Build networks of peer advocates to support vulnerable groups in urban communities to access free healthcare services as a means to regain control of their lives.

Freedom for Health

Personal experience makes volunteers better health advocates for homeless people

Homelessness in the UK is rising. Since 2010 rough sleeping in the UK has risen by 37%. People experiencing homelessness on average experience worse health than the general population and face multiple barriers to accessing healthcare. These barriers mean treatment for health issues is often only sought when the need becomes critical, resulting in homeless people using A&E services more frequently – 38% of the homeless population has accessed A&E in the past six months. The health inequalities associated with homelessness are stark; people experiencing homelessness have a life expectancy 30 years less than the general population. Furthermore, health issues compound barriers to employment and training, further increasing the challenge of moving from homelessness to a stable life and independent livelihood.

Groundswell is a London based organisation which enables homeless people to take more control over their lives through supporting them to access healthcare services. They achieve this through the involvement of peer volunteers who have been homeless themselves. By tapping into the lived experience of homeless people, Groundswell is able to support those struggling to access healthcare. 

Groundswell’s peer advocates provide practical support, including reminding patients of appointment times, going with them to appointments and paying for transportation. They also work with the UK’s National Health Service (NHS) to provide testing for homeless people for conditions including HIV, tuberculosis and Hepatitis B & C. The approach also benefits the volunteers themselves, who report feeling pride and a sense of achievement gained from helping others overcome the very same barriers that they themselves experienced, often moving into employment as a result of their volunteering. Working with their peer volunteers, Groundswell deliver training to healthcare professionals and work with them to improve the way health services are run.

James first met a Groundswell peer advocate after he had missed two appointments for a chest x-ray from the hospital. His hostel key worker referred him to Groundswell. He was apprehensive at first about going to the hospital in case he received bad news. At his first meeting with the Groundswell peer advocate, he soon realised the advocate was like him and wasn’t judging him; instead they were there to support him. James went to his next appointment, with the advocate, and was told he needed some medication. Fortunately the problem was caught early enough that after taking the medication he quickly recovered. Without this support, James was unlikely to have gone for the x-ray until his condition severely deteriorated, which would have meant a longer road to recovery.

Groundswell’s peer advocacy reduces health inequalities and saves the NHS money. Their programme so far has achieved a 68% reduction in missed outpatient appointments resulting in an up to £60,000 reduction in related costs to the NHS per year. A further 42% reduction in unplanned care activity has created even more savings. 

The peer element of the programme is crucial to its success, as peer advocates are able to form trusting relationships based on shared experience. They increase homeless people’s confidence, knowledge and motivation to access healthcare. In turn Groundswell has found this helps homeless people to transition from homelessness and unemployment to a stable home and employment or further training. Groundswell also supports their volunteers to develop and grow through their Volunteer Progression Programme, which enables its formerly homeless volunteers to overcome employment barriers by providing training, support and coaching that builds their self-reliance and self-determination. 

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