Medicine on the margins: A mission to provide care for the homeless


Dr Philomena Commons

Dr Philomena Commons, senior lecturer at Leeds Beckett, is a qualified physiotherapist who works with St George’s Crypt, a charity giving support and hope to the homeless. She combines her clinical practice with teaching the social side of care. Working with the homeless, her students see for themselves how treating patients with compassion is just as important as the treatment itself.

Philomena has dedicated her career to supporting NHS patients and has also gained experience in developing countries. Hands-on work in the field that supports her academic knowledge has been crucial for her.

When she started teaching a physiotherapy module around social needs, she discovered a way for her to carry on caring for patients, but also pass on her expertise to students. Philomena explains, “We had a guest speaker from Simon on the Streets, a charity supporting the homeless. What he shared made me realise that I could address the issues mentioned, with support from my students.”

She’d heard about the services St George’s Crypt provided for the homeless in the local area, so she got in touch. Little did she know this would be the start of a decade-long relationship that continues to evolve today as the Crypt’s work has expanded to five locations

The start of an incredible journey

In 2011, Philomena started to volunteer at the Crypt by offering a physiotherapy service once a week. Over the last 10 years, the partnership has evolved, and our students now help Philomena treat people at the Crypt too, carrying out treatment under supervision and shadowing experienced clinicians.

At the Crypt, we’re helping people who are experiencing difficult circumstances and for different reasons are unable to access the support they desperately need.

“Our work there allows us to build connections to the real world when we’re teaching, and we embed different case studies from the Crypt into our teaching to enrich students’ learning.”

Our partnership work with the Crypt continues to grow and grow. It’s not just physiotherapy students improving the health of the homeless people there. Occupational Therapy students are involved too, as well as Sports and Exercise Therapy students who have implemented a fitness program for Growing Rooms, the addiction recovery program run by the Crypt.

“A number of our masters physiotherapy students have chosen to base their final research projects around patient and student experiences working with this group”

The partnership is unique to Leeds Beckett and Philomena is proud that her work aligns with the University’s mission to ensure we use our knowledge and resources to make a positive and decisive difference to people, communities and organisations.”

Physiotherapy care to support the homeless Physiotherapy students from Leeds Beckett have been working with the homeless, seeing how treating patients with compassion is just as important as the treatment itself. Dr Philomena Commons, senior lecturer at Leeds Beckett and a qualified physiotherapist, talks about how her students have been working with St George’s Crypt, a charity giving support and hope to the homeless.

An invaluable experience

With 73% of homeless people suffering from a physical health problem (, Philomena knows it’s a brilliant opportunity for undergraduate and postgraduate students to gain clinical experience.

In the classroom students learn about how social issues such as poverty and family stability impact on health. Their experiences at the Crypt bring this to life and students can see how easy it is for someone to end up homeless. They can hear first hand how family breakdown and a poor family support network can lead to homelessness.

“Working at the Crypt, as well as completing placements with the NHS definitely boosts students’ employability – they graduate, understanding more about the different groups of people they will serve in the community.”

Exploring biases

To provide effective care, Philomena knows adopting the right mindset is just as important as having the right skills. Working at the Crypt, her gives students have the chance to examine their own subconscious biases, “They take time to reflect on what stigma really is and the impact it has on the homeless population.”

It’s very rewarding for me. But also, I love watching the students learn from their own experience, interacting with patients and treating the homeless people with the respect they deserve – but sadly often don’t feel entitled to.

“My students have to overcome their own preconceived ideas of how homeless people look and how they behave. It’s often a lightbulb moment for them when they don’t fit the stereotype of being aggressive, lazy or hopelessly dependant on substances,” she says. “Students see that homelessness can happen to anyone and everyone wants to be treated with respect. They witness first-hand that being welcomed, valued and cared for as a person is therapeutic in itself.”

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