Meadowell

Meadowell is a primary healthcare practice tackling homeless health in Watford & Three Rivers area.

Meadowell is a specialist GP surgery which was originally set up in 2003. Its aim was/is to tackle the barriers to accessing healthcare for homeless people in the local area. After consultation with local GP’s, providers of homeless services and homeless people it was agreed that there was a need for a specific surgery providing a focused healthcare.

Homeless people often have multiple health needs, including mental health and addiction issues which will be exacerbated by housing need; the patient can then present displaying behaviour which reflects those needs and sometimes this behaviour can be perceived as being disruptive and disturbing to other patients and mainstream general practices. Therefore it was important to put in place a project that delivered the correct care management which was able to address those issues, meaning that homeless patients would be able to gain access to the healthcare which up until that point had been lacking.  

One of the effects caused by homeless people not being able to receive effective healthcare, especially at the early stages of ill-health, is that their condition can deteriorate rapidly which leads to more hospital admissions. They may also need longer stays in hospital as there may be nowhere suitable to discharge them to. In addition, this lack of healthcare access can be a contributing factor in the number of deaths among the homeless, whose average life expectancy already is as low as 42.  

Meadowell opened in November 2003 but within a short space of time threats to funding due to budget cuts meant the risk of disbanding of the service became very real. This would have completely undone the hard work which had taken place and destroyed the doctor-patient relationships that had been established. With some help from the local press and raising public awareness we managed to fight of the threat of immediate closure.

Thankfully things have changed and Meadowell is now being run by a Community Interest Company, with the same GP providing medical care and the practice manager combining her role with the added responsibility of being a Director. Both have been at Meadowell since its inception. Although still funded in the main through the PCT this change in status has ensured the future of the practice and safeguarded the healthcare for the homeless patients for at least the next three years.

This change in status means Meadowell can now continue providing a much needed front line healthcare service but will also have the freedom to explore further innovative strategies which may provide a benchmark for other health providers to raise the quality of care for homeless people across the UK.