Arch Health CIC GP Surgery: Case study

Arch Health CIC GP Surgery: Case study

Arch Health CIC exists to explore every opportunity to improve the health and well-being of people without a secure home in Brighton and Hove. We are committed to this because periods of homelessness can have a devastating impact on a person’s life and we believe that excellent, caring, primary health care can prevent long term suffering and save lives.

Many people who are experiencing homelessness face complex health challenges, often further exacerbated by a lack of trust in healthcare systems and services. In order to provide an effective healthcare service for people facing homelessness, Arch runs a unique GP surgery, Arch Healthcare, which provides a specialist service that acknowledges the whole person and provides care with kindness, respect and humanity.

To register as a patient at Arch Healthcare, people need to be either sleeping on the streets, living in emergency accommodation, living in a hostel, a traveller, living in a van or ‘sofa surfing’ with friends or acquaintances. Many of the patients at Arch Healthcare have multiple and compound needs which require highly specialised care and attention which we endeavour to provide with every interaction.

• The surgery environment is warm and welcoming; Our reception team are often praised by patients for their kind and understanding manner; everyone is very aware that the way we make people feel in the waiting room has a direct impact on what happens in the consulting room and beyond, and in itself provides an opportunity for meaningful interactions.

• Our reception team, as well as clinicians, are well-trained and knowledgeable about non-clinical matters which can have a profound bearing upon our patients’ lives, for example support networks, foodbanks, housing rights, and local organisations to call to make the next step a little easier.

• Support and time is given to clinicians in order to develop their skills and knowledge, so they can provide expert healthcare tailored to the needs of patients.

• We have a relatively small number of registered patients (1400), many of whom are known to staff by their first name.

• In addition to a schedule of pre-bookable appointments we have lots of same-day appointments available every day to ensure those with urgent needs can see a clinician quickly. This is also in acknowledgement of the fact that periods of homelessness mean it can be harder to plan one’s time in advance.

• Longer appointment times (15 mins) help to give time to build up a relationship of trust between doctor and patient.

• All of the above go towards providing restorative, person-centred care, and place an emphasis on a strong therapeutic alliance. This helps to build a relationship of trust and encourages patients to engage with their care, moving towards long term health improvements.

• In recognition of all of these factors, Arch obtained a rare CQC rating of Outstanding across all areas, at last inspection (2019)

• Much of the care Arch offers is vastly strengthened by partnerships with key organisations in the city. For example Arch commissions health engagement workers from the specialist charity Justlife in order to support patients with complex health challenges to manage their care. This has made a huge difference to patients’ health and wellbeing.

• Accessibility: in order to keep improving Arch’s accessibility, an expanded outreach service was established (see our case study on our outreach service, also submitted) - this was in response to the fact that not everyone is physically able to travel to the surgery, and also in response to the fact that Arch is not universally known about, amongst people who could benefit from our service

• Patient voice: Arch is a lead partner in the Common Ambition project (see our case study on this, also submitted) - which puts patient voice at the heart of driving improvements to the homeless healthcare system. Having people with lived experience of homelessness is essential to targeting the issues that matter to Arch’s patients, and what works, and what does not, in supporting them to access healthcare and move towards long term wellbeing.

• Great listening - felt respected - fit me in for a face to face promptly

• You're all amazing and caring. I felt taken seriously for the first time in my life.

• Perfect code of conduct. All inclusive and equality for all patientsVery friendly

• Empathetic - Patient led care - Respectful of Trans identity

• Keep being awesome

• I think I'm very lucky to have Doctors and Nurses that really care about my wellbeing with a drop in surgery on call twice a day/five days a week