Homelessness in primary care—a day with an emerging GP specialism

Alina (name changed for anonymity) had been sleeping rough on the streets with her husband before she was brought into Westminster’s Great Chapel Street general practice by an outreach worker from homelessness charity St Mungo’s. The 22 year old Roma woman was 24 weeks’ pregnant and had received no medical care since conceiving, neither in the UK nor in her home nation, Romania, where Roma are often excluded from healthcare systems and from which she had fled with her husband after a violent physical attack.Staff at Great Chapel Street—one of England’s five homelessness specialist surgeries—know from long experience that they have a narrow window of time to tackle the multiple health inequalities faced by vulnerable patients such as Alina. On the day of Alina’s arrival, practice nurse Maggie Fielder undertook a full medical and psychological check, made referrals to safeguarding midwives and children’s services, and applied for the maternity exemption…
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