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Women Accessing Services – A Statutory Perspective

Women Accessing Services – A Statutory Perspective. Amy Hall Clinical Nurse Specialist Health Inclusion Team. 3 Boroughs Health Inclusion Team. Homeless, Refugee and Blood Borne virus clinics Homeless hostels, day centres and drug and alcohol clinics across Lambeth, Southwark and Lewisham

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Women Accessing Services – A Statutory Perspective

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  1. Women Accessing Services – A Statutory Perspective Amy Hall Clinical Nurse Specialist Health Inclusion Team

  2. 3 Boroughs Health Inclusion Team • Homeless, Refugee and Blood Borne virus clinics • Homeless hostels, day centres and drug and alcohol clinics across Lambeth, Southwark and Lewisham • 15 nurse specialists, 2 refugee case workers, 1 pain specialist and 1 GP session • Health assessments, treatment, referrals

  3. 2011 - 2012 • 3592 clients seen across the 3 services, 142 clients cases managed • 13897 face to face contacts • 21.8% were female • 59.2% homeless clients had a mental health condition, 50.1% were alcohol dependent and 41.3% drug dependent

  4. Cuts to the service • Reorganisation resulted in move of 2 valued senior caseworkers to the TB team • Loss of the practice development Nurse post • Lewisham disinvested in the Refugee health service from April 2012 • Southwark disinvested in a 0.5wte Band 6 nurse post from April 2012 • A further refugee case worker post was cut July 2012

  5. Women in our services Numbers hard to assess due to: • Transient nature • Non- engagement • Often hidden (ie. Sofa surfers and B&Bs) Homeless link: Approx 11% of rough sleepers in 2010 were women

  6. The nature of the problem • Research shows that women who are drug or alcohol dependent get significantly more social disapproval than men (Klee, Jackson and Lewis, 2002) • This gender bias has led to punitive responses and restricted options for treatment and care • Negative attitudes coupled with discriminatory practice have deterred women from seeking help (Morrison, 1999)

  7. Issues facing our female patients • Substance misuse • Mental health issues • Domestic violence • Prostitution • Pregnancy • Having children taken away • Partners with multiple issues

  8. Other statutory partners • General practitioners • District and practice nurses • Specialist substance use services • Specialist midwives • Health visitors • Domestic violence services • Lambeth prostitution group • Acute trusts • Social services • Mental health services • Drug and alcohol services • Sexual health services

  9. Organisational difficulties • No common or shared approach • Poor liaison and communication between services • Unrealistic expectations / treatment goals • Inconsistent advice given • No ONE professional taking responsibility for co-ordinating care

  10. Key to moving forward • Preventing further cuts • Inter-agency communication • Collaboration • Obtain consent to share information • Some examples of good practice….

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