Hospital discharge of homeless people

Abstract

Life on the streets is rough. Homeless people not only have high physical and mental morbidity, but also seem to experience poor access to health services in our communities. According to a report by the UK Department of Health, more than 70% of homeless people who are admitted to hospitals are discharged back onto the streets, instead of shelters, sometimes prematurely and without having been treated for their underlying health problems. The report, produced by Homeless Link and St Mungo's homeless services with the purpose of informing the National Inclusion Board, highlights the main issues encountered by this marginalised population and by staff from hospitals, local authorities, and social care agencies. It gives recommendations to the NHS, and presents examples of successful models to follow. By ensuring that patients are given the appropriate housing, these models show that medical staff can reduce the number of readmissions, improve patients' experiences, and save money for the NHS. But putting this theory into practice is not always easy. Factors such as time, bed spaces, or poor coordination between hospitals and homelessness agencies can slow down this process. One successful model mentioned in the report is the Pathway Homeless Team at the University College Hospital, London, which allowed a reduction of total bed days relating to admissions of homeless people by a third and made cost savings of £100 000. Key to their success is the early identification of homeless people, the personalisation of the patient's needs, and the collaboration with other services to establish a safe plan for the patient's discharge. Ideally, every homeless person should be guaranteed a bed, and hospitals are in a pivotal position to help. In the UK, homeless people are estimated to use four times as many acute health services as the general population. Therefore, the NHS should do what is necessary to prioritise the safe discharge of these patients and use that opportunity to begin tackling the health and social issues associated with homelessness. By doing so, the NHS would continue to ensure its main responsibility, to look after every patients' wellbeing, is fulfilled. For more on health care for homeless people see http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_114250 For more on health care for homeless people see http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_114250