Abstract
Background The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery.
Aim To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care.
Design and setting Qualitative semi-structured face-to-face and telephone interviews conducted in the north east of Scotland.
Method Participants were patients and healthcare staff including GPs, nurses, substance misuse workers, administrative, and local community pharmacy staff recruited from one SHHC, two mainstream general practices, and four community pharmacies. Interview schedules based on the 14 domains of the Theoretical Domains Framework (TDF) were drafted. Transcripts of the interviews were analysed by two independent researchers using a framework approach.
Results Seventeen patients and 19 staff participated. Key barriers and facilitators aligned to TDF domains included: beliefs about consequences regarding relocation; patient intention to relocate; environmental context and resources in relation to the care of the patients and assessing patient eligibility; patient skills in relation to integration; social and professional role and identity of staff and patients; and emotional attachment to the SHHC.
Conclusion Implementation of services, which promote relocation and integration, may optimise patient relocation from SHHCs to mainstream general practices. These include peer support networks for patients, better information provision on the relocation process, and supporting patients in the journey of identifying and adjusting to mainstream practices.
- delivery of health care
- general practice
- homeless persons
- primary health care
- Theoretical Domains Framework
- Received February 15, 2017.
- Revision requested June 6, 2017.
- Accepted July 18, 2017.
- © British Journal of General Practice 2018