In Dublin, 2366 adults were homeless in the last census. Access to both mental health and primary care services may be more difficult for these patients and it has been shown that homeless mental health service users have low rates of GP attendance.

We aimed to look at General Practitioner (GP) involvement in the care of patients referred to a Dublin city mental health service for homeless people. The initial audit cycle looked at referrals from August 2004 to February 2005. The second cycle looked at referrals from August 2007 to January 2009. Notes were retrospectively reviewed looking in particular at these issues:

The contact our service made with GPs following the first cycle of this audit improved from 50% to 63%. Letters to GPs were sent in 48% of cases which shows an improvement from 36% but still falls short of the agreed standard of letters to all GPs. The breakdown of the figures for cases that did not have a letter sent to their GP highlights the difficulties involved in follow up of this patient group.

Close collaboration between mental health services for homeless people and general practitioners is vital in the management of this vulnerable patient group whose needs are complex. Audit is a continuous cycle and further, more frequent reviews of this subject are required to maintain and improve on these results.