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Joanne Brown is Counselling Lead of the Homeless Palliative Care service at St Ann’s Hospice in Greater Manchester. Here she tells us about setting up this much-needed new service.

I am sure everyone will agree that 2020 has been a unique year and not without its difficulties.   Here at St Ann’s Hospice it also presented us with an opportunity to create a unique service.

Earlier this year the hospice was awarded funding from the Big Lottery Community Fund to start a Homeless Palliative Care Service that delivers support to people experiencing homelessness and who have palliative care needs. It is also providing education and training to health and homeless sector staff on the unique needs of this client group. When the pandemic hit the hospice we were able to secure extra funding to set up a counselling service for homeless people in Greater Manchester, with a focus on bereavement and loss.

Dealing with loss

I have been in post since the beginning of August and have been busy from the start. It is no surprise that people who are homeless have experienced significant loss, and this can take many forms, whether it is a bereavement, loss of a significant relationship, job, status etc.  In fact, most people have experienced more than one of these losses, compounding their trauma and increasing barriers to services.

With this in mind we set up a service that is very flexible.  I cover all the boroughs in Greater Manchester and travel to the person to minimise their barriers to engagement – meeting people in hostels or temporary accomodation.  For people who are rough sleeping, or do not have a safe place to meet, we have made some links with other homeless providers who are kindly allowing us to use their meeting rooms so we can see people in a private and safe place.

Flexible, supportive care

This has also allowed us to work inter-professionally and link clients in with other organisations that may be a source of support to them.  Also, unlike some mainstream services, we are not limiting the number of sessions or cancelling access to support if they miss appointments or struggle to engage.  We recognise that this group is one of the most marginalised in our society and we want to create a service that is inclusive and adaptable to people’s individual needs.

The work is challenging as well as rewarding.  Although initially the referrals are for bereavement I am finding that most of my clients have significant childhood trauma, which laid the foundations for many difficulties throughout their lives.  The risk of suicide is also high in this group, so risk assessments and joint working are fundamental.

It is early days, but it’s clear that this is an essential service that offers flexible support for people who are marginalised by mainstream services.  Although we only have funding for six months initially, we are hoping that by demonstrating the compelling need for this type of care we will secure funding to continue this much-needed service.