An exploration of GP care in outreach settings for people experiencing homelessness: a qualitative study

Abstract

Background: Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing access into primary care but little is known about the experience of patients receiving care in this way. Aims: 1) To explore homeless patients’ experiences of GP care in community outreach settings in UK; 2) To seek staff/volunteer views on the strengths and weaknesses of the GP community outreach services. Design and setting: A qualitative study with PEH and staff/volunteers working in 3 different community outreach settings in the UK. Method: Individual semi-structured interviews with 22 PEH and two focus groups with key staff/volunteers. Data was analysed thematically using framework analysis. Findings: GP outreach services better enabled PEH to access medical care and staff/volunteers valued GP support to promote, and facilitate access to, health care services. In particular, findings illuminate the high value that PEH placed on the organisational environment of the GP outreach service. Valued aspects of GP outreach were identified as: 1) comfortable, safe and engendered a sense of belonging; 2) convenient, opportunistic and a one stop shop; and, 3) being heard, having more time and breaking down barriers. Conclusion: Organisational environment is important in enabling PEH to engage with GP services. The physical and organisational environment of the outreach settings were the most important factors: they created a space between the GP and patients where professional barriers were flattened and facilitated a therapeutic relationship.