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The Impact of COVID-19 Pandemic and the ‘Everybody In' Campaign on a Physical Health Outreach Team for the Homeless in Warwickshire

Leads: Mr Paul Bird (WM-AHSN), Prof Richard Lilford (Meths), Prof Aileen Clarke (Public Health)

Public Contributors linked to the ARC WM Research Methods theme will work with the project leads to maximise impact of this study.

Dates: November 2019 - ongoing (first publication reviewing local implementation submitted January 2021)

Background:

ARC West Midlands were developing an evaluation of a new homeless physical health outreach service being piloted in Warwickshire under the Cold Weather Fund by South Warwickshire Foundation Trust and Warwickshire County Council. Within six weeks of launching, the ‘Everybody In’ national campaign to house rough sleepers during the COVID-19 pandemic, fundamentally changed the delivery of the service. As a result, the project changed from being a before and after evaluation of the physical health outreach team, to be a narrative of the changes in service delivery resulting from the 'Everybody In' initiative, underpinned by data from the outreach team.

Policy and Practice Partners:

Warwickshire County Council.

Co-Funding Partners:

Warwickshire County Council, South Warwickshire NHS Foundation Trust.

Aims and Objectives:

The aim was to describe the changes in service provision attempted to understand how and why the work of the service changed as a result of the ‘Everybody In’ campaign.

Methods:

Data was collated and reviewed for the period January 2020 to August 2020. The evaluation compared electronic patient records including demographics, service level activity, time spent with patients, and A&E attendances before and after the ‘Everybody In’ campaign. This provided a ‘natural experiment’ in understanding how and why the work of the outreach team changed based on the nationwide approach to house rough sleepers.

Main Results:

The team were able to conduct significantly more appointments with service users each day due to being able to locate them more easily and consistently. This also led to increased frequency of contact with service users. The duration of consultations decreased however, due to limited availability of private and indoor space in which to conduct consultations. The outreach team also saw an increased activity in wound management activity following the ‘Everybody In’ campaign.

Conclusions:

The campaign provided more stable living circumstances, made it easier for the outreach team to engage with patients, and exposed previously unknown unmet needs amongst the rough sleeping population. The physical health outreach team have had their funding extended, so we plan to conduct further work following the end of the 'Everybody In' campaign. This will include continuing to evaluate local policy and monitoring the numbers of service users following a big rise in the number of 'hidden homeless', which the campaign helped to reveal.

Implications for Implementation:

The plight of the homeless is subject to considerable change over the COVID-19 pandemic, which we are trying to track with the view to working with our partners on policy change.