We have been coordinating the London COVID-19 Homeless Health Response Cell, as a multi-agency approach to managing the health needs and minimising the transmission of COVID-19 within the homeless population in London. Please see a range of resources, information and further contacts below.
Case studies
- The pan-London response: A podcast and a written case study on ‘Homeless health in London – the response to Covid-19’, covering the period March to early June 2020 have been created. For the podcast, click here and the written case study, click here. (both published June 2020)
- North West London CCGs response to ‘Everyone In’ – read the report (published October 2020)
Flu information
In London if you are homeless you qualify for free flu vaccine. GP’s and pharmacies may offer this in other areas. A range of resources and guidance is available to promote flu jabs for the homeless.
Groundswell Flu vaccination guidance resources
‘Lockdown 2’ guidance for people experiencing homelessness (England only)
NHS England advice and information on getting the flu jab
Public Health England campaign materials that can be adapted for on-site use. Empty belly posters can be adapted to promote vaccination programs.
General guidance
NHS England and Improvement COVID-19 Clinical homeless sector plan: triage – assess – cohort – care
NHS England and Improvement COVID-19 Homeless Health staffing approaches and Homeless Health oversight implementation
NHS England Mental Health and Primary Care guidance
Latest Public Health England guidance.
Doctors of the World COVID-19 latest NHS guidelines translated into 60 languages
Local Authority rough sleeper accommodation guidance
Crisis COVID-19 transition planning toolkit
Guidance for commissioners
Ideal staffing and equipment specifications for COVID facilities
Site operational commissioning checklist for COVID CARE facility
Site operational commissioning checklist for COVID PROTECT facility
Moving on from hotels
HDAS London information and support guides for drug and alcohol support (also translated in Romanian, Polish and Punjabi) and smoking cessation (also translated in Romanian, Polish and Punjabi)
Groundswell leaflets for registering with a GP and GP preventative care:
Registering with a GP during COVID-19 and translated in Arabic, Bulgarian, Persian, Polish, Punjabi, Romanian, Russian
GP Preventative Care and translated in Arabic, Bulgarian, Persian, Polish, Punjabi, Romanian, Russian
An information leaflet on Safer Sex and Contraception
Information about the NHS App to help clients check symptoms, book appointments, order repeat prescriptions and view their summary care record.
London NHS commitments to former rough sleepers being resettled in London.
Information for hotels
Hotel Frequently Asked Questions and guidance on adapting facilities and procedures during the coronavirus (COVID-19) pandemic
Department of Health & Social Care signed Control of Patient Information (COPI) notice
Communication processes for COVID Hotels and Hostels
Health model for care in COVID-PROTECT sites
COVID symptoms notice for hotels. To be edited with local details, printed out and put under everyone’s door when they come in
Homeless Hotel poster (this can also be used in hostels)
Useful contacts poster for hotel site staff
FAQs on PPE and cleaning for GLA-funded COVID-19 response hotels
Homeless Health COVID-19 waste disposal pathway
Managing Covid hotels interview: Sam Dorney Smith, Senior Nursing Fellow at Pathway, has shared her valuable insight to meeting this challenge with us. Watch the video to learn about the process of setting them up, the challenges and guidance for other sites (YouTube).
Information for hostels
Mini CHRISP Plus guidance tool – Quickly identify those at increased risk to COVID-19 who need to be shielded in appropriate accommodation
COVID-19 Risk Assessment – Screening tool to support non clinical outreach workers
Updated Government guidance – Covid-19: provision of night shelters (13/10/20
Hostel Frequently Asked Questions and guidance on adapting facilities and procedures during the coronavirus (COVID-19) pandemic
Department of Health & Social Care signed Control of Patient Information (COPI) notice
Communication processes for COVID Hotels and Hostels
Quick PPE reference guide for those working in hostels
Webinar – ‘Supporting homeless hostels in responding to COVID-19’ (29 April 2020, presenters from UCL/Pathway, PHE, GLA, Look Ahead) – watch again here and find the full slide pack here.
Health needs assessment multi-disciplinary team guidance, based on CHRISP assessments.
CHRISP and Health Needs Assessments: Follow on work.
Referrals for testing
If you have a resident showing COVID-19 symptoms, please refer to the Find and Treat Team
From Monday 20th July 2020 – if any residents have symptoms of COVID-19, please contact the Find and Treat Team by email: haltTeam.cnwl@nhs.net
Please complete this referral form available here
For further information about what action hostels should take if they have a symptomatic case please see the frequently asked questions
Referrals to COVID CARE
If you are referring from an Outreach Team please contact the COVID CARE team directly. All outreach referrals to CARE need to take place only with the agreement that if the client tests negative the referring team maintains responsibility.
If you are referring from a residential setting for the homeless, please call COVID CARE on 07376 185873 or email Covidcare.mildmay@nhs.net. Once the referral has been accepted, please complete the transfer form for people accepted into COVID CARE from hotel or hostel
Guidance for non-clinical settings referring into COVID CARE
Hospital discharge
Management of Homeless Patients on discharge from hospital; hospital discharge to COVID CARE pathway, COVID CARE process map from hostels and hotels and COVID CARE referral form for hospital discharge
Management of Homeless patients on discharge from the emergency department process and pathway
Please refer any homeless clients who attends a site directly to StreetLink London or contact your local Homeless Outreach team.
Information for primary and community care
Primary Care Standards COVID-19 Homeless Health
Webinar series: Homeless health, primary care and Covid
In June 2020, this HLP series featured experts with lived experience and specialist GPs:
- Webinar 1: Homeless health background, overview and London’s Covid response, with Dr Caroline Shulman and Dr Zana Khan – 8 June 2020. Watch again here.
- Webinar 2: Homeless health, Covid and the patient journey through general practice, with Groundswell’s Sharon Clint and Dr Jasmin Malik – 11 June 2020. Watch again here.
- Webinar 3: Homeless health, Covid and safer surgeries, with Doctors of the World – 12-1pm, 18 June 2020. Slides here.
- Webinar 4: Next steps for London: health needs assessments and the importance of MDTs, with Dr Binta Sultan, Dr Caroline Shulman, and guests from HDAS, Haringey, Kingston and Hackney. Watch again here.
Recommended PPE for primary, outpatient and community care by setting, NHS and independent sector. Need to wear face and eye protection to see symptomatic patients (would include visors) and surgical masks when seeing asymptomatic ‘extremely vulnerable’ patients (COVID PROTECT).
Guidance for putting on and removal of PPE
British Medical Journal visual summary for COVID-19 remote consultations. A quick guide to assessing patients by video or voice calls
Hierarchy of Vulnerabilities and risk factors for COVID-19 for ARC
Barnet CCG Primary Care Guide during COVID-19 flowchart
NHS England National Early Warning Scores (NEWS)
Community testing for suspected COVID-19
Primary Care and Community Respiratory Resource pack for use during COVID-19
Pragmatic guidance from the Primary Care Respiratory Society (PCRS), for the routine and crisis management of patients with asthma and chronic obstructive pulmonary disease (COPD) during the COVID-19 epidemic. Nebulisers should, where possible, be avoided for acute attacks due to the increased risk of disseminating COVID-19 (to other patients AND to physicians, nurses and other personnel)
COVID-19 Homeless urgent dental pathway
Process for getting primary care advice template for hotels
Drug and alcohol guidance
PHE and Department of Health and Social Care (DHSC) COVID-19 guidance for commissioners and providers of services for people who use drugs or alcohol
Launch of Homeless Hotels Drug and Alcohol Support Service (HDAS London) and additional resources; smoking and COVID-19 guide for residents and smoking cessation product user guides for residents including JUUL e-cigarette, Vype ePen, nicotine mouth spray and pouch and Voke nicotine inhalator
HDAS London workbooks on Cannabis, Cocaine and Crack, Alcohol (Polish translation), Heroin, Spice and 2 activity packs (activity pack 1 and activity pack 2)
HDAS London link to training video for tobacco harm reduction and e-cigarettes
Protocol for the management of alcohol withdrawal in temporary homeless hotels during COVID-19
Protocol for the management of nicotine withdrawal in temporary homeless hotels during COVID-19
Protocol for the management of opioid dependance in temporary homeless hotels during COVID-19
Harm reduction strategies for alcohol dependence
Additional resources and poster on substance misuse (article on supervised consumption during COVID-19 and information on naloxone including when and how to administer Prenoxad Injection)
Mental health guidance
If staff and clients are unsure where to get crisis guidance from, they are advised to call 111 and ask for the local mental health crisis line
Monitoring mental health clients one pager
Safety Plan form for clients with suicidal ideation
Self-harm alternative coping strategies
Getting Help in a Mental Health Crisis (Westminster example)
Palliative and End of life care
A collated list of National, Regional and North West London local good practice resources for community practitioners to use to support anticipatory care planning and palliative care during COVID-19 crisis
Admission and Care of Residents during COVID-19 Incident in a Care Home
Planning for your future care – a guide
Pandemic palliative care: beyond ventilators and saving lives
Homelessness and palliative care
Google drive link to guidance related to COVID19, homelessness and palliative care (open access)
Symptom control guidance for the last days of life during the COVID-19 pandemic (summary)
Contact
For more information contact the team at hlp.homelesshealthcovid19team@nhs.net
