Somerset County Council: running outreach clinics for the homeless

At the start of the pandemic the council set up a homelessness cell - which led to many rough sleepers being encouraged off the streets and into accommodation.

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This is part of a series of case-studies published on 1 April 2021 

  • Public health team has worked with Somerset’s four district councils, drug and alcohol and local NHS services to co-ordinate working around homelessness
  • The rural nature of the county created challenges and so transport was provided to help people get to clinics 
  • People coming forward for vaccination were also offered a general health check 
  • More than 250 were vaccinated during 10 clinics in February and March 

Local context 

Somerset County Council covers a population of 560,000 across four districts, covering an area of 3,500sq km. Half the population live in rural areas. North Somerset and Bath and North East Somerset are both unitary authorities outside the boundaries of the county council. 

At the start of the pandemic the council set up a homelessness cell. This involved the public health team and housing and homelessness officers from the four district councils along with input from the drug and alcohol service and mental health. It led to many rough sleepers being encouraged off the streets and into accommodation. 

Public Health Consultant Matthew Hibbert said: “It meant when the vaccination programme started we had a very good foundation to build on. We had engaged the homeless population and started doing a lot more on health. 

“In Taunton we brought the rough sleepers into some student accommodation that was not being used and got services in to support them, such as dental care. We have been able to develop it from there and we have now got funding for a homeless health service.” 

How the outreach clinics were run

As soon as the vaccination programme got under way, Somerset decided it would prioritise its local homeless community. 

Mr Hibbert said: “We recognised they were vulnerable and so that gave us a head start. Because the homeless population is spread out across the county we knew we could not simply do a drop-in clinic at a single hostel or day centre as you would in a city. 

“We have people in B&Bs and houses of multiple occupation along with some bigger hostels. In total, along with the day centres, there are about 30 different sites. We knew we could not visit them all.” 

Instead, the council working with the mass vaccination programme team and local primary care networks set up a series of outreach clinics, held at day centres and at the larger hostels. 

“There was a lot of preparation that had to be done. The housing and homeless officers visited all the sites in advance to promote the vaccination clinics and book people in. But we also had to build in some flexibility as we knew there would be people who would just turn up. Transport was arranged to get them to the sites.” 

Around 250 were vaccinated during the 10 clinics in February and March. There are further clinics planned. 

“We are pleased with the impact is has had. As well as offering the Covid vaccine, some primary care networks also incorporated a health check into the appointment. A lot of people assume there is a lot of vaccine resistance in this group, but we found that was not the case. On the whole, they really wanted the jab.” 

And it already appears to be having an impact. “We had a positive case recently and tested all his close contacts – none were infected. These are people he would have been sitting with, drinking with. You would have expected there to be some spread.” 

Flexible approach could be used for other distinct populations

Following on from the success of the project, Somerset has started thinking about other ways it can use the outreach model. 

Mr Hibbert said: “We have had good uptake among older age groups. We have done a lot of promotion and communication. But we are aware as we get to the younger age groups we may have to do more outreach. 

“We have a relatively large central and southern European population. It may be that we do some pop-up clinics at local Catholic churches or other settings which they attend. We are also thinking about our van-dwelling and traveller communities.

“We are talking to our teams that work with these populations as many are registered at local GP surgeries so can access the vaccine via the normal routes, but we are definitely thinking about how outreach could work. The work with the homeless community shows the important impact it can have.”