Manager Practice


INNOVATION: Managing


director and practising nurse Gina Rowlands, left, at Bevan


Healthcare CIC, and in this picture, consulting with colleagues.


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PEOPLE WHO ARE HOMELESS DIE OF OFTEN TREATABLE MEDICAL CONDITIONS – WHICH IS JUST UNACCEPTABLE


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easier but it’s also about engagement, building trust to encourage them to come to the surgery and register which then opens up a whole host of services.” The bus operates on a set timetable, parking in different parts of the city on different days. “We learned a long time ago by trial and error that where there’s food, there are our patients. So we go to a lot of the faith groups, churches that maybe run soup rooms or kitchens giving out meals.”


KEY RELATIONSHIPS Bevan works in partnership with numerous such voluntary and local government organisations. “If we didn’t have those key relationships this model wouldn’t work,” says Gina. One initiative that particularly impressed CQC inspectors was a


service run by the practice along with a local social housing provider. The Bradford Respite and Intermediate Care Support Service (BRICSS) comprises a residential 14-bed temporary unit offering accommodation for homeless patients who require medical care after being discharged from hospital. “It really helps get people back on their feet in terms of housing and


addressing health needs. It gets them moved on to a better place,” says Gina. “But it’s also been successful in terms of helping some homeless people get access to palliative care. That’s probably one of the best aspects. It’s provided them with a dignified death.” And death on the streets can be quick and untimely. The average


age of death for a homeless woman is 42 and for a man it’s 48, compared to age 86 and 88 respectively for a pensioner in Chelsea. “Nobody dies of homelessness,” says Gina. “People that are homeless


die of often treatable medical conditions – which is just unacceptable.” Gina began her career working as a secondary care nurse in A&E


where she often dealt with homeless patients attending for basic care such as epilepsy medication or asthma inhalers – treatments that should have been accessed via primary care. This was one motivating factor in her joining Bevan in 2003 as a practice nurse.


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“These patients are often called ‘hard-to-reach’ groups,” she says. “But I don’t think they’re hard to reach. I think it’s the completely wrong term to use. I think they are ‘easy-to-ignore’. They are often difficult to look after due to the chaotic nature of their lifestyles. They don’t often fit into mainstream services. They may not have telephones or mobile phones to make appointments. They often have other challenges in their lives and pressures that stop them turning up for an appointment. If you say to some of our patients we would like to see you next Wednesday at three o’clock. That’s absolutely setting them up to fail before they even get out the door.”


ONE-STOP SHOP It was this ethos of truly patient-centred care that also impressed CQC inspectors and recently won Bevan an Innovators of the Year Award in the 2015 General Practice Awards. It is also embodied in the physical layout of Bevan House which has been designed as a one-stop shop, hosting benefits services, refugee support workers, rape crisis, legal, housing, midwifery and health visiting teams. Says Gina: “We wanted to create a hub with tenants who are like- minded partners. We also knew that we wanted to open a health and well-being centre and really go for the social prescribing model which is important for our patients.” Patients also play an important role in how the practice is managed.


Bevan has a very active patient participation group and also an experts-by-experience group, which is a small cadre of volunteers including people who have had experience of homelessness or have come to Bradford as asylum seekers or refugees. It meets every eight weeks and offers an invaluable service user perspective. Staff motivation at Bevan is high given the unrelenting nature of


the work. Gina puts this down to a common sense of purpose and belief and buy-in to practice goals which are reflected in the motto: “health, hope, humanity”. “We are not evangelical about the model here, but we do feel enormously proud of what we’ve achieved.”


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