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Sunderland Health Bus pilot improves access to care for people facing the greatest health inequalities

A mobile health service piloted in Sunderland has improved access to primary care for people affected by substance use, homelessness and severe social disadvantage.

Sunderland experiences some of the highest levels of alcohol and drug‑related harm, poverty and homelessness in the region. People affected by these issues often face stigma, digital exclusion, financial barriers and complex personal circumstances that make it difficult to access traditional GP services.

The six‑month Sunderland Health Bus pilot, co‑designed by researchers from the NIHR Applied Research Collaboration (ARC) North East and North Cumbria (NENC), Sunderland City Council, Sunderland GP Alliance and people with lived experience, brought flexible, walk‑in primary care directly into communities across the city. The service ran from April to October 2025 and was funded by the North East and North Cumbria Integrated Care Board (ICB).

Taking healthcare into the community

The Health Bus offered drop‑in appointments with a GP or Advanced Nurse Practitioner, supported by admin staff and relational peer workers with lived experience of substance use or homelessness. Peer workers played a central role in helping people feel safe, understood and able to seek help, and all staff received Recovery Ally training to support compassionate, stigma‑free care.

An evaluation led by researchers from the NIHR ARC North East and North Cumbria showed that the scheme was able to reduce barriers, improve access, and support re‑engagement with healthcare for people who experience the deepest health inequalities.

Over the six‑month pilot:

• 164 patients used the service, aged 17 to 92
• 96% rated their experience as good or very good

Patients valued being able to walk in without an appointment, talk about multiple issues in one visit, and receive care in a welcoming, non‑judgemental environment. For many, visiting the bus was their first step back into healthcare after long periods of disengagement.

Staff reported increased confidence in working with people with complex needs and said the bus strengthened relationships across public health, primary care, community and voluntary organisations.

Value for money

A Social Return on Investment (SROI) analysis of the scheme found:

• A 10% return during the pilot (10p for every £1 invested)
• A projected 100% return (£2 for every £1 invested) if the model was scaled up

The success of the pilot has already shaped local decision‑making. Sunderland GP Alliance has secured NIHR Capital Investment Funding to purchase a new, permanent health bus, enabling the model to continue and expand to support more people across the city.

Read more about the pilot and evaluation