We’ve partnered with a PHN in Victoria to co-design, accredit and deliver whole-of-practice training that makes primary care more accessible, trauma-informed and stigma-free for people experiencing or at risk of homelessness in rural and remote communities. Client, funder and location details are intentionally de-identified.

From needs analysis to action: what we learned

Part One showed how health unravels without a safe place to live. Our training needs analysis with general practices and community services confirmed the practical barriers — and the appetite to fix them.

Hidden homelessness is common and complex. People are couch-surfing, in motels or cars, moving between towns; continuity, medication storage and follow-up become fragile. Standard appointment models rarely fit this complexity.

“It’s heartbreaking to see patients sleeping in their cars outside our clinic — we’re seeing it more.” — GP 

Affordability and identification are gatekeepers. Scripts, gap fees and specialist costs force trade-offs with food and fuel; lost ID or unstable Medicare access can block care at the door.

“Clients tell us they often have to choose between medication or meals.” — Community worker 

Rural realities magnify risk. Sparse transport, distance between towns and centralised services turn a simple check-up into an ordeal — especially if you’re managing trauma, mental ill-health, or chronic disease.

Stigma shuts the door. Fear of judgement in waiting rooms and past negative encounters deter people from seeking help; the most powerful fixes here are cultural and operational.

“For people in these communities, there’s shame and stigma seeing a GP… one of our GPs goes to the car park to see patients if they feel this way.” — GP 
“Past negative experiences with healthcare can leave lasting scars — every interaction needs patience and compassion.” — GP 

System fragmentation is real. Disconnection across mental health, AOD and primary care leaves people bouncing between services. Teams want practical tools to coordinate care — not just more brochures.

What we’re building together

With practices across the Primary Health Network (PHN), Larter is co-designing a tiered training program for whole-of-practice teams (front-of-house, nurses, GPs, practice managers). The program is:

• RACGP CPD–accredited, so participation counts toward annual professional requirements
• Delivered as online e-modules (flexible, scenario-based) with in-person workshops across Local Government Areas to strengthen local networks and pathways
• Built from what teams told us they need most: ways to reduce stigma, deliver same-day care for complex needs, and keep continuity when phones/addresses change.

“We understand sometimes people need more than medical care. We go the extra mile with practical assistance.” — Practice team member 

The three tiers (co-designed with practices)

• Tier 1 — Foundations: homelessness literacy; challenging stigma and bias; health equity; scripts and environmental cues that create a safer experience from reception to consult.
• Tier 2 — Intermediate: same-day care (wounds, vaccines, brief mental-health screening), rapport and risk identification (family violence, suicide, substance-related harm), continuity when contact is unstable, and practical resource kits.
• Tier 3 — Advanced: complex chronic disease in resource-limited contexts; safer prescribing and deprescribing; harm-reduction; using long-acting formulations where adherence is hard.

How and where the training will roll out

• E-modules that offer short, case-based learning for onboarding and refreshers.
• Practice-based workshops and facilitated sessions to stress-test workflows (flexible appointments, “safe-space” signage, walk-in slots, transport scripts, medication-storage workarounds).
• Regional networking & professional development events delivered across selected LGAs with neighbourhood houses and local services to map referral routes and agree warm-handover protocols.
• Communities of Practice facilitated in quarterly forums to share cases, troubleshoot barriers (ID, My Health Record visibility, after-hours options), and invite experts in family violence, AOD and youth mental health.

“It’s a complex issue that needs collaboration across sectors — working together is how we’ll build a more supportive environment.” — Community Partner 

What whole-of-practice change looks like

Front-of-house

• Welcome without prerequisites: pathways for people without ID or fixed address; privacy-preserving intake; de-escalation skills and scripts
• “No wrong door” checklists that turn first contact into a health-access opportunity.

“Our frontline staff juggle a lot; with the right scripts and de-escalation skills, first contact can be transformational.” — Practice Manager 

Nurses

• Rapid health/risk checks; opportunistic vaccines and wound care; medication navigation; warm handovers to community services
• Light-touch follow-up methods that work even when phones or addresses change.

GPs

• Short-consult frameworks that still create traction (one health priority + one safety check + one concrete next step)
• Safe prescribing in the context of malnutrition, unstable storage and polypharmacy; harm-reduction conversations that reduce shame and increase uptake.

Practice managers

• Policies for flexible scheduling, walk-ins and “car-park consults” where dignity or safety is a concern
• Simple equity dashboards to monitor progress without adding admin burden.

“You always wonder and hope… wishing you knew they’re okay.” — GP 

Five operational shifts every practice can make now

1. Welcome without prerequisites — see the person, not the paperwork; clear pathways for no-ID/no-address; visible statements of safety and inclusion
2. Short consults that still help — one priority + safety check + next step; nurse-led follow-up; warm handovers
3. Medicines that fit life — simplify regimens; plan for storage instability; pharmacy partnerships and vouchers where available
4. Partner where trust already exists — bring the clinic to neighbourhood houses and community hubs; agree scripts and feedback loops
5. Plan for rural constraints — reserve walk-in slots around transport schedules; bundle care to reduce return trips; use telehealth intentionally.

“We’re reserving more same-day slots and bringing services closer to where people already feel safe.” — Nurse 

Policy settings that help — and how we’ll operationalise them

Larter welcomes the Bulk Billing Practice Incentive Program (BBPIP) commencing 1 November 2025. For practices that participate, BBPIP adds an extra 12.5% incentive on every $1 of MBS benefit from eligible services, split 50/50 between the GP and the practice — a lever to remove cost as a barrier to care for people doing it tough.

Additionally, from 1 November 2025, practices that choose to bulk bill can apply this to standard GP consultation items for all Medicare card holders — not only children and concession-card holders — with expanded bulk-billing incentives supporting that shift.

What Larter is doing to assist practices:

• Build a business case and scheduling model that uses BBPIP to sustain low-barrier access (same-day appointments, longer consults when needed).
• Embed practical workflows (billing, documentation, data capture) that make equity improvements measurable and sustainable.

Measuring what matters

We’ll partner with clinics to track a few meaningful metrics:

• Access and affordability — proportion of bulk-billed consults for people without stable address/ID; on-the-day care delivered; scripts filled via pharmacy partners.
• Continuity and safety — successful follow-ups when contact details change; brief mental-health screens and safety checks completed.
• Process — utilisation of low-barrier walk-in slots; number of warm handovers to community partners.
• Learning health system — quarterly Communities of Practice to review barriers, share micro-innovations and agree the next tests of change.

Our commitment

This isn’t a one-off workshop series; it’s a partnership to redesign access so the most marginalised are the first to benefit. We’ll keep showing up — in e-modules, practice huddles, and cross-LGA events with neighbourhood houses — until the changes hold.

“We must balance professionalism with empathy — strong communication and calm, consistent responses build trust.” — Reception/administration team member 

If you’re a general practice or community partner in the PHN region and want to collaborate, contact us.

Missed part one? Read The Health Needs of People Experiencing Homelessness – Voices of Lived Experience