Background People experiencing homelessness have a high rate of multi-morbidity and age related conditions at a young age (Lewer, Aldridge, Menezes, et al. BMJ Open. 2019;9(4):e025192; Rogans-Watson, Shulman, Lewer et al. Housing, Care and Support. 2020), are at high risk of dying young, yet rarely access palliative care (Shulman, Hudson, Low, et al. Palliat Med. 2018;32(1):36–45; James, Flemming, Hodson, et al. BMJ Support Palliat Care. 2021; published online 03 May). There is clinical and research activity across the UK aimed at improving palliative care access for this group. However, no single network or mechanism exists through which interested and experienced people can connect, share ideas and best practice, generate research questions or support to improve care.
Aim To create an ECHO (Extension for Community Healthcare Outcomes) network open to all professional groups to promote shared learning and a multidisciplinary approach to the care received by those experiencing homelessness towards the end of their lives, and drive enthusiasm and connections for developing research and practice in this area.
Methods Development of an ECHO network around palliative care and homelessness. Creation of a curriculum and evaluation of attendance within each ECHO session.
Results As of May 2023, 218 people had attended at least one ECHO session. Different professional groups were represented, inclusion health and general nurses (n=77, 35%), doctors (n=32, 15%), social workers (n=17, 8%), academics (n=9, 4%) and homelessness staff (n=9, 4%). The participant set curriculum included; medications management and active addictions, addressing stigma around substance use, managing inflexibility in systems, connecting and engaging with people experiencing homelessness, supporting someone in temporary accommodation and safe hospital discharges.
Conclusions The levels of attendance at and participation within the ECHO sessions highlights the growing recognition of the need for multi-professional responses to the challenges of supporting people experiencing homelessness towards the end of life. There is an appetite to continue this network to maintain the momentum generated and to facilitate the creation of inter-professional relationships and connections to understand and improve palliative care for people experiencing homelessness.
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