Public Health - Homelessness/Asylum seekers Flashcards
Social exclusion and loneliness.
a) Defining loneliness
b) Societal measures
a) Companionship, quality and meaning of relationships, contentment with self, social interaction, hobbies/interests
b) Labour - social exclusion policy; Tory - ministry for loneliness (individualisation?)
Recognising loneliness
a) Appearance
b) Body language/conversation
c) Living circumstances
d) Medical
e) Life events
a) Neglect (or over-dressing)
b) Boredom (or over-friendliness/over-talkativeness, clinging, etc.)
c) Lives alone
d) Immobility, multiple co-morbidities
e) Bereavement, recent transition (into care, etc.)
Managing loneliness.
a) i) Social prescribing - ii) give examples
b) Initiatives/charities
a) i) refer people to ‘services’ in their community instead of offering only medicalised solutions,
ii) Gardening, singing, dancign and walking clubs, Dementia cafes
b) AgeUK, Silverline, Dementia Friends, Men in Sheds, U3A
NHS Five Year Forward View.
a) 2 services focused on
b) 2 groups of conditions
c) Emphasis on the elderly
a) Take strain off A&E, allow people to get timely GP appointments
b) Cancer, mental health
c) Allowing older and frail people stay healthy and independent
Reasons for homelessness
EVICTION, Substance misuse, relationship breakdown, abuse/neglect (Most common in children), unemployment, vulnerable groups, mental health, cared for children, asylum seekers and refugees, ex-veterans, ex-convicts, poor education
Inverse care law
Those most in need of care receive the least
Refugees.
a) What is refugee?
b) Where are they from?
c) What rights do they have?
d) Describe their family reunion rights
e) What is Human Rights Protection?
a) A person granted asylum and refugee status (due to fear of persecution in home country). Usually means leave to remain for 5 years then reapply.
b) Usually war-torn countries
c) Same as UK citizen once they have refugee status
d) Can be reunited with spouse and children < 18 years
e) Failed to demonstrate claim for asylum but face serious threat to life if returned
Asylum seekers.
a) What is an asylum seeker?
b) What three things are they entitled to? (2 extra for children)
c) What are they not entitled to?
d) What health problems do they get?
e) What barriers are there to healthcare?
f) What service is available to support them?
a) A person who has made an application for refugee status (awaiting Home Office approval)
b) Money (£35/week), NHS care, housing. Child - social services key worker and schooling
c) A job, any other benefits
d) PTSD, insomnia, malnutrition, physical and sexual abuse, war/torture-related injuries, infectious/global diseases
e) Language, access, culture, health is not priority (Maslow’s hierarchy)
f) ‘Asylum Seeker Health’ - a primary care service - catch up programmes, screening, vaccinations, mental health expertise, rapid access
Homelessness.
a) Diseases common in the homeless
b) Diseases specific to IVDUs
c) Healthcare barriers
d) Charities
a) Infection, malnutrition, substance misuse, trauma and injury, dental problems, mental health, TB, STIs
b) HIV, DVT
c) Access (opening times, appointment procedures location and perceived or actual discrimination).
Lack of integration between mainstream primary care services and other agencies (housing, social services , criminal justice system and voluntary sector).
Other priorities (Maslow’s) - People do not prioritise their health when there are more immediate survival issues.
d) Shelter, Crisis
Traveller community
a) Health problems
b) Barriers to healthcare
c) Healthcare initiatives
a) Smoking, asthma, infection, miscarriage, angina
b) Reluctance of GPs to register Gypsies and Travellers, and to visit sites. Poor reading and writing skills. Communication difficulties. Too few permanent and transient sites. Mistrust of professionals. Lack of choice
c) Specialist health visitor - mobile clinics
What is the individualisation of risk
Moving away from collective pooling of responsibility (Welfare state) to the individual being burdened with more responsibility. Libertarian.
The NHS Constitution
a) What is it?
b) What principles does it set out?
c) What values does it espouse?
a) A guiding set of principles and values for the NHS and rights for patients and HCPs
b) Available to all; access based on clinical need not ability to pay; clinical and professional excellence; patient-centred; good value for the taxpayer; accountable
c) compassion, everyone counts, respect and dignity, commitment to high quality care
