Purpose and Importance

1
Service User Needs
Housing
Health
Social
Other
CO-ORDINATING ON OVERLAPPING ISSUES By working
together
2
Homelessness in Glasgow

• 10,000 homeless presentations per year in
  Glasgow.
• 8,000 households - 60 of whom are single
• 4,000 households likely to be homeless at any
  time
• Family homelessness rising
• Highest drug using population in western Europe
• Presenting with increasingly complex needs
• (

3
Health Homelessness Coordinator
Homelessness Health Services 2005-7

• Homeless Mental Health Team
• Primary Care Mental Health Team
• GP Practice
• Homeless Families Service
• Physiotherapy
• Dieticians/ Podiatry / OTs
• Sexual Health Service
• HART / ADT
• PD and Trauma Service
• Homeless Addiction Team (2007)
• DART Acute and Mental Health

4
Health Services Within the Homelessness
Partnership

• 120 Health Staff across various teams
• Mental Health Teams (primary and secondary)
• GP Practice, Physio / Pod /OTs / Diet, PHT DNs /
  RGNs
• Homeless Families Service, Sexual Health Service
• PD and Trauma Service
• Homeless Addiction Team (2007) (45 staff Health
  SW)
• DART Acute and Mental Health
• Integrated Health / Social Work (housing )
• HART / ADT
• Additional Capacity to mainstream
• Locality Development Coordinators

5
Partnership Working in Glasgow
CHCPs Community Health Care
Partnerships

• Consists of all Services Within Defined Area
• Primary Health Care Services
• Social Work Teams
• Mental Health Services
• Addiction Services
• Learning Disability Services
• Working with
• GHA RSLs
• Voluntary Sector Providers
• Community representatives
• Police

Other Partnership Structures Addictions
Partnership Mental Health Partnership
Learning Disability Partnership
Homelessness Partnership
6
The Homelessness Partnership is the mechanism
for the coordination of Glasgows response to
homelessness by agencies working together within
a partnership organisation
7
Overlapping Issues for Homelessness service
providers?

• Levels of accommodation available ?
• Supply and demand for services
• Multiple assessments - multiple conflicting
  views
• Financial constraints - a reality for services
  and service users
• Managing a complex client group
• Barriers to joint working - affect on service
  delivery
• Attitudes to homeless people ? deserving v
  undeserving
• Sharing / obtaining information
• Overcoming prejudice
• Policy constraints versus practice realities

8
Impact of these Issues on Service Users

• Conflicting views expressed by professionals
• Pass the parcel culture
• Confusion for service user who is right? Who
  is responsible?
• ? Who to trust
• Inequalities in service provision - luck of
  the draw?
• Prejudicial treatment / service received
• Lack of coordination of response
• Duplication of effort and or service at times
• Duplication of cost waste of resource
• Lower service users expectations of service
  delivery
• Poorer outcomes for service user
• Neither policy nor practice meets the needs of
  the client

9
How do we overcome these Challenges ?

• Agree principles in partnership working across
  agencies
• Develop training jointly with partners
• Agree information sharing process (consent, can
  be given at various levels and on a need to know
  basis)
• What are the competing priorities find a way to
  balance
• Identify blocks, gaps pressure points to be
  addressed
• Plan in partnership - (use expertise across
  agencies)
• Measure and share successes across services
  develop best practice models
• Involve staff and service users at all levels

10

Similarities across homelessness agencies ?

• Direct Access / Needs led services
• Deliver service where people affected by
  homelessness present
• Services tend to respond quicker than other
  mainstream areas
• We are all affected by same shortfalls in the
  system
• Our client group is often difficult to engage
  with complex issues
• We find it difficult access mainstream services
  for this client group
• All have meeting the needs of homeless people as
  our core objective
• Why then are there barriers to joint working?

11
Differences Across Agencies

• Cultural
• Based on organisational norms and history of
  service development
• Ethos, values and beliefs of the organisation
  shape its response
• Systems and processes
• Designed to meet organisational needs but can be
  self limiting
• Often task led not needs led (eg supporting
  people financial requirements)
• The bigger the org the Slower to respond to
  change
• Different organisations have different reporting
  requirements

12
Differences across agencies (cont.)

• Knowledge and skills
• Knowledge base varies across agencies
• Training opportunities and personal development
  support varies across agencies
• Linked to terms and conditions and ability to
  fund for Vol org. and professional role for
  health and social work.
• Priorities
• Working towards org. objectives as defined (which
  may change)
• Competing local and national priorities
• Managing financial constraints
• Target driven
• Political drivers and legislative requirements

13

• What Helps ?
• Integrated Assessment across agencies
• Developing integrated teams
• Sharing care, experience and building trust.
• Planning services together to a joint strategy
• Information sharing
• Improving access back into mainstream services
• Work locally on prevention models
• Joint agreed and signed up protocols
• Joint training initiatives
• Developing effective service user and
  stakeholder consultation
• RESPECT

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AN EXAMPLE OF GOOD PRACTICELOCALITY DEVELOPMENT
CO-ORDINATORS ROLE(temporary posts 3 4 years
2004 2008)

• To work with key local managers to implement the
  homeless strategy at community level
• Embed homelessness in local community and health
  planning
• Facilitate commissioning locally work with
  elected members
• Monitor the effectiveness of new services
• Facilitate improved joint working across key
  agencies
• Support the management of change to achieve best
  practice

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AN EXAMPLE OF GOOD PRACTICELOCALITY DEVELOPMENT
CO-ORDINATORS ROLE

• Actively facilitate Joint training initiatives
  and awareness raising
• Develop an effective two way communication
  structure across agencies within localities and
  the partnership
• Develop and support effective homeless user
  involvement within localities
• Identify gaps, blocks and pressure points within
  localities and take appropriate action to address
  with local managers.
• Measure service user outcomes and feedback to
  services
• Troubleshoot access issues from an objective
  stance
• Evaluate effectiveness of resettlement through
  Continuity of Care Audits

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IN SUMMARY Shared Care - The Buck Stops Here

• Define basic principles of service and share
• Share care instead of pass care when
  appropriate
• Recognise the barriers we build and
  dismantle them
• Take a different perspective
• Recognise where objectives meet
• Put the service user at the centre
• Value the experience of others

The Buck
STOP HERE
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• Alice Docherty
• Health Homelessness Coordinator
• Glasgow Homelessness Partnership
• Granite House
• 31 Stockwell Street
• Glasgow G1 4RZ
• Alice.docherty_at_GGC.scot.nhs.uk 0141.276.4860