Access to primary care for those with multiple needs

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Summary of report content

Healthwatch Stoke-on-Trent conducted a review into the experiences of people who have no fixed abode accessing primary care services. GP registration is key to accessing social care, mental health services and substance abuse services. Healthwatch Stoke-on-Trent worked in collaboration with other community organisations, VOICES and Expert Citizens, using a mixed methods approach. Case studies with three service users, staff at GP practices and testimonials from experts in the field were used to explore peoples’ experiences with registering with GP practices. In addition, the team conducted a mystery shopping exercise to find out how many GP practices were registering patients who were experiencing homelessness. Their project found that nearly half of the GP practices said they were not able to register the person with no fixed abode. The ‘gatekeepers’, frontline staff such as receptionists, were found to not have a clear understanding on the current NHS England guidelines for registering patients and it was not clear how much autonomy they had when making these decisions. The team identified a number of barriers to accessing primary care, in addition to registration. The gatekeepers did not understand the needs of people who were homeless and people with no fixed abode experienced stigma both internally and externally. Healthwatch Stoke-on-Trent made recommendations to improve people’s access and experience to primary care services. They recommended that all GP practices are to abide to NHS England practice for registering all patients, to communicate this guidance to practices and ensure that the gatekeeping staff receive training to understand the needs of patients who are homeless. No response to the recommendations or other feedback has been received at the time of distribution of this report.

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General details

Report title 
Access to primary care for those with multiple needs
Local Healthwatch 
Healthwatch Stoke-on-Trent
Date of publication 
Thursday, 7 January, 2016
Type of report 
Report
Key themes 
Access
Healthwatch reference number 
Rep-5509

Methodology and approach

Primary research method used 
Survey
User stories
How was the information collected? 
Research
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Primary care services 
GP practice

Details of people who shared their views

Number of people who shared their views 
3
Age group 
Not known
Gender 
Male
Ethnicity 
Not known
Sexual orientation 
Not known
Other population characteristics 
Homeless people
Does the information include public's views? 
Yes
Does the information include carer's, friend's or relative's views? 
Not known
Does the information include staff's views? 
Yes
Does the information include other people's views? 
No
What was the main sentiment of the people who shared their views? 
Negative

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Yes
Does the information contain a response from a provider? 
No
Is there evidence of impact in the report? 
No
Is there evidence of impact external to the report? 
No

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.