“Bev made me do this — it’s only my leg, it’ll heal on its own”

Inclusion health means designing the safest plan the person can actually follow. Lower-limb cellulitis with fever and tachycardia but no sepsis red flags (alert, normal BP, respiratory rate and oxygen saturation, NEWS2 1) can be treated with oral flucloxacillin (500 mg to 1 g four times daily for 5–7 days; clarithromycin, erythromycin in pregnancy, or doxycycline if penicillin allergic) when the person declines admission and has capacity — but only with a robust safety-net: a marked margin, daily review by the outreach nurse, rapid escalation if spreading, systemic deterioration, blistering, necrosis or severe pain, and admission considered if not improving at 48 hours. Ask why he refuses: practical barriers (a dog, belongings, losing a sleeping place) are often solvable. People experiencing homelessness can register with a GP without proof of address or identity; GP care is free regardless of immigration status. Alcohol: do not advise abrupt cessation in a dependent drinker with previous withdrawal seizures; offer thiamine and alcohol-service referral, and ensure any admitting team knows his intake. Address feet (immersion foot), nutrition, housing (local authority housing options, StreetLink) with consent, and mood.