It could be argued that in no area of health care provision are “Health Services without Walls” more necessary than in the care of people without walls, in other words people experiencing homelessness. In any country of the world, homeless people will have among the worst health profiles and the greatest health needs in the population; perversely, a whole range of legal, financial, geographical and psychosocial factors usually limit their access to the health care which they so urgently need.

Models of health care provision meeting these needs have arisen, often serendipitously, as the result of efforts by concerned agencies or individuals. However, there appears to be an increasing realization that a more structured approach to healthcare provision for people experiencing homelessness is necessary in order to ensure equity of access and consistent quality of care with good outcomes.

In this session, I will present information on the different groups represented among people who are homeless and will consider why it is important to characterize the homeless population, and their health care needs, within any area in order to target and tailor health and health promotion services appropriately. The challenge of providing care in an inclusive manner is discussed, as are the economics, and the practicalities of providing a healthcare model especially targeted at socially excluded or disadvantaged groups.

The issue of attitudes of both health and social care professionals and of their clients will be explored, to discover the effect that these attitudes have on the outcomes of health care interventions both in the mainstream and in targeted services.

Finally innovative examples and models of health care provision will be described and recommendations suggested for discussion.