How to create accessible primary healthcare for people with multiple and complex needs

Fulfilling Lives South East has collaborated with the University of Brighton to explore how to maximise access to primary healthcare for people with multiple and complex needs. The research informed a report which highlights approaches to improving access which work, based on academic research and the experiences of local client-facing workers.

The problem with primary healthcare accessibility

People who have faced disadvantages such as mental health issues, homelessness, substance misuse issues and offending histories are much more likely than an average UK citizen to require primary healthcare for a range of long term conditions. However, evidence suggests they are much less likely than average to receive it – with indicators such as low life expectancies and disproportionately high access to A&E building a picture of the gap between need and adequate provision.

The solutions for people with Multiple Complex Needs

The research conducted by student research Inja Vetter indicated that the following approaches work well:

1. Intensive outreach programs carried out by multi-skilled teams to see people in the community

2. ‘One-stop-shops’ which consolidate social and health care services to provide holistic care in one place

3. Staff knowledge & awareness– informing workers about the challenges people with multiple and complex needs face, and skilling up the workforce in trauma-informed approaches 

4. Flexibility in services with making appointments, appointment times and locations. 

5. Continuity of care Striving for linked social care and health care networks which ensure close communication and collaboration 

6. Secure, long term funding to achieve meeting the health care needs of people with MCN in an appropriate way

Inja reflected on her reaction to the findings as they emerged:

‘Thematically, what surprised me most is how well health inequalities for people with MCN and many other groups are researched and documented. Seeing the so-called ‘science-practitioner gap’ reinforced my belief that it is really important to push for systematic changes around the provision of (primary) healthcare.’ – Inja Vetter

What next?

This research will now be used to identify the ‘bright spots’ within primary healthcare systems. Our systems change team will look to collaborate with local partners to celebrate these areas and explore how we can nurture and grow these further. The research author supported the continuation of building strong links with practice and academic research in the future:

‘Working with Fulfilling Lives was a wonderful partnership experience. It was a boost to my motivation to experience Fulfilling Lives as a place where scientific research and practical experiences really come together, inform each other and are applied in order to create change.’ – Inja Vetter

If you are interested in working with us in this area, please contact Rebecca at The full report is out now and available to download here:

Author – Kerry Dowding

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