Primary Health Care Research and Development

Original Article

The role of the public health nurse in meeting the primary health care needs of single homeless people: a case study report

Brenda Poulton a1c1, Hugh McKenna a2, Sinead Keeney a3, Felicity Hasson a3 and Marlene Sinclair a3
a1 Institute of Nursing Research, School of Nursing, University of Ulster, Ulster, Ireland
a2 Faculty of Life and Health Sciences, University of Ulster, Ulster, Ireland
a3 Institute of Nursing Research, School of Nursing, University of Ulster, Ulster, Ireland

Article author query
poulton b   [Google Scholar] 
mckenna h   [Google Scholar] 
keeney s   [Google Scholar] 
hasson f   [Google Scholar] 
sinclair m   [Google Scholar] 


Links between homelessness and ill health are well established. However, homeless people are less likely to access traditional health care due to administrative barriers and hostility of professionals. For this reason more flexible modes of health care delivery, including nurse led care, have been explored. There has been a rapid increase in innovative nursing roles over the last two decades and the literature suggests that a clear role definition, good interprofessional working and supportive cultures are some of the features which ensure role effectiveness. A large study exploring new roles in nursing and midwifery in Northern Ireland identified an innovative nurse led approach in meeting the needs of single homeless people. The aim of this paper is to explore the effectiveness of this role using a public health framework. A case study design was used incorporating semi-structured interviews with analysis of secondary sources and a period of observation. Results demonstrated that the role fitted within a public health framework in that it involved assessment of need, skills to meet need, facilitation of access to care, partnership working, health promotion, health protection and influencing policy, and strategy development. The conclusion is that the role met the set criteria for innovative nursing roles. Furthermore, this practitioner meets the criteria for advanced nursing practice, providing evidence of effective nurse led care that meets the health agenda of targeting inequalities in health.

(Published Online October 31 2006)
(Received August 2005)
(Accepted December 2005)

Key Words: advanced nursing practice; case study research; homelessness; innovative role; primary care; public health.

c1 Address for correspondence: Brenda Poulton, Institute of Nursing Research, School of Nursing, University of Ulster, Shore Road, Newtownabbey, Co.Antrim, BT37 0BQ, Ulster, Ireland. Email: