Benefits of GP care in outreach settings for people experiencing homelessness: a qualitative study

BACKGROUND: Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing their access into primary care but little is known about the experience of patients receiving care in this way. AIM: To explore PEHs’ experiences of GP care in community outreach settings in UK; and to seek staff/volunteers’ views on the strengths and weaknesses of GP community outreach services. DESIGN AND SETTING: A multi-method qualitative study with PEH and staff/volunteers working in three different community outreach settings in the UK. METHOD: Individual semi-structured interviews were carried out with 22 PEH and two focus groups with key staff/volunteers. Data were analysed thematically using framework analysis. RESULTS: GP outreach services better enabled PEH to access medical care and staff/volunteers valued GP support to promote, and facilitate access to, healthcare services. In particular, the findings illuminate the high value that PEH placed on the organisational environment of the GP outreach service. Valued aspects of GP outreach were identified as comfortable, safe, and engendering a sense of belonging; convenient, opportunistic, and a one-stop shop; and being heard, having more time, and breaking down barriers. CONCLUSION: The organisational environment is important in enabling PEH to engage with GP services. The physical and organisational environment of the outreach settings were the most important factors; they created a space where professional barriers between the GP and patients were flattened, so facilitating a therapeutic relationship.