• Health workers in Bolton inspire initiative to improve diabetes care for homeless population
• Yearlong project looking at what can happen nationally to provide better support
• Local organisations in Bolton are working together to identify who has diabetes

Health workers in Bolton have inspired a new initiative to improve the care and support people experiencing homelessness receive for managing their diabetes.

The Journal of Diabetes Nursing has highlighted the work of Lynne Wooff, a Diabetes Specialist Nurse at Bolton NHS Foundation Trust, and the Homeless and Vulnerable Adult team, for the progress they have made in improving engagement and health outcomes in a hard to reach group.

That work has now inspired a yearlong project, funded by the Queens Nurse Institute Burdett Trust for Nursing, that has seen nursing workshops, patient interviews, a survey and improvement projects take place to better understand what can be achieved nationally to better support those who are homeless manage their diabetes.

‘Bringing organisations together’

In 2020, Lynne and the Homeless and Vulnerable Adult team at the Trust set up a multidisciplinary team made up of a diabetes consultant and nurse, homeless team nurse, health specialists and charities to transform what local organisations knew about diabetes within the homeless population.

Lynne said:

At the start of the programme, the Homeless Team were supporting approximately 100 people who were experiencing homelessness. They didn’t have a full picture of who had diabetes and often were needing to intervene when a diabetes crisis had happened. No active diabetes screening had been taking place.

“By bringing local organisations together we’re now able to better identify who has diabetes and ensure they receive face-to-face appointments to educate them about diabetes and their medication so that they can hopefully manage their condition more effectively.

The team are now able to take a point-of-care blood-testing machine to hostels and their community clinic to screen for diabetes, whilst the Emergency Department now have the option to screen anyone identified as No Fixed Abode for diabetes.

Patients with positive results are all referred directly into the programme for face-to-face assessments.

Lynne added:

We’re now in a place where we’re able to screen more effectively who is living with diabetes within the homeless population and then better placed to put management and support plans in place through flexible face-to-face appointments, which are delivered in the community.

Training and raising awareness

Bolton “Community Diabetes Champions” and Health Improvement Practitioners are delivering regular diabetes awareness sessions to staff and residents of the local hostels and Emmaus, and free online diabetes awareness and management training has been made available to hostel staff.

An online database has been created by Lynne and the Trust’s Business Intelligence team to provide full oversight of the work taking place, and Lynne has been awarded funding from Greater Manchester to support the programme for another twelve months.

Figures show since the project began, the multidisciplinary team has supported 44 people experiencing homelessness with diabetes, with nearly 90% completing the nine essential standards of care required for any person living with diabetes in the UK.

The Queens Nurse Institute Burdett Trust for Nursing project has been running since April 2023, and will report formally in July 2024.