719 Barriers and Facilitators Towards People Experiencing Homelessness When Accessing Surgical Care: A Critical Review of the Literature

Abstract

Abstract Aim People experiencing homelessness (PEH) are a vulnerable group in which physical health morbidities are much more common than the general population. Despite this, the inability to access healthcare remains a main concern. This literature review aims to identify the barriers and facilitators PEH face towards accessing safe surgical care, and to provide actionable strategies. Method A literature search was carried out on multiple databases. Thematic analysis of the included papers identified themes relating to barriers, facilitators, and actionable strategies. Result Twelve papers were identified. Eleven themes related to barriers and facilitators were identified and five for actionable strategies. The themes related to barriers included access to community care, fragmented follow-up care, transportation, lack of recovery shelters, infections, and post-operative complications. Themes related to facilitators included street medicine programmes and the utilisation of patient navigators. Actionable strategies identified for health workers included the improvement of education, enhancing existing social safety nets, improved screening, tailoring discharge and surgical plans with the view of unfeasible follow up. Conclusions Current papers are not based on UK data and there are limited data sources available. However, analysis of the available data has shown many barriers and limited facilitators towards surgical care, highlighting the need for further studies. With a rising population of PEH in the UK these findings highlight the need for further research to create strategies that allow for safe surgical care in this population.