Document resource
Background People experiencing drug and alcohol use related harms (PWUS) experience worse health and more barriers to accessing healthcare than the general population. Many PWUS have complex social needs including low-income and insecure housing. Neighbourhood health initiatives may help meet the needs of PWUS. One such initiative is a community-based co-designed mobile health bus established in Sunderland, UK in April 2025 to improve access to primary healthcare for PWUS. The bus was funded via the local authority public health team, other partners included a group of general practices and a lived-experience recovery organisation.Methods Mixed methods process evaluation conducted between April-December 2025 comprising: patient surveys (N=110); researcher observation (N=40 hours); qualitative interviews (N=30 stakeholders); and analysis of routine patient data (N=160 patients). Data were combined; thematic and quantitative analysis is ongoing. Preliminary results from observations and stakeholder interviews are described here with findings from the full evaluation to be presented.Results In the first six-months the bus attended six community venues and saw 160 people. Observations and interviews highlighted that the implementation benefited from: the flexible approach of all partners; existing relational infrastructures of community support; experienced administrators and peer workers; a clear line of responsibility for partnership’s co-ordination; and access to electronic patient records. Factors outside the control of partners sometimes prevented people from getting the care they needed (e.g., pharmacists’ willingness to fill a prescription).Conclusion The Sunderland mobile health bus provides a promising way to improve access to healthcare for PWUS, drawing on a multidisciplinary partnership and wider community and voluntary sector infrastructures. Involving experienced and paid peer workers to provide relational support with accessing follow-on health and social care has been central to the success. The bus needed to be located at venues where people already accessed support for the wider determinants of health e.g. community kitchens.