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One of the many challenges for community nurses is supporting the groups who have difficulty accessing mainstream health services.

One of the many challenges for community nurses is supporting the groups who have difficulty accessing mainstream health services. These include people who are homeless, vulnerable migrants (such as asylum seekers and refugees), sex workers, gypsies, Roma and travellers.

Evidence indicates these groups have worse health outcomes than the rest of the UK population. The average life expectancy of a male gypsy is under 60 years - a stark contrast to the increasing average life expectancy of the general population of more than 80 years.

Most frontline community nurses will see people who fall into one or more of these groups. Some nurses work exclusively with vulnerable individuals and families, often employed by charitable organisations in outreach work, taking the (often specialist) healthcare to the people.

The QNI has for many years supported a unique network of more than 750 practitioners who work with homeless people. The aim of the Homeless Health Practitioner Network is to share best practice and support the development of skills in policy influence, practice and education that impact on the health inequalities.

Last year, the QNI could not offer any active support to the network. Now, a three-year commitment to the project from the Monument Trust has ensured that this work can continue and we are again engaging with the network to develop opportunities and resources to support practitioners.

There are some challenging outcomes for the project, which include measurable improvements in the health of the vulnerable. There are targets for improving access to mainstream health services. We will work with the network to identify innovative ways of evaluating these improvements.

As community nurses, we are committed to reducing health inequalities in the communities we serve. Participating in the network is one way to gain greater understanding about how the health needs of such vulnerable groups can be developed and practice successes shared.

Crystal Oldman, chief executive, Queen's Nursing Institute