Crisis support service offering remote clinical support to 14 second stage accommodation sites in Lewisham to assist in supporting clients at risk of a physical or mental health crisis.
We are currently piloting a new crisis support service across 14 2nd stage accommodation sites across Lewisham which will support approximately 93 clients. The sites house vulnerable adults with complex health and social needs under the vulnerable adult’s homeless pathway.
Working with hostel providers and wider stakeholders we have co-developed a pilot to support these clients and address the gap.
The pilot will;
- Offer remote access (telephone/email address/ video consultation) support to clients and/or site staff to support clients to prevent a potential crisis.
- Provide primary care clinical advice to assist in managing a client’s crisis.
- be accessible to staff members/ / clients’ key workers for and on behalf of the client. By contacting the service, there is implied consent from the client either directly or through a nominated staff member working on behalf of the client(s).
- Liaise with relevant healthcare, community, voluntary services to support management of the crisis, this may include the patient’s own GP practice in Lewisham.
- Establish a pathway for seeing the client in any of the 4 clinic sites should a face-to-face appointment be required and they are unable to access their own GP.
The pilot does not intend to replace general practice and if a patient is registered with a GP then every effort should be made to contact the patients GP as a first point of contact.
Referral Criteria
· Client aged 18 years on over residing in one of the 2nd stage accommodation sites listed.
· Client be at risk of a potential crisis* situation that would have imminent impact of the clients mental or physical health.
* The stakeholder focus group defined a crisis situation as
‘a circumstance where there is a potential safeguarding risk to a client and their physical and/or mental health.
or
where a client has had incidences of frequent urgent care/ A&E attendances and therefore at risk of further attendance and could be avoided through intervention.’
Likely scenarios might include.
- urgent medication requests,
- mental health crisis,
- urgent physical deterioration needing assessment,
- Med3 requests (if unregistered and money depends on it).
Background
In Lewisham, residents that are homeless or at risk of homelessness are supported by the council to access emergency or temporary accommodation often known as first stage accommodation or hostels.
Clients often move from hostels onto alterative supported accommodation in the borough, often referred to as 2nd stage accommodation. Transition between stages is often very fluid.
Although many clients are registered with a GP, access is often difficult, or the clients may be temporarily accommodated out of borough. Health needs are often neglected due to more pressing social, housing, and mental health issues and can lead to a decline in their health and self-neglect and result in a possible crisis point. Staff working with these clients have difficulties accessing primary care services for their clients or to obtain support for medically related queries.
A crisis situation would include a circumstance where there is a potential safeguarding risk to a client and their physical and/or mental health or where a client has had incidences of frequent urgent care/ A&E attendances and therefore at risk of further attendance and could be avoided through intervention.
Lewisham Homeless Outreach
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