Westminster Homeless Health Action Group Meeting Minutes Venue: Westminster City Hall 15 attendees Service presentations 18 October, 12pm 2pm 1. Find and Treat Team Mobile Health Unit - Phil Foley The van was set up to screen for TB, but has developed into more of a Mobile Health Unit, which can test for: Visual radiology - which can detect respiratory conditions (TB, COPD, Lung Cancer) Hep C - saliva swabs Seasonal influenza vaccine - pneumonia vaccine Fibro-scan to test for cirrhotic livers Latent TB testing (recent study illustrated that approximately 1/5 of clients have latent TB) 2 outreach nurses who will locate and find clients that have diagnosed with TB and have disengaged with their treatment. The van goes round Westminster twice a year and will be going to daycentres approximately every 3 months. Although TB cases in the UK are going down, TB cases within homeless services are increasing. Provisional calendar for Find and Treat MHU in Westminster: When the calendar is updated it will be sent around to staff again.
Date/ time Venue Address 8.30-1pm, Tuesday 29 th November Passage Resource Centre SW1P 1NL 9am-1pm, Wednesday 30 th November 9am-11.30am, Friday 2 nd Edward Alsop Court/ King George s Hopkinson House St Vincent s Centre, Carlisle Place, 18 Great Peter Street, SW1P 2BT Number 2, Hopkinson House, 88 Vauxhall Bridge Road, SW1V 2RW TBC Passage House 1-5 Longmoore Street, SW1V 1JH 8am-1pm, Monday 5 th 8.30am-11am, Tuesday 6 th 6pm-9pm, Wednesday 7 th 8.25am-11.30am, Friday 9 th 12pm-2pm, Friday 9 th Connections at St Martin s Harrow Road TBC Outreach targeted shift West Day Centre Marylebone Day Centre nearest to Shroton Street 12 Adelaide Street WC2N 4HW 217 Harrow Road, W2 5XQ 134-136 Seymour Place Marylebone W1H 1NT Bradbury House 1-5 Cosway Street NW1 5NR 2. Change Grow Live Adelaide McKenzie Adelaide.Mackenzie@cgl.org.uk Change Grow Live is the new alcohol service for tri-borough. DAWs to be accessed for clients with drug use and criminal justice issues. The service will include the below as well as the Older Persons Alcohol service (for anyone over 60 years of age). Information and advice Health and wellbeing assessments BBV screening and vaccination Brief interventions Alcohol reduction plans Alcohol Prescribing services Clinically assisted reduction plans Community detoxification over a week Counselling Specialist staff; LGBT, Older Person, Women, Night Time Economy Full clinical team including a Psychologist, Doctors and Nurses Hospital Alcohol Liaison (if a client has an emergency detox in hospital then CGL will aim to work with them). Contact details for hospital alcohol liaison nurses: St Mary s = Sam Francis Hospital Alcohol Liaison Nurse, Mobile 07500 836952 / 0203 312 7663 bleep 2134 Chelsea and Westminster = Alex Roberts Hospital Alcohol Liaison Nurse, Mobile 07793 619987 / 0203 315 8000 bleep 8802 Page 2 of 5
Charing Cross = Charles Euzebio Hospital Alcohol Liaison Nurse, Mobile 07500 806970 / 0203 311 1234 bleep 7792 Service User Involvement via BRIC volunteering and mentoring Inpatient detox can be applied for however it is Substance Misuse team who will decide whether the criteria for funding has been met. ETE via Daws Group work via Daws The service aims to provide the same as before, but what has decreased is the 1to1 service as treatment tends to be more outreach (e.g. at GP). CGL has an outreach presence at Edward Alsop Court, Hopkinson House, Semi-independent Housing, King Georges and Harrow Road. Action: To discuss with Shroton Street/Montford House the possibility of having outreach/ link worker There is now a joint referral form for CGL and Daws. Alcohol awareness week 14 th -20 th November. Projects were asked whether they would like CGL to run a promotion event. CGL liaising with EAC and HH to run a stall during the week. Questions 1. Who currently provides pabrinex injections? No-one currently need to refer to GP. CGL are looking to see whether they can provide in the future maybe alongside community detox. Potential for Collen CNWL nurse to do pabrinex injections? 2. CGL assessment process is quite traumatic and has meant that some clients have stopped engaging with it. Would it be possible to be flexible with the assessment process? Yes, could do 2 meetings instead of 6 or CGL could come in and do assessment in house. Adelaide believes this may have been more of a problem with the staff member being inflexible and will discuss this with them. 3. Martin Jones CLCH Diabetes Service, vulnerable client s service Martin Jones Martin.Jones@clch.nhs.uk Martin informed attendees that he has worked in Westminster for 6 years and that he would like to be more connected with the specialised GPs and hostels in the area. Diabetes: Type 2 pancreas doesn t produce enough insulin Type 1 this happens when younger pancreas stops creating insulin all together. Both types are as dangerous as each other and have a risk of stroke and blindness. Page 3 of 5
Risk factors for diabetes Alcoholism, weight around the stomach, genetic factor (ethnicity; black, African, Caribbean), individuals on anti-psychotics (as the drugs make them want to eat more). Symptoms Thirst, blurred vision, using the toilet frequently during the night, slow wound healing. National screening programme for diabetes Screening for diabetes should take place over 40 yrs. of age/ or 25 yrs. of age anyone in a risk ethnic group. Diabetes risk screening tools can be downloaded at https://www.diabetes.org.uk/professionals/diabetes-risk-score-assessment-tool/ Referral to Diabetes service Referral is via the GP. Ask GP to state on referral paperwork that client is vulnerable adult/ homeless and they will be linked in with Martin s Vulnerable Diabetes service (protected from DNA levels). 4. Risk management paperwork Natalie Lodge Risk management paperwork was developed due to there being 4 deaths, numerous overdoses and suicidal clients in the hostel. In addition, a client nearly died as refused any medical help and had capacity when emergency services were needed the client had full renal failure and was in hospital for 6 weeks. Paperwork was produced with a solicitor and the client. Red flag on board in hostel indicates to staff who is at risk and needs monitoring. Monitoring paperwork in red file at reception and 1 person help to account each shift to do the checks. Paperwork includes (attached): Policy to explain how to use the paperwork Overdose monitoring Suicide monitoring Risk safety plan (used with suicide risk clients on day they say they are going to kill themselves or if they have a history of suicide) The HHCP has developed Treatment refusal form a form for a client to sign to acknowledge refusal of health treatment has been developed (attached). This can be used as a tool to encourage the client to accept treatment, but also to document when treatment has been declined. Page 4 of 5
A.O.B Supported housing projects were asked to encourage clients to share their CHAT information remind them that it is anonymous and non-identifiable. Health improvement team is looking for another project to run a sleep workshop Hopkinson House said they may be interested. Health files are being put together for services these will include the HHCP resources, health directories, referral forms and relevant health information. Date of next meeting: 20th, 12pm-2pm, Westminster City Hall, 17 th Floor. Page 5 of 5