This developing way of working aims to reduce health inequalities by picking up untreated chronic and infectious disease in groups of individuals who have been shown to have the poorest health outcomes. The Cardiff and Vale Health Inclusion Team (CAVHIT) provides an initial health assessment and public health screening to vulnerable individuals who are newly arrived in Cardiff or may live in Cardiff but are not registered with a GP practice.
The clinical team is made up of an Advanced Nurse Practitioner, health inclusion nurses, specialist homeless nurses, a health visitor, midwife, a healthcare support worker, and GPs. The CAVHIT team work closely with partners including the Infectious Diseases and Tuberculosis team, the department of Sexual Health, and local mental health services. CAVHIT also has close links with Cardiff Council, as well as housing, local, and national third sector agencies who provide vital support for the service users. CAVHIT is not a GMS service but a screening service which supports registration at a practice for the service users where needed.
Specific groups of individuals who could benefit from this service are vulnerable migrants, homeless individuals, sex workers, and the Traveller community. These groups of individuals are shown to have the poorest health outcomes and find it hardest to access healthcare. Broadly speaking, they are more at risk than the general population from conditions such as blood borne viruses, parasitic infection, and tuberculosis. The screening of these individuals is paramount to protect them from the long-term effects of untreated infection and to reduce the public health risk. Mental health problems such as traumatic stress, PTSD, depression, and anxiety are also more prevalent in these groups and early referral to allied teams and third sector organisations is beneficial.
When screening has been completed and any urgent health needs have been met, the individual will be directed to register with a GMS practice in their local area and given support from the health inclusion support worker to enable them to do this where needed.
