Managing vulnerable patients during the COVID-19 crisis

Dr Stephen Bradley talks about some of the concerns of managing vulnerable patients during the COVID-19 crisis. Homeless patients, people who use drugs, asylum seekers and refugees have particular needs that are particularly challenging to meet just now.


  1. Dr Stephen Bradley’s talk on managing the needs of vulnerable patients demonstrates the challenges for this population which are multi layered. It was reassuring to hear the commitment towards this demographic who are often stigmatised. I am curious about how we are approaching the needs of sex workers during this time and what special considerations we may need to make.

  2. I’m a colleague of Steve’s from Bevan Healthcare and I’m involved in our late clinics for women involved in prostitution. Unfortunately we have had to stop these clinics due to COVID-19 but we are taking other measures to try to ensure the health and safety of this particularly vulnerable patient group. We are acutely aware that social distancing also equates to forced social proximity for some and that victims of coercion and domestic abuse are at significantly higher risk than usual.

    Firstly we have created a list of patients who are social vulnerable and are proactively contacting the individuals in this group, which includes women involved in prostitution, to check on their wellbeing, offer advice and support. This is being done by our GPs, nurses and social prescriber, we are also soon to utilise the help of medical students who would otherwise have been on their electives abroad.

    We are working very closely with support workers who have formed trusted relationships with the women and they are letting us know if they have specific concerns about any of their service users. We have been providing mobile phones to the women who don’t have access to a telephone to enable us to keep in contact and consult remotely. For the patients we are most concerned about we are doing proactive outreach, obviously using PPE as appropriate.

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