Working with vulnerable groups: learning objectives for GP trainees

This is not an exhaustive list  of objectives. It will hopefully help guide you during your placement and inspire you to explore certain aspects of caring for people from vulnerable groups.

For each vulnerable group:

  1. Understand the group’s specific physical and mental health needs
  2. Know about health inequity faced by people in this group
  3. Appreciate barriers to accessing healthcare, including social and cultural norms, language, economic factors, practical issues and health beliefs

Homeless people

  1. Know how homelessness is defined
  2. Differentiate vulnerably housed, homeless and roofless states
  3. Be aware  of the risk factors for homelessness
  4. Be aware of the healthcare services available to support homeless people, including initiatives such as The Pathway project
  5. Be aware of the different accommodation options for homeless people
  6. Develop the skills to advocate for patients to obtain accommodation or other relevant services
  7. Learn about principles of outreach & key workers
  8. Appreciate how being homeless can affect patient’s ability to access primary care and prescribing medication / dressings etc

Travelling community

  1. Know about the make up of this heterogenous group of people
  2. Know about the impact of travelling, facilities  for travellers and the effect of having a fixed abode on health and access to healthcare
  3. Have heard about different models of care developed to try and meeting this group’s needs

Refugees

  1. Understand the terms “refugee” and “asylum seeker”
  2. Appreciate how being a refugee impacts on peoples’ health and wellbeing
  3. Know about services for people who have suffered rape, torture and FGM
  4. Be aware of NHS and voluntary/charitable sector organisations that work with refugees
  5. Be aware of the concept of “triple trauma” experienced in country of origin, transit and destination

People who misuse drugs and alcohol

  1. Understand the challenges for patients with dual substance misuse and mental healthcare needs and the difficulties faced by professionals working with these patients
  2. Appreciate the aetiology of substance misuse and better understand the lives of people who misuse drugs and alcohol so you are able to “meet them in their own reality”
  3. Be aware of NHS and non-NHS organisations who work with this group
  4. Know about how to initiate methadone/buprenorphine
  5. Know about how to perform an initial assessment of patients with substance misuse issues
  6. Be able to screen for blood borne viruses
  7. Be aware of detox facilities and options available
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