Working with homelessness

One thing that strikes you when treating a patient experiencing homelessness is just how much they simply want to be believed. 

On our latest student placement, we set up clinics for the vulnerable and those living on the streets at drop-ins run by Manchester homeless charities. 

Many patients there told us they’d turned up in NHS waiting rooms only to be ignored, labelled ‘difficult’ just because they were living on the streets. You get challenging people within any population, and yes many we saw struggled with drink, drugs or mental health problems. But the patients who came to us simply wanted help.

A lot had broken bones and had never had follow-up. Many felt they’d not had a proper conversation about their health, and most who had no fixed address missed out on appointments that are only arranged by letter. 

The challenges of assessing fractures left untreated for decades in some cases were matched by how differently we had to think when giving exercises and advice to people whose home may be a park bench. Forget ‘put some ice on it’ – it was ‘soak an old t-shirt in cold water and wrap the affected area’. Rehab all had to be equipment free. 

We certainly learned a lot.

For populations with unconventional lifestyles, you need agile solutions – which is why we need to add physio to drop-in clinics nationwide. When people who feel alienated by traditional healthcare can get treated somewhere they feel comfortable, they will. When word got around about our drop-in, we got 10 bookings in a day.

We’re planning to set up an Amazon wish list so future students on this placement can have kit to give out.

We hope our response whenever we see an individual experiencing homelessness in the waiting room is - there is a complex person with a complex life who needs help and deserves it as much as anyone. 

Amber Sconce is a recently graduated BSc physiotherapist studying advanced physiotherapy MSc and Amber Lynch is a recently graduated BSc physiotherapist working within Rochdale Infirmary