Funded by the Burdett Trust for Nursing under their type-2 diabetes prevention programme, a partnership project focused on improving diabetes care for people experiencing homelessness has been progressing amazingly well. Pathway Nursing Fellow and project lead Sam Dorney-Smith tells us more… 

As reported in our last blog, we were delighted to hold our first workshop at the end of September, which focused on the challenges of diabetes and homelessness. The session was attended by a whopping 53 people from a variety of professional backgrounds, allowing us to obtain some very rich data and insights. This was then followed by a nurses’ meeting on 9 January, where we had the opportunity to hear from some fantastic colleagues undertaking Quality Improvement projects in their localities. 

As you can see from the photos below, another key strand of the project has been our visits to services around the country. These have been a real eye-opener into some of the innovative practice going on out there, and so far have included visits to Bolton, Plymouth, Bournemouth, Liverpool and St Helens.

Bolton

In Bolton we witnessed the partnership work of Specialist Diabetes Nurse Lynne Wooff with the Homeless and Vulnerable Adults Team, and the many other diabetes and inclusion focused innovations taking place there, including the Diabetes Champions project, the outreach podiatry service and their transitions service. 

Project Lead Sam Dorney-Smith met with Specialist Diabetes Nurse Lynne Wooff, and Homeless and Vulnerable Adults team lead Joanne Dickinson, as well as Faisa Abdi, a volunteer ‘Diabetes Champion’.

BOLTON – Faisa outreaches to hostels for people experiencing homelessness
BOLTON – Faisa outreaches to hostels for people experiencing homelessness
BOLTON – Faisa outreaches to hostels for people experiencing homelessness
BOLTON – Meeting to discuss the wrap around approach in Bolton – Lynne knows all the patients with diabetes on Joanne’s team.
BOLTON – Meeting to discuss the wrap around approach in Bolton – Lynne knows all the patients with diabetes on Joanne’s team.
BOLTON – Meeting to discuss the wrap around approach in Bolton – Lynne knows all the patients with diabetes on Joanne’s team.

Plymouth

In Plymouth we heard about the outreach work of Specialist Diabetes Nurses Emma Green and Amy Banks.  

Bournemouth

In Bournemouth we saw the partnership working between the inclusion health Health Bus and Samantha Whittle, Diabetes Specialist Community Lead from University Hospitals Dorset.

We met with Health Bus Operations Director Kate Hibbit, GP Dr Maggie Kirk, Inclusion Health Nurse Chrissie Croucher and Specialist Diabetes Nurse Samantha Whittle.

BOURNEMOUTH – Meeting the team onboard the health bus.
BOURNEMOUTH – Meeting the team onboard the health bus.
BOURNEMOUTH – Meeting the team onboard the health bus.
BOURNEMOUTH – Chrissie shows us the new electric car from which she undertakes her outreach. 
BOURNEMOUTH – Chrissie shows us the new electric car from which she undertakes her outreach. 
BOURNEMOUTH – Chrissie shows us the new electric car from which she undertakes her outreach. 

Liverpool

In Liverpool we saw the partnership working at Brownlow Health between the inclusion team led by Specialist GP in Homeless, Asylum and Inclusion Health Dr Ryan Young, and Specialist Diabetes Nurse Juliette Palmer. They have produced a poster winning first place at last year’s Primary Care Diabetes Society profiling their work in this area. Brownlow Health covers a practice population of nearly 80,000 across Liverpool, and thus is able to employ a senior diabetes nurse. 

LIVERPOOL –with a practice population of nearly 80,000 across Liverpool, Brownlow Health is able to employ a senior diabetes nurse
LIVERPOOL –with a practice population of nearly 80,000 across Liverpool, Brownlow Health is able to employ a senior diabetes nurse
LIVERPOOL –with a practice population of nearly 80,000 across Liverpool, Brownlow Health is able to employ a senior diabetes nurse
LIVERPOOL – Ryan shows us the Primary Care Diabetes Society trophy (after considerable persuasion!)
LIVERPOOL – Ryan shows us the Primary Care Diabetes Society trophy (after considerable persuasion!)
LIVERPOOL – Ryan shows us the Primary Care Diabetes Society trophy (after considerable persuasion!)

St Helens

In St Helens we heard about the amazing work Lesley Mitchell, Laura Walmsley and Rebecca Smith from the St Helen’s Special Diabetes Outreach Team. This included in particular their outreach to Teardrops, a support hub for people experiencing homelessness and other vulnerable adults, as well as their general approach to community engagement and diabetes care. Nick Dyer, Teardrops Hub Manager, is a diabetic himself, and has worked extremely hard to make sure his attendees get access to the best care. 

ST HELENS – The team showed us their poster profiling work with the Teardrops organisation
ST HELENS – The team showed us their poster profiling work with the Teardrops organisation
ST HELENS – The team showed us their poster profiling work with the Teardrops organisation
ST HELENS – As a diabetic, Teardrops Hub Manager Nick has worked extremely hard to make sure his attendees get access to the best care.
ST HELENS – As a diabetic, Teardrops Hub Manager Nick has worked extremely hard to make sure his attendees get access to the best care.
ST HELENS – As a diabetic, Teardrops Hub Manager Nick has worked extremely hard to make sure his attendees get access to the best care.

We have been totally blown away by the commitment shown to improving care at these services, and are really looking forward to be able to showcase this good work in the Queen’s Nursing Institute Homeless and Inclusion Health Programme guidance and Fairhealth E-Learning that will result from the project.  

You will also be able to hear from these practitioners in our upcoming ‘Diabetes and Homelessness: Solutions’ workshop on Thursday 25th January at 2pm.  

This workshop will profile eight examples of innovative work from across the country, and will also use facilitated focus groups as we look to gain consensus on the things that we believe that all health care practitioners can do to improve care. Everyone and anyone with an interest in diabetes and homelessness is welcome, so if you have not yet signed up please contact george.clark@pathway.org.uk to receive your invite. 

Additionally, we have also been undertaking some incredibly valuable patient interviews as part of the project, helping us to keep it focused on what matters to the people we care for. Insights from these interviews include the fear of being ‘told-off’ that many patients experience, and just how devastating a diabetes diagnosis can be at first, as well as very difficult to face up to when other more practical matters feel like a priority. They have also told us how difficult it is to manage their condition whilst being homeless. 

All of which leads us to the fantastic news that our diabetes and homelessness survey is now live. 

Aimed at nurses, healthcare professionals, hostel workers, health support workers and outreach workers, this survey seeks to get evidence of the challenges associated with diabetes and homelessness and find out about all the innovative practice that is out there. Subsequently, the data will hopefully be used in a journal article that will profile and support the need for innovative approaches to care like the ones we have seen in the project so far, as well as the aforementioned QNI guidance and E-Learning.  

The survey is set to be open until midnight on Sunday 3rd March, so please do help us to get as many responses as possible!  

We want everyone and anyone with an interest in diabetes and homelessness to take part, so that together we can make a difference in this crucial area of care. 

And that’s it for today’s update! If you want to get more involved, please do get in touch at samantha.dorney-smith@nhs.net. If you have been doing innovative work in this area then we would love to hear from you, as well as if you are just starting to think about your quality improvement journey.