Power hair-dos will be much in evidence on Blackpool's streets this week: the Conservative Party conference is in town. But away from the glitz of the Winter Gardens, haircuts are also a subject of interest to the town's homeless population.
'We give people a bit of a treat - spoil them, make them feel better about themselves, ' health visitor Pamela Greenhill says of a health roadshow for homeless people run by Blackpool, Wyre and Fylde Community Health Services trust.
Despite its popular image as a holiday resort, Blackpool has a significant homeless population and transient population, which is swelled by those who have arrived looking for seasonal work in the tourist trade.
'There are more day-trippers now, ' says Margaret Lishman, health partnerships manager at North West Lancashire health authority. There used to be wakes weeks in the cotton and industrial towns. So the old hotels, once booked for the week by holidaying cotton workers, have become bed and breakfast joints or cramped bedsits.
The trust team working with homeless people uses a broad definition of the term, including those in B&Bs, winter-let holiday flats, hostels, women's refuges, night shelters, bedsits or sleeping on friends' floors, as well as rough sleepers.
On that basis, says Ms Greenhill, the level of homelessness is equivalent to that of a London borough.
In addition to the roadshow, the team runs a clinic in its own small premises, offering dental services, minor dressings, mental health assessments and support, a needle exchange, tuberculosis screening and showers on site.
It also helps with access to mainstream health services and GPs and referral for chiropody and drug and alcohol advice. Last year it saw 420 clients, and has contact with about 100 families.
Low self-esteem is a problem - hence the popularity of haircuts, offered along with healthcare information, dental checks, X-rays and sexual health advice at the roadshow, which won an award for innovation from the Queen's Nursing Institute.
This year's roadshow also offered a chance to evaluate the event, through interviews with 57 of the 129 people who visited it (see box).
In the town centre, where the trust's positive-parenting scheme operates, bedsit-land is one street away from the promenade, says trust spokeswoman Michele Guiness. 'There's fun to be had for people who have money, but it's depressing if you can't make it.'
The scheme's co-ordinator, Christine Heath, points out the low health status of people in the area, identifying deprivation, a mobile population and poor housing as causes. 'We've got all the problems of the inner city in a small town.'
Ms Heath, like Ms Greenhill, emphasises the importance of selfesteem. 'If parents are feeling better about themselves, they have more of a healthy life.'
The homelessness team's work is being integrated into the local health improvement programme for 200001, Ms Lishman says, and the HA has been supportive.
Queen's Nursing Institute professional officer Kate Green emphasises the team's success in its relationship with service users. 'We felt it was exceptionally innovative in getting user perspectives on their own access to healthcare and views of their own health status, ' she says.
The evaluation brought out issues such as the scale of mental health problems, the need for a separate event for women and the different interpretations between professionals and homeless people of what constitutes 'safe sex'.
Client satisfaction is an important indicator for Ms Greenhill. 'The fact that patients continue to refer to us and see us as able to assist gives me a good indication that we are providing the services needed, ' she says.
Some of the clients are frequently violent or disturbed, but the team sees very little violence, she adds.
'They have respect for us and vice versa - that speaks volumes.'
Between a rock and a hard place What the roadshow found Seven out of 10 visitors suffered physical health problems.
Three-quarters reported stress, anxiety and depression.
A third had had a diagnosis of psychiatric illness in the past.
Self-harm and suicide attempts were common.
86 per cent were registered with a GP.