Homeless people face huge health inequalities. The life expectancy of someone who sleeps rough is 30 years lower than the national average, and there are significant barriers to accessing healthcare. Homeless people are much less likely to be registered with a GP and poor links to primary care leads to higher use of emergency services. To reduce these stark inequalities, a different approach to healthcare is necessary, especially in major cities. In this article a specialist nurse working in London outlines the services her team provide, how the nursing role has developed, and how the London Network of Nurses and Midwives (LNNM) Homelessness Group provides support and networking opportunities for nurses in these challenging roles.