Table 1 Research priorities, questions, relevant methodology, study outcomes and potential implications to practice

Improving access to services

-What barriers do PEH face in accessing primary healthcare services?

-Qualitative study, surveys with patients, healthcare professionals and social workers

-Barriers and enablers of access to healthcare

-Widening access to mainstream health services and specialist services aimed at PEH by addressing the barriers

-How can knowledge and awareness of healthcare staff be improved in relation to rights access to services by PEH?

-Interventional methodology through training, education and distribution of ‘my rights of access to healthcare’ cards to frontline healthcare staff

-Knowledge and awareness of healthcare staff around rights of PEH to access services

-Number of PEH with access to primary healthcare services

-Greater inclusion of PEH in mainstream healthcare, use of specialist homeless healthcare services by patients where needed

-How can we understand the impact of local and national policy interventions such as the Homelessness Reduction Act, Housing First and health charging guidance?

-A time trend analysis investigating homelessness and adverse health outcomes prior to and after the introduction of relevant policies

-Homelessness in numbers, mortality in PEH, average age of deaths of PEH, number of PEH effectively housed, episodes of repeat cycle of homelessness per person

-Identifying effective and ineffective health and social care policies

Interventions to prevent drug and alcohol-related deaths

-How could substance misuse services be extended to the population in need?

-Undertaking pilot provision of existing substance misuse services through new avenues such as provision through outreach and specialist homeless healthcare services

-Number of affected persons who access services, number of drugs and alcohol-related deaths

-Maximising access to substance misuse services, reducing associated mortality

-What unique barriers people with dual diagnoses of substance misuse and mental health face in accessing services?

-Qualitative study, surveys and case study with patients

-Barriers and enablers for accessing services by patients with dual diagnoses of mental health and substance misuse

-Enhanced provision of services to patients with dual diagnoses, addressing the link between dual diagnoses and homelessness

-How can naloxone services be made more widely available?

-Qualitative study and surveys with patients, healthcare professionals and stakeholders

-Barriers to provision of naloxone services through a variety of settings such as through community pharmacy and outreach services

-Enhanced provision of services by addressing the barriers and facilitating the enablers, prevention of opioid-related deaths

Improving existing services through quality improvement and better integration, operationalising current policy drivers and best practices

-How can we improve patient engagement with services by redesigning patient pathways?

-Quality improvement methodology

-Number of people accessing primary healthcare, substance misuse and mental health services

-Enhanced access to services by PEH, preventing the use of emergency departments and improving health outcomes

-How effective are novel services such as social prescribing?

-Interventional methodology in new geographical areas, observational data collection in areas where such services already exist

-Number of people utilising social prescribing services, number of people being referred to appropriate services, health outcomes in relation to the clinical area of focus

-Greater engagement of patients with existing and new services, greater liaison between service providers

-How can we minimise fragmentation of care for PEH?

-Qualitative study with patients, healthcare professionals and wider stakeholders

-Establishing and evaluating referral pathways through interventional methodology

-Quality improvement methodology offering relevant services for PEH under one roof

-Barriers to minimising fragmentation of care

-Number of affected patients who use services, associated health outcomes

-Enhanced access to services and improved health outcomes

-Minimising delays in communication and transfer of information in relation to care of PEH

-How can clinical and communication skills of healthcare professionals be improved in relation to specific needs of PEH?

-Qualitative study with patients and healthcare professionals to identify current gaps in knowledge and skills of healthcare professionals

-Interventional methodology to improve knowledge and skills of healthcare professionals in relation to care of PEH

-Communication skills of healthcare professionals

-Clinical outcomes in relation to management of multi-morbidity, prescribing in acute or long-term conditions, alcohol and substance misuse, mental health

-Greater engagement of patients with mainstream and specialist homeless healthcare services

-Greater rapport of PEH with healthcare professionals

- improvement in clinical and communication skills of healthcare providers in relation to specific needs of PEH

Research to identify PEH’s preferences around service delivery

-What do PEH prefer in relation to addressing their unmet healthcare needs?

- Qualitative study with PEH to identify unmet needs

-Patient and public involvement to engage service users in services design and evaluation

-Using existing healthcare utilisation data (primary, secondary and emergency healthcare) to identify unmet needs

-Unmet healthcare needs of PEH

-Patient and public involvement in research, policy and practice

-Identifying services to meet the needs of PEH

Reinforcing the link between vulnerabilities - modern day slavery and homelessness

-Is there a link between modern day slavery and homelessness?

-Ethnography with affected persons to understand any links that exist

-Identifying how modern slavery and homelessness are inter-related

-Preventing homelessness and modern day slavery by early interventions and referrals, preventing adverse health outcomes