An exploration of access to healthcare for women experiencing homelessness in Northern Ireland

BACKGROUND: People experiencing homelessness have poorer health than the general population. Therefore, they are more likely to struggle with accessing healthcare, described in the Inverse Care Law. To date, there has been no peer reviewed research published from Northern Ireland on the topic of homelessness and health. Data published in recent reports shows a rise in the number of women experiencing homelessness in Northern Ireland. This research asks about the nature of access to healthcare for women experiencing homelessness in Northern Ireland and how can it be improved. METHODS: Semi-structured interviews were conducted with women experiencing homelessness, hostel staff and healthcare staff. Following the interviews, a stakeholder workshop was hosted to gather views from stakeholders in policy, planning and healthcare education. Data were analysed following Reflexive Thematic Analysis. RESULTS: There were 19 participants interviewed. All participants were female. Healthcare and hostel staff experience ranged from 1 year to over 30 years and included staff from each of the Health Trusts around Northern Ireland. The interviews were followed by a stakeholder workshop with 13 participants representing various groups and organisations. Preliminary themes constructed during Reflexive Thematic Analysis include health and social care complexities, awareness of services and needs, relationships, system design and connectedness. CONCLUSIONS: Preliminary conclusions confirm both supply and demand side barriers for access to healthcare for women experiencing homelessness in Northern Ireland, also included are recommendations for practice in Northern Ireland to improve this access journey. There is need for increased awareness of services for and needs of WEH, through improving service navigation and providing training for health and hostel staff. Alongside this, is the need for improved connectedness between services, both with referral and data sharing. KEY MESSAGES: • Women experiencing homelessness have complex health and social care needs that impact how they access healthcare. • This research is the first of it’s kind in Northern Ireland and provides insights into how to improve access to healthcare for women experiencing homelessness.