A review of a GP registrar-run mobile health clinic for homeless
Received: 16 February 2016 / Accepted: 1 November 2016 / Published online: 24 November 2016
Ó Royal Academy of Medicine in Ireland 2016
Background Homeless people have excessively high mor-
bidity and mortality rates, yet they face barriers accessing
primary care. A mobile health clinic, staffed by GP regis-
trars, was developed to provide services to homeless people,
particularly rough sleepers and sex workers.
Aim The aims were to improve access to primary care and
to challenge the stereotypes and prejudices of GP registrars
through direct contact with homeless people.
Design and Setting This was a qualitative study; ques-
tionnaires were completed on the mobile health clinic and
two focus groups were conducted.
Methods All service users were asked to complete a
questionnaire over a 3 month period. Two focus groups
were conducted with 6 and 14 GP registrars who had
worked on the bus.
Results There was an 80% response rate (116 of 145).
Fifty-two percent had no Medical Card meaning that they
had no way to access the free primary care to which they
are entitled. Had the clinic not been available, over half
would not have sought further treatment and 16% would
have gone to an Emergency Department. Ninety-one per-
cent of users rated the service 10/10. The focus groups
found that GP registrars who worked on the mobile health
clinic had decreased negative stereotypes, increased
empathy, and more knowledge of homeless issues. Fur-
thermore, they intended to ensure that homeless people will
not face discrimination in their future practice.
Conclusion A GP Registrar-run Mobile Health Clinic
achieved its aims of improving access to primary care for
rough sleepers and sex workers, and challenging stereo-
types of GP Registrars.
Keywords Homeless persons Á Mobile health units Á
Primary health care Á Prejudice Á Stereotyping Á
ModelsHow this ﬁts in
How this ﬁts in:
This article demonstrates:
That a mobile health clinic for homeless people provides access to
primary care services for people who, without this clinic, would
either have not accessed treatment or would have gone to the
That contact with homeless people in the setting of a mobile health
clinic, staffed by voluntary agencies, can challenge stereotypes
and prejudice towards homeless people, increase empathy for
them, and contribute to the formation of intentions by young
doctors not to discriminate against homeless people in the future.
It is well established that homeless people have poorer
health than the housed population. International evidence
shows an average life expectancy of 42–52 years for
homeless people, compared with 80 years for their housed
counterparts . Homeless people have increased mor-
bidity due to higher rates of common chronic diseases,
substance abuse, and mental health difﬁculties [2, 3].
Homeless people use healthcare services differently to
the housed. They are low attendees at primary care  and
& N. Irving
North Dublin City GP Training Programme, Dublin 7, Ireland
TCD/HSE Specialist Training Programme in General
Practice, Dublin 24, Ireland
Ir J Med Sci (2017) 186:541–546