-Friday. We offer a telephone service for urgent medical enquiries only from 5-6:30pm. Walk-in appointments are given out at 8am and 2pm each day.