NIHR Applied Research Collaboration (ARC) South West Doctoral Award: STEP-WISE: Developing and feasibility testing a multi-domain needs assessment and referral intervention for people experiencing homelessness

Applications are invited for a three-year PhD studentship. The studentship will start on 1 October 2026.

DoS: Dr Daniela Oehring (daniela.oehring@plymouth.ac.uk)

2nd Supervisor: Dr Martha Paisi

3rd Supervisor: Lynne Callaghan

The NIHR Applied Research Collaboration (ARC) South West is inviting applications for a PhD studentship, funded by an ARC South West Doctoral Award, to commence on 1 October 2026 or as soon as possible thereafter. For eligible students the studentship will cover Home tuition fees plus an annual tax-free stipend of at least £21,805 for 3 years full-time We welcome applicants who wish to study less than full-time, provided they are intending to complete their studies within the ARC funding period. The student would be based at the University of Plymouth. A training and development budget will also be provided to support the activity of the student.

Project Description

People experiencing homelessness (PEH) die on average 30 years younger than the general population (1,2). While inclusion health services prioritise mental health and substance use, three interconnected everyday health needs remain critically underserved: dental care, foot health, and vision -directly affecting ability to eat, walk, read, and seek employment (3-9). NICE guideline NG214 highlights urgent need for cross-sector continuity, yet these services operate in isolation with separate pathways. Existing holistic assessment tools are designed for clinical settings and comprehensive health review. No tool exists specifically for focused triage of dental, foot, and eye needs in low-threshold outreach contexts by non-clinician workers, with integrated warm referral mechanisms. In Plymouth, HIPP coordinates Peninsula Dental Social Enterprise, Forgotten Feet, and Vision Care for Homeless People - linked but without cross-service collaboration. STEP-WISE addresses this gap. 'Integration' is operationalised at micro-level (single encounter assessment and warm referral) and meso-level (shared protocols, feedback loops, tracking dataset). Macro-level integration (commissioning) is beyond scope but evidence will inform future development.

Currently, PEH needing help with teeth, feet, and eyes must navigate three separate systems. Most disengage. Our survey found 57% of professionals rate diabetes outcomes for PEH as poor, with 66% reporting more frequent amputations and vision loss (10). STEP-WISE enables one outreach worker, in one encounter, to conduct multi-domain needs assessment and facilitate warm referrals - opportunistic case-finding identifying expressed need, not clinical diagnoses.

How can multi-domain needs assessment be integrated into outreach services, and what mechanisms enable or constrain integration?

Potential applicants working in community, social care and public health are welcome to contact us to explore their suitability.

If you wish to discuss this project further informally, please contact Dr Daniela Oehring (daniela.oehring@plymouth.ac.uk).