A primary care practice providing health and social care to homeless people, asylum seekers and refugees in Bradford and Airedale has become a social enterprise organisation.
Bevan Healthcare, a community interest company formed recently by the staff of Bevan House Primary Care Centre, took on responsibility for running the service on 1 September, as part of the NHS Transforming Community Services agenda. It will deliver primary care services to its patients on behalf of the NHS.
The primary care centre, which was previously run by NHS Bradford and Airedale, has developed into a unique service since it first opened in 2003. The key to success for the specialist workers within Bevan Healthcare is treating their patients with respect, when they are often marginalised by society.
The service is made up of a core team of GPs and nurses working with a range of different health and social care professionals.
It is a one-stop-shop and has a range of services on site which include a health trainer, rapid HIV testing, contraception and sexual health service, podiatry and mental health support including the women’s therapy team and a psychologist.
The practice has a list size of around 1,500 patients, with new ones joining each week and others leaving. Half of the patients are homeless – in temporary housing, hostels or due to domestic violence – and this number is increasing in number; while the other half are asylum seekers, but this number is decreasing.
Most have serious health problems and live in poor social conditions: the biggest problems they face are poverty, deprivation and poor health. Common physical health problems include injuries from war or torture and infectious diseases; psychological problems include loss, bereavement, post-traumatic stress disorder, depression and other mental health problems.
Dr Les Goldman, who has worked as a GP at the practice since it opened and is now chair of the Bevan Healthcare board of directors, said:
“Becoming a social enterprise is the best way to preserve and develop the services we provide for our patients and is an exciting and innovative way to provide primary care.
“We aim to provide sensitive, holistic care that recognises the particularly challenging problems and backgrounds that many patients have.
“We deal with socially excluded groups who often struggle to access mainstream health services, but who are some of the most vulnerable people in our society and have urgent health needs. When patients come to us our priority is to make sure they have some stability and are linked to appropriate health services as quickly as possible. Eventually, once they are stable from a health point of view and living in permanent housing, we encourage them to register with a GP in the area where they live.”
The service also works closely with charities, faith groups and the voluntary sector and often signposts patients to other agencies who can offer other support.
Catherine Thatcher, deputy director of primary care at NHS Bradford and Airedale, said:
“Bevan House has provided a much-needed service for many years; helping to meet the needs of homeless people, asylum seekers and refugees and pave the way for them to transfer back into mainstream healthcare and integrate into the wider community.
“The team at Bevan Healthcare is very experienced and committed to making a difference to this group of people’s lives. I’m sure the service will continue to grow and develop as a social enterprise and I wish the team all the best for the future.”
Before Bevan House opened in October 2003, similar services used to be delivered on an outreach basis but it was decided to create a much more comprehensive service within a primary care centre, offering a central point of contact to deal with patients’ immediate health needs and then help them integrate into mainstream services.
In this way it has helped to reduce health inequalities and relieve pressure from other GPs and hospital A&E departments dealing with patients with acute problems which developed from primary care not being accessed in the first instance.
Homeless people often have numerous and severe health problems, but sometimes find it difficult to register with a GP and access basic health care services. Similar problems are also faced by people who have come to Britain as refugees or asylum seekers.
