City Of Glasgow Research Articles

Compatibility of local climate zone parameters for climate sensitive street design: Influence of openness and surface properties on local climate

Streets are the fundamental elements of urban form in terms of microclimate as well as place making in cities. Microclimate itself is influenced by climate critical parameters of the Local Climate Zone Classification (LCZ) system. Therefore, a key design question is the role, if any, of LCZ classification for climate guidelines at street scale.In this paper we explore the Intra LCZ zone temperature variation at three street typologies with North- South and East-West orientation within the city core of Glasgow as a case study. We then investigate the compatibility of LCZ parameters related to openness (determined by sky view factor and aspect ratio) and surface properties (determined by albedo) with Glasgow City Council's Development Plans Policies and Proposals for street design in order to identify the possibility of using these parameters for climate sensitive street design.The results suggest that a fixed design strategy would not be applicable across all street typologies and that the identified LCZ parameters combined with form-based parameters of orientation and façade geometry can play a vital role in climate-sensitive street design.

A spatial exploration of deprivation and green infrastructure ecosystem services within Glasgow city

Contemporary changes to climate pose increasing hydro-meteorological risks to cities. In Glasgow, key hydro-meteorological risks include alluvial and pluvial flooding and overheating. While the need to address these risks are clear, it is equally important to tackle these in a climate just manner. Having understood the benefits Green Infrastructure (GI) can provide in tackling the impact of climate change while ensuring environmental equity for Glasgow, we attempt to assess the equitability of GI distribution in Glasgow especially in relation to the potential for GI to reduce vulnerability and exposure of deprived communities to climate risk in terms of flooding and overheating. We map potential of ecosystem services within urban areas to provide cooling and increase resilience to surface flooding and highlight the geographical mismatch between social deprivation and the preponderance of these ecosystem services. We explore the implications for a ‘climate just transition’ using GI as a performance indicator.

P195 What drives physical activity behavior and mental well-being? A green and blue formula

Purpose: The global pandemic of non-communicable diseases has been increasing exponentially with socioeconomic development and accelerated urbanisation. The ramifications of urbanisation include physical inactivity, pollution and chronic stress that creates widespread global economic and health consequences. Urban waterways have been identified to be health supporting environments with latent green and blue space pathways that can promote physical activity, mental well-being and other associated health behaviours. Its public nature potentially also can mediate health and social inequalities in public health. The aim of this study was to investigate physical activity behaviours and associated health impacts of an urban waterway in Glasgow city together with geographical spread of these impacts.

High willingness to use drug consumption rooms among people who inject drugs in Scotland: findings from a national bio-behavioural survey among people who inject drugs

BackgroundTo address rising drug-related harms (including significant transmission of HIV) among people who inject drugs (PWID) in Glasgow, officials have proposed the introduction of the UK's first drug consumption room (DCR) in Glasgow city centre. Using a nationally representative sample, this study aimed to determine willingness to use a DCR among PWID nationally, in Glasgow city centre (the proposed DCR location), other Scottish city centres (excluding Glasgow) and the rest of Scotland (excluding city centres). MethodsBio-behavioural survey, of 1469 current PWID (injected in last 6 months) across Scotland during 2017-18. Willingness to use DCRs was examined by drug-related risk behaviours and harms overall in Scotland, and then stratified by Glasgow city centre (n = 219), other Scottish city centres (n = 226) and the rest of Scotland (n = 1024). ResultsThe majority of PWID overall in Scotland (75%) were willing to use a DCR; willingness was higher among those recruited in Glasgow city centre (83%) and other Scottish city centres (83%), compared to the rest of Scotland (72%) (p < 0.001). Willingness was greater among PWID who reported (compared to those who did not report) injecting heroin (76%, p = 0.002), cocaine injecting (79%, p = 0.014), homelessness (86%, p < 0.001), public injecting (87%, p < 0.001) and an overdose (80%, p = 0.026). Willingness was found to be associated with a cumulative multiple risk variable: increased from 66% among those with a score of zero to 85% with a score of at least three (p < 0.001). ConclusionsThe vast majority of PWID at greatest risk of drug-related harm in Glasgow and elsewhere in Scotland would be willing to use a DCR, supporting proposals for the introduction of DCRs nationally.

Dialectograms

‘Invented’ by artist and researcher Mitch Miller, ‘dialectograms’ are detailed, intricate drawings of place. Made mostly in Miller’s home city of Glasgow, they are drawn with and through close collaboration with local communities of interest. A process as much as a product, the ‘dialectogram’ borrows liberally from the disciplines of cartography, oral history, architecture and sociology, is articulated through visual disciplines such as illustration and sequential art and informed by writers such as Judith Okely, Michel de Certeau and Tim Ingold. In a decade of experimentation and testing of the limits of drawing, mapping and participatory practice the ‘dialectogram’—originally the signature piece of one artist has since developed into a methodology that has itself, been (liberally) borrowed by many others.

The Effects of Destination Brand Personality on Chinese tourists' Revisit Intention to Glasgow: An Examination across Gender

The aim of this research is to examine the mediating effects of self-congruity between destination brand personality, to revisit intention and heed the moderating effects of gender between self-congruity. Therefore, data were collected through a survey from 226 Chinese outbound tourists in Glasgow city, United Kingdom and was analyzed to provide evidence. Based on the results, the analysis of partial least squares structural equation modeling (PLS-SEM) using the Smart PLS 3.0 program indicated that self-congruity was mediated partially through destination brand personality and revisit intention. In tourism destination, Aaker five dimension of brand personality model was particularly adapted into practice. However, the model failed to perform an actual self-congruity to mediate all five dimensions (i.e., sincerity, excitement, competence, excitement, sophistication and ruggedness) of destination brand personality and revisit intention. The results revealed that the ideal self-congruity is a mediating effect between destination brand personality (i.e., sincerity and excitement) and revisit intention. Moreover, this study also reported that the moderating role of gender has no effects on self-congruity and revisit intention. No difference was observed between female and male Chinese tourists who rely more on destination brand personality over self-congruity when the impact of symbolic destination brand benefits on their intention to revisit Glasgow was considered. Findings further offer specific implications for both theoretical insight and marketing practice in context of tourism destinations in Glasgow.

Increased risk of HIV and other drug-related harms associated with injecting in public places: national bio-behavioural survey of people who inject drugs

BackgroundWhilst injecting drugs in public places is considered a proxy for high risk behaviour among people who inject drugs (PWID), studies quantifying its relationship with multiple drug-related harms are lacking and none have examined this in the context of an ongoing HIV outbreak (located in Glasgow, Scotland). We aimed to: 1) estimate the prevalence of public injecting in Scotland and associated risk factors; and 2) estimate the association between public injecting and HIV, current HCV, overdose, and skin and soft tissue infections (SSTI). MethodsCross-sectional, bio-behavioural survey (including dried blood spot testing to determine HIV and HCV infection) of 1469 current PWID (injected in last 6 months) recruited by independent interviewers from 139 harm reduction services across Scotland during 2017–18. Primary outcomes were: injecting in a public place (yes/no); HIV infection; current HCV infection; self-reported overdose in the last year (yes/no) and SSTI the last year (yes/no). Multi-variable logistic regression was used to determine factors associated with public injecting and to estimate the association between public injecting and drug-related harms (HIV, current HCV, overdose and SSTI). ResultsPrevalence of public injecting was 16% overall in Scotland and 47% in Glasgow city centre. Factors associated with increased odds of public injecting were: recruitment in Glasgow city centre (aOR=5.45, 95% CI 3.48–8.54, p<0.001), homelessness (aOR=3.68, 95% CI 2.61–5.19, p<0.001), high alcohol consumption (aOR=2.42, 95% CI 1.69–3.44, p<0.001), high injection frequency (≥4 per day) (aOR=3.16, 95% CI 1.93–5.18, p<0.001) and cocaine injecting (aOR=1.46, 95% CI 1.00 to 2.13, p = 0.046). Odds were lower for those receiving opiate substitution therapy (OST) (aOR=0.37, 95% CI 0.24 to 0.56, p<0.001) and older age (per year increase) (aOR=0.97, 95% CI 0.95 to 0.99, p = 0.013). Public injecting was associated with an increased risk of HIV infection (aOR=2.11, 95% CI 1.13–3.92, p = 0.019), current HCV infection (aOR=1.49, 95% CI 1.01–2.19, p = 0.043), overdose (aOR=1.59, 95% CI 1.27–2.01, p<0.001) and SSTI (aOR=1.42, 95% CI 1.17–1.73, p<0.001). ConclusionsThese findings highlight the need to address the additional harms observed among people who inject in public places and provide evidence to inform proposals in the UK and elsewhere to introduce facilities that offer safer drug consumption environments.

Eight weeks of sofosbuvir/velpatasvir for genotype 3 hepatitis C in previously untreated patients with significant (F2/3) fibrosis.

SummaryTwelve weeks sofosbuvir/velpatasvir (SOF/VEL) is a highly effective pan‐genotypic regimen for hepatitis C. Phase 2 data suggest 8 weeks of treatment may be sufficient for previously untreated noncirrhotic patients with genotype 3 (GT3) infection. To maximize the number of patients potentially cured within a fixed treatment budget, we elected to treat such patients locally eligible for treatment (F2/3), with 8 weeks of SOF/VEL. By local protocol, treatment‐naive patients with F2 (LSM > 6.9kPa < 9.5kPa) or F3 fibrosis (≥9.5kPa < 12.5kPa) were eligible for 8‐week SOF/VEL treatment. Patients commencing treatment before 1 Oct 2017 were identified from the Scottish HCV database. Baseline and treatment outcome data obtained. Ninety patients were included for analysis (72 (80%) male, mean age 45 (IQR ± 8.4), 28 (31.1%) F3 fibrosis). Opioid agonist therapy (OAT) was prescribed in 82 (91.1%) patients. Of 49 patients attending Glasgow city Alcohol and Drug Services, 27 (55.1%) had evidence of recent drug use (< 3 months) including 8 (16.3%) with self‐reported intravenous drug use. On an intention‐to‐treat basis, SVR rates were 86/90 (95.6%, 95% CI 89.0‐98.8). Excluding those who prematurely discontinued treatment (n = 4), died prior to SVR testing (n = 1) or whom experienced reinfection (n = 1), per‐protocol SVR rate was 84/84 (100%, 95% CI 95.7‐100.0). In conclusion, eight‐week SOF/VEL is highly effective in treatment‐naive GT3 patients with significant fibrosis. This offers a non‐protease inhibitor‐based 8‐week regimen which may be useful for complex drug interactions or where time‐limited opportunity for treatment. In limited resource settings, reduction in drug acquisition costs may help achieve progress towards the goal of HCV elimination.

Migration and Urbanism in Glasgow: The Spatial Impact of South Asian Communities

South Asian communities have lived in Scotland since the late nineteenth century, experiencing a substantial growth in the post-war period. This paper contributes a new understanding of the spatial practices of South Asian communities in the city of Glasgow based on statistics and surveys. The authors aim to address the gap in literature by analysing patterns of location and trends across the city region over the census period of 2011. The study furthermore integrates a walking tour assessment generated by checklists and a recording scheme. The attributes of cultural identity, economic diversity and socio-spatial practice of six urban spaces within three selected neighbourhoods are examined. Two urban spaces were chosen from each neighbourhood to interpret the diversity of land uses along each case study and the social interaction as well as economic activities of South Asian residents. This suggests that the idea of a coherent 'Asian community' obscures differences and generates assumptions regarding residential behaviour and 'in-group' identities. The research, therefore, provides an enhanced understanding of how these distinctive communities interact with a built environment, which has not been designed to cater certain spatial practices.

Bad Medicine: Nofreelunch.

I am a nobody. A bang average medical student who found a home working in the inner city of Glasgow. I also felt like a square peg in a round hole but I tried hard to fit in with my chosen profession. Twenty years ago drug reps were omnipresent in general practice, providing lunch and restaurant nights out, paying for Christmas parties, and offering international trips and endless freebies. I accepted the status quo because it was all I knew, for the hospitals had been just the same. Doctors were entitled. And when I became the local prescribing lead this largess escalated with offers of a lot more hospitality and highly paid ‘teaching’ opportunities. In the late nineties during the statin wars, a rep cupped my ear and simply …

Impact of a community respiratory service on emergency hospital admissions

Abstract Background A community respiratory service was implemented in the North West of Glasgow in January 2013, comprising a team of physiotherapists, occupational therapists and support workers, to provide education, self-management advice, and, where appropriate, treatment at home, for COPD patients, to reduce the risk of hospital admission. This study measures the impact of the service on emergency admission to hospital. Methods COPD EAs were defined as emergency admissions to hospital with a primary diagnosis of COPD. Rate of COPD EAs per 1000 population aged 65 years+ in Glasgow City was compared before and after onset of the service, using segmented linear regression with 21-month pre- and 17-month post-intervention periods. COPD EAs for residents of South and North East Glasgow (S+NE) - areas with no such service in place - were used as a comparison group. The model adjusted for the rate of all-cause emergency admissions. Autoregressive terms were included in the model, as well as a fourier term to adjust for seasonality. Models were similarly run for outcome emergency admissions with COPD in any of the other five fields of diagnosis. Results Adjusting for all cause EAs and changes in S+NE, thus factoring out the impact of other initiatives that may have affected emergency admission to hospital, the impact of the service was found to be a level change of -0.33 (-0.51, -0.16) and a trend change of -0.03 (-0.05, -0.02) COPD EAs per 1000 per month. This is equivalent to a predicted reduction due to the service of -0.88 COPD EAs per 1000 popn per month, in March 2015, and a relative reduction of 35.8%. Rate of COPD EAs per month reduced over time after the introduction of the service (from the point of full staffing). Rate of EAs with COPD in a field of diagnosis other than primary saw no significant change in level or trend associated with the service. Conclusions The community respiratory service was associated with a significant reduction in the rate of COPD EAs. Key messages The Community Respiratory service was associated with reductions in emergency hospital admissions with COPD as a primary diagnosis. There was no significant change in emergency admissions with COPD as a secondary diagnosis, suggesting hospital attendance for patients with COPD overall reduced following the intervention.

Increased risk of HIV and other drug-related harms associated with injecting in public places among people who inject drugs in Scotland: a national bio-behavioural survey

BackgroundAlthough public injecting is considered a proxy for high-risk behaviour among people who inject drugs (PWID), studies quantifying its relationship with multiple drug-related harms are lacking. Furthermore, none have hitherto examined this issue in the context of an HIV outbreak, which has been ongoing in Glasgow, Scotland since 2015. We aimed to estimate the prevalence of public injecting in Scotland and associated risk factors; and estimate the association between public injecting and HIV, active HCV, overdose, and skin and soft tissue infections (SSTI). MethodsA cross-sectional, bio-behavioural survey (including dried-blood spot testing to determine HIV and HCV) of PWID recruited by independent interviewers from 139 harm reduction services across Scotland was done between July 7, 2017, and Oct 1, 2018. Participants were eligible if they had a history of injecting drug use. Only current PWID (ie, in the past 6 months) were included in the analysis. Primary outcomes were injecting in a public place (yes or no; used both as outcome and exposure); HIV infection; active HCV infection; self-reported overdose in the past year (yes or no), and SSTI the past year (yes or no). Multivariable logistic regression was used to determine factors associated with public injecting and to estimate the association between public injecting and related harms (HIV, active HCV, overdose, and SSTI). Findings1469 eligible PWID were included in the study. Prevalence of public injecting among PWID was 16% [95% CI 15–18] overall in Scotland and 47% [40–53] in Glasgow city centre. Factors associated with public injecting were recruitment in Glasgow city centre (adjusted odds ratio 5·45 [95% CI 3·48–8·54], p<0·0001), homelessness (3·68 [2·61–5·19], p<0·0001), high alcohol consumption (2·42 [1·69–3·44], p<0·0001), high daily injection frequency (3·16 [1·93–5·18], p<0·0001), and cocaine injecting (1·46 [1·00–2·13], p=0·046). Odds were lower for those receiving opiate substitution therapy (0·37 [0·24–0·56], p<0·0001) and older age (per year increase; 0·97 [0·95–0·99], p=0·013). Public injecting was associated with an increased risk of HIV (2·11 [1·13–3·92], p=0·019), active HCV (1·49 [1·01–2·19], p=0·043), overdose (1·59 [1·27–2·01], p<0·0001), and SSTI (1·42 [1·17–1·73], p=0·00046). InterpretationIn the context of UK policy debates about the provision of safer drug consumption facilities, these findings highlight the need to address the additional harms evident among people injecting in public places. FundingHealth Protection Scotland.

OA05.07 Co-Operation Between the Cities of Glasgow and Bethlehem and the Development of a Cancer Nursing Diploma at Bethlehem University Palestine

OA05.07 Co-Operation Between the Cities of Glasgow and Bethlehem and the Development of a Cancer Nursing Diploma at Bethlehem University Palestine

Improving medication optimisation in left ventricular systolic dysfunction after acute myocardial infarction

Glasgow city has the highest cardiovascular disease (CVD) mortality rate in the UK. Patients with left ventricular systolic dysfunction after acute myocardial infarction represent a ‘high-risk’ cohort for adverse CVD...

Implementing a step down intermediate care service

PurposeThe purpose of this paper is to explore implementation and development of step-down intermediate care (IC) in Glasgow City from the perspective of staff.Design/methodology/approachThe study used qualitative methods. Nine key members of staff were interviewed and three focus groups were run for social work, rehabilitation and care home staff. Framework analysis was used to identify common themes.FindingsThe proposed benefits of IC were supported anecdotally by staff. Perceived enablers included: having a range of engaged stakeholders, strong leadership and a risk management system in place, good relationships, trust and communication between agencies, a discharge target, training of staff, changing perception of risk and risk aversion, the right infrastructure and staffing, an accommodation-based strategy for patients discharged from IC, the right context of political priorities, funding and ongoing adaptation of the model in discussion with frontline staff. Potential improvements included a common recording system shared across all agencies, improving transition of patients from hospital to IC, development of a tool for identifying suitable candidates for IC, overcoming placement issues on discharge from IC, ensuring appropriate rehabilitation facilities within IC units, attachment of social work staff to IC units and finding solutions to issues related to variation in health and social care systems between sectors and hospitals.Originality/valueThe findings of this study help the ongoing refinement of the IC service. Some of the recommendations have already been implemented and will be of value to similar services being developed elsewhere.

Glasgow City Region sets a new benchmark for dealing with climate change

Kit England and Ruth Wolstenholme from environmental charity Sniffer and Graham Edmond of Transport Scotland and ICE Scotland describe Glasgow City Region’s pioneering risk assessment for adapting to climate change. It offers numerous opportunities for civil engineers.

‘We are still obsessed by this idea of abstinence’: A critical analysis of UK news media representations of proposals to introduce drug consumption rooms in Glasgow, UK

BackgroundDrug consumptions rooms (DCRs) are a well-established and evidence-based harm reduction response to drug use. Recently, a consortium led by health services in Glasgow, United Kingdom (UK), proposed piloting a DCR. In this article, we examine how the proposals were represented in news media reporting, and the possible effects of such reporting. MethodsA quantitative content and qualitative thematic analysis of UK news media (n = 174 articles) representations of the proposals to introduce DCRs in the city of Glasgow, UK, was conducted. Analysis was informed by Bacchi’s (2009, 2012, 2017) approach to policy analysis, ‘What's the problem represented to be?’ FindingsCompeting representations of the ‘problem’ of injecting drug use (IDU) were contested by a range of actors with different political visions. The applicability of the ‘evidence base’, potential benefits of DCRs to both users and the public, and the associated economic costs, were presented in differing ways depending on the underlying assumptions and presumptions of the arguments constructed (e.g. harm reduction vs recovery). As a result, a number of conflicting subject positions were presented that may have implications for the way that people who inject drugs (PWID) see themselves, and how they are viewed and treated by society. Whilst proponents positioned DCRs within a discourse of public health, an underlying rhetoric of abstinence and recovery underpinned the arguments against DCRs. It was this latter discourse that underpinned the UK Government’s rejection of the proposals, which the Scottish Government were prevented from overruling within the political constraints of their devolved powers, with the lived effect of people who use drugs (PWUD) being denied access to public health services that mitigate harm. ConclusionWe conclude that attempts to introduce and gain public and political support for harm reduction responses such as DCRs through the news media face challenges within the historical and political context of prohibitionist UK drugs policy.

Re-emergence of HIV related to injecting drug use despite a comprehensive harm reduction environment: a cross-sectional analysis

In 2015, an outbreak of HIV was identified among people who inject drugs (PWID) in the Greater Glasgow and Clyde (GGC) area of Scotland, an area which distributes more than 1 million needles and syringes per year. This is the largest such incident in the UK for 30 years. Here, we provide an epidemiological analysis of the impact of the outbreak on HIV prevalence trends in the population and the individual and environmental risk factors associated with infection. Four cross-sectional, anonymous, bio-behavioural surveys of almost 4000 PWID attending services providing injecting equipment across GGC between 2011 and 2018 were analysed. Participants were recruited by trained independent interviewers and eligible if they had a history of injecting drug use, either current (within the past 6 months) or historical. Interviewers asked participants questions about demographics, behaviours, and service use and to give a dried blood spot sample that was tested anonymously for the presence of blood-borne viruses. Our primary outcome measure was HIV infection status, as determined by the dried blood spot sample. We removed duplicates and participants with missing data and used all remaining participants to examine trends in prevalence of HIV infection, risk behaviours, and intervention coverage. We then did multivariate analysis with adjusted and unadjusted logistic regression to determine individual and environmental factors associated with HIV infection. The overall GGC sample comprised 3641 PWID; data from 2712 PWID were available for multivariate analysis after further removal of duplicate participants and missing data. Between 2011 and 2018, HIV prevalence in GGC rose from 0·1% (95% CI 0·0-0·6) to 4·8% (3·4-6·2) overall, and from 1·1% (0·2-6·2) to 10·8% (7·4-15·5) in Glasgow city centre. Over the same period, the prevalence of cocaine injecting in all individuals in GGC in our sample rose from 16% (129/805) to 50% (291/583) overall, and from 37% (26/70) to 77% (117/153) in Glasgow city centre. HIV infection was more likely among PWID who had participated in surveys after the start of the outbreak in 2014 (adjusted odds ratio 3·4, 95% CI 1·7-6·7; p=0·00052), been homeless in the past 6 months (3·0, 1·7-5·0; p<0·0001), had had more than five incarcerations since they first began injecting (2·1, 1·2-3·7; p=0·0098); and had injected cocaine within the past 6 months (6·7, 3·8-12·1; p<0·0001). Age (per 1-year increase) was also a significant factor (1·1, 1·0-1·1; p=0·0016) but sex was not (1·7, 0·9-3·2; p=0·083). Despite high coverage of harm reduction interventions, Glasgow has experienced a rapid rise in prevalence of HIV among its PWID population, associated with homelessness, incarceration, and a major shift to injection of cocaine. Robust surveillance through regular HIV testing of high-risk populations is crucial to ensure outbreaks are detected and rapid responses are informed by the best available evidence. Health Protection Scotland.

The evaluation of large cycling infrastructure investments in Glasgow using crowdsourced cycle data

The benefits of cycling have been well established for several decades. It can improve public health and make cities more active and environmentally friendly. Due to the significant net benefits, many local governments in Scotland have promoted cycling. Glasgow City Council constructed four significant pieces of cycling infrastructure between 2013 and 2015, partly in preparation for the 2014 Commonwealth Games and partly to encourage cycling more generally. This required substantial capital investment. However, the effectiveness of these big new infrastructure investments has not been well examined, mostly due to data limitations. In this study, we utilised data from the activity tracking app Strava for the years 2013–2016 and fixed effects panel data regression models to examine whether the new cycling infrastructure has increased cycling volumes on these routes. Our results show that three of the infrastructure projects have a positive effect on the monthly total volume of cycling trips made by users of the app, with flows up by around 12% to 18%. Although this result is promising, it needs to be interpreted with care due to the characteristics of the data.

A descriptive study of a novel pharmacist led health outreach service for those experiencing homelessness.

To illustrate and review this new service and to describe the demographics of the patient group and the typology of interventions made by the pharmacist prescribers. Pharmacists provided pop-up, drop-in (no appointment needed) health clinics to various homeless support venues in Glasgow City Centre. Data from pharmacists' interventions (n = 52) and patient demographics were gathered from clinical records. Data were then extracted, transcribed and analysed. The demographics of the homeless patient group consisted mainly of white middle-aged males (mean age 39.8 years), of Scottish ethnicity and living in homeless hostels. Medications were prescribed by pharmacists in 62% of all patients. New medications were initiated in 69% of these patients; repeat/re-issues of lapsed medications were issued in 66% of these patients; changes were made to existing medication in 16%. The most commonly prescribed items were as follows: wound dressings; antihypertensives; antidiabetics; analgesics; inhalers; antidepressants; and nutritional supplements. Pharmacists diagnosed a new clinical issue in 69% of patients, most commonly with infections (skin or respiratory) in 36% of patients. Sixty-two per cent of patients had their presenting symptoms managed by the pharmacist alone. Patient engagement was good with 85% subsequently attending either a follow-up with the pharmacist or onward referral (to specialist services, secondary care, general practitioner appointment etc). Assertive outreach by pharmacist independent prescribers for people who are homeless is feasible and leads to increased access to medicines for acute and chronic health problems. Further work is needed to evaluate the impact of this new service on key clinical outcomes.