A 'house doctor' scheme for primary health care for the single homeless in Edinburgh.

The single homeless are a heterogeneous population with health care needs greater than those of the general population. The Edinburgh primary health care scheme for single homeless hostel dwellers is an attempt to provide an easily accessible service for this population. Having continued for eight years it is one of the longest established of such schemes. The original aim was for house doctors to take services to the residents in the hostels but the scheme has developed to include a primary health care team operating from a central clinic.The scheme was evaluated by a study of the use of the service and by interviews with recipients of the service, hostel managers and others. The study confirmed the high health care burden from chronic handicapping conditions for this population. It was also found that the nature and level of primary health care provided by the scheme was acceptable to the hostel residents and the majority of hostel managements and to accident and emergency department staff. The female hostel dwellers expressed a need for a female practitioner in the scheme. Alternatives for primary health care provision for the single homeless are discussed in the light of the findings, and recommendations are made for the future of the scheme.