Delivering health for all
- Shrewsbury Ark
- 11 minutes ago
- 6 min read
We are delighted to announce our vital GP clinics are back thanks to the support of Riverside Medical Practice, part of the Shrewsbury Primary Care Network (PCN).
Dr Sam and Dr Nicki have worked closely with the Practice Team and Shrewsbury PCN, to create this support, and the service is running once a week on Thursday morning.
It’s hoped that the service can offer training to GP registrars and medical students in order to give a unique insight into a group of people difficult to reach and support.
Our day centre manager Rose says: “We believe that everyone, regardless of their housing status, deserves the right to good health and timely medical care.
“We are completely and utterly thrilled to thank Shrewsbury Primary Care Network for providing the funding for a trial to have Dr Sam or Dr Nicki back with us once a week. Sue and her incredible team at Riverside medical practice have put in a huge amount of work to create this trial and our clients are very grateful.”
The first morning the GP clinic ran, Dr Sam barely had time for a break; over ten people asked to see her about medical problems they were suffering with, such as trench foot and infected wounds.
Why the in-house GP clinics are an essential service
As well as being devastating, dangerous and isolating, people experiencing homelessness face some of the worst health outcomes. Homeless Link’s report, The Unhealthy State of Homelessness, found in its data collected between 2018-2021, that 78% of respondents reported a physical health condition, compared to 73% in the original cohort (2012-2014). For those reporting a mental health diagnosis, the change has become even more significant, increasing from 45% of respondents in 2012-14 to 82% in 2018-2021.
The homelessness charity, Crisis, states the average age of death for people experiencing homelessness is 46 for men and 42 for women. In addition, homeless people are over nine times more likely to take their own life than the general population. It’s vital therefore, that homeless and other vulnerable people are connected to support services as soon as possible.
Barriers to accessing healthcare
A person who has had complex life challenges and experienced horrendous trauma often lacks the skills and knowledge to cope; often substance misuse adds another layer of chaos to a person’s life too. If you’ve been abused as a child, come out of care, prison or the forces, or even lost your job due to the pandemic, or cost of living, sometimes it’s easier to turn to something to take the pain away.
Substance misuse causes and may exacerbate existing conditions, and it often brings about changes in personality and can present as extremely challenging behaviour.
Unlike a glamourous film or pop star, who immediately has support and access to resources, many people without homes are pre-judged, stigmatised and ostracised from society.
The very act of booking a medical appointment (and going) is anxiety inducing for a lot of the people using our services, and people experiencing homelessness or other vulnerable people are intimidated or do not feel comfortable accessing health and care services through usual routes. The result is health deteriorates and they only present to healthcare services when they are at crisis point.
Cost savings to NHS
Providing in-house GP services for homeless individuals not only benefits the patients but also offers significant financial savings to the NHS in the following ways.
Early detection
By having the healthcare services in-house, in particular a GP clinic, conditions such as respiratory infections, cancer, cardiovascular problems, trench foot, and mental health issues are identified early, and treated appropriately to prevent further deterioration. For example, a person with chronic respiratory issues might be able to receive regular check-ups, advice on managing their condition, and necessary prescriptions.
In-house GP services allow for more consistent and proactive care. By addressing health concerns early, these services can prevent the escalation of conditions that may otherwise require expensive emergency treatments or hospital admissions.
Furthermore, in-house services allow GPs to develop a deeper understanding of each patient’s unique situation and medical history. This continuity of care ensures that health interventions are tailored to the individual, reducing the risk of misdiagnosis or missed opportunities for early intervention.
Missed appointments
Non-attendance at appointments is all a cost to the NHS. There are many barriers to a person experiencing homelessness failing to attend an appoint. They may have difficulty to travel to the appointment, and the chaos in their lives makes them poor time keepers.
One study estimated that in 2022/23 the average 10-minute face-to-face GP consultation costs £56.*
When our funding for an in-house GP clinic ceased last year, in November, 22 appointments were booked and 15 of these were not attended, and in December- 20 appointments were booked and 12 of these were not attended.
Emergency services
Homeless individuals are more likely to use emergency services due to lack of access to primary care. In fact, a Birmingham University study, people experiencing homelessness in England are 60 times more likely to visit the emergency department in a year than the general population. This is more expensive for the NHS.
The cost of an individual going to A&E depends on the type of A&E – which can range from a major consultant-led department in a hospital to an urgent care centre or walk-in clinic – and the type of treatment the individual receives. For someone who attends an urgent care centre and receives the lowest level of investigation and treatment, the average cost in 2024/25 is £91. For an individual at a major A&E department who receives more complex investigation and treatment, the costs range on average from £137 to £445.*
In 2022/23, the estimated average cost of a patient taken to A&E by ambulance was £417. Ambulance call outs that didn’t result in a trip to A&E cost an estimated average of £287.*
These GP clinics are a vital addition to other healthcare services we are able to offer on our premises, such as the heptology clinic run in partnership with Shrewsbury and Telford Hospital NHS Trust, and through The Hepatitis C Trust; in this clinic, people are regularly tested for hepatitis; if anyone tests positive, we support them with wrap around care for their ongoing treatment.
In addition, through the RESET team, people have access to mental health, and drug and substance misuse support services.
With the above figures in mind, when we reviewed the conditions treated by the GP services and in-house health services last year, we estimate the teams are saving the NHS in the long run an average of £12k per person is in terms of missed appointments, fewer ambulance callouts/A&E attendants, early detection of health conditions and mental health intervention preventing deterioration and relapse.
By addressing both the immediate and long-term health needs of homeless individuals, we are helping to break the cycle of poor health and homelessness, and are providing a much-needed solution for both the individuals we serve and the broader healthcare system.
*All NHS cost figures taken from The King’s Fund Key facts and figures about the NHS.
A HUGE thank you to everyone who support us!
From January to March 2025, we supported more than 20 homeless and vulnerable people, and we helped 11 to move into permanent accommodation.
The Ark is the only organisation in Shrewsbury where those experiencing homelessness, or at risk from being homeless can seek help. As well as the people we support, and who are known to us, on average an additional 20 people in crisis come to our door seeking help, support or advice and information each month.
This means we have helped and supported nearly 100 people in crisis in the three months Jan-March.
We don't receive any government funding and are reliant on grants, our team of volunteers and your support.
Everything we do to support vulnerable people in our community, and help them make positive changes, is because of your generosity.
Like many charities, we have been hit by an increase in staff costs, and with donations down, we are facing urgent funding shortfall of £30,000 per month to maintain current levels of support.
We are very grateful for all donations, and would for you to consider setting up a regular donation by becoming a ‘Friend of the Ark. Donation details here.
If you are looking for a volunteer role, either at the day centre or at our shop, please get in touch.
And please do spread the word - follow us on social media and give us a shout-out: we’re active on Facebook, LinkedIn, Instagram, TicToc, and X (formally known as Twitter),