Dr Gary Colman won £20,000 in this year’s London Homelessness Awards. We asked him to tell us a bit more about what a typical day might look like.
Profile: Day in the life of ‘Homelessness GP Outreach’- Dr Gary Colman.
Many people imagine that working at a specialist practice for homeless patients must be full of sadness yet I have never worked at a GP Surgery which was as happy, hopeful, or positive.
My morning starts by attending the practice meeting. Today we are reviewing our flu vaccination plans. Most years we don’t see a measurable increase in deaths over the winter period (possibly due to additional services and shelters being available) and, hopefully, this winter will be the same. However, I imagine the cold weather brings additional misery to our patients and Covid has added to this despair as the quiet streets make ‘street activity’ (begging) much harder.
Then it’s out on my home visits. Today I’m visiting 15 patients across three hostels. I carry on my back a small rucksack of diagnostic and emergency equipment and also a laptop which allows me access to clinical notes and to prescribe electronically direct to the patients designated chemist. As well as clinical mask and gloves I also always wear thick soled walking boots as occasionally a more chaotic patient’s hostel room floor can be littered with drug injection needles. However, by far, the most important piece of kit is my rusty old bicycle as pedal power is the quickest way to get around the hostels in central London.
At our practice we have Targeted GP Outreach, where a GP goes out to review non-engaged patients who we suspect are at increased risk of death or serious disease. This programme has significantly increased the life expectancy of our homeless patients at a time when, nationally, homeless patients are dying ever younger.
My first visit today is to a patient whom the hostel staff are extremely concerned about. I know this patient very well and like so many of our patients he seems to be at risk of dying in his early forties from the psychological consequences of a history of complex childhood trauma. My role is to help non-engaged patients manage their chronic disease. It is also about vigilance; catching a patient before they deteriorate. It is not unusual for a ‘routine’ hostel visit to result in the emergency admission of a patient with suspected sepsis (infections), DVT (blood clots) or, as in this case, sudden vomiting of blood likely caused by his worsening liver failure. After a full assessment I arrange admission to the local hospital and transport is arranged.
My day continues. I chat with my patients, checking that all is well, that they’re taking their medications and that their concerns are being addressed. I’m constantly humbled by the huge challenges my patients face, and try and overcome, all year round, year after year. And impressed by the incredible support they receive from their hostel keyworkers.
Like most GPs my day finishes with more admin, and more emails. Then home.
For more information about this year’s winning projects in the London Homelessness Awards please go to www.lhawards.org.uk