Abstract
Introduction: The Complex Needs Service operates a single point of access to a vulnerable, transient, and high-risk population, providing a range of medical, health and social care interventions for individuals with multiple and complex health and social care needs.
The Service replaced the previous Homeless Health model which focused on homelessness status rather than complexity and need. This development occurred as a direct result of the Covid-19 Pandemic which, due to significant increase in city centre homeless hotel population and the associated level of risks and vulnerabilities required a complete review of service delivery.
Aims, Objectives, Theory or Methods: An assertive outreach model was established and face to face contact was increased. The Service ensured that appropriate assessment and level of response was in place in relation to level of individual risk.
The aim was to actively engage “hard to reach” individuals with a particular focus on women and young people.
Continuous collaborative working was critical and maintained across multiple agencies and services.
The team adapted and developed whilst maintaining the priority of optimum level of engagement and care. Holistic care management ensured individual, personalised and person centred care; providing the right service and response, at the right time.
Highlights or Results or Key Findings: The Complex Needs Service responded to a population experiencing multiple disadvantage, often underpinned by the impact of poverty and health inequalities; whose needs do not fit neatly into one group. A large percentage of this population have multiple historical events highlighting previous unsuccessful attempts at engagement with mainstream services. The multi-disciplinary approach of the service achieved positive and sustainable outcomes with the following key findings:
· Significant decrease in lost contacts and improved treatment retention impacting on rough sleeping figures maintained at single figures.
· Protection and support was maintained by pro-actively taking the service to the service user; led by intelligence sourced from key partners.
· Impact on health directly related to the pandemic was minimal.
· Improvement in uptake of health interventions including BBV testing and treatment and delivery of over 800 Covid vaccinations and Naloxone.
· Decrease in drug related deaths which continues to be maintained.
· Increase in collaborative working across statutory, commissioned and third sector agencies.
Conclusions: The outcomes and key findings have confirmed the requirement for a service and model such as this. Despite the service being at a developmental stage; the significant benefits of a fully integrated, dynamic and highly performing team who rapidly respond to the presenting needs of our most vulnerable are clear.
Implications for applicability/transferability, sustainability, and limitations: Work is underway to establish strategic aims and objectives of the Complex Needs Service ensuring the team remain focused on shared outcomes as an integrated service. Improving interface between complex needs and mainstream locality services is a priority moving forward, supporting accessibility to the right service at the right time.