I recently quoted some research from Leicester that homeless men and women are six times more likely to attend at A&E than the ‘housed’ population, four times more likely that they will be admitted, and are likely to stay twice as long.
Today on the radio I heard that the cost to the NHS of treating a homeless person is five times that of the housed population.
In a previous post I reflected on the medical interventions at First Base Day Centre, and how they prevented the need for A&E presentations and hospital admissions. The savings to the NHS must be far greater than the cost of running the whole of the service at First Base which has a deficit each year of between £50,000 and £100,000.
Today Homeless Link published an excellent guide for hospital staff and managers “From Hospital to Home: Steps for hospital staff – identify need and take action”.
Homeless Link says “When someone who is homeless is admitted to hospital, their stay will often last longer, and become more complex and costly for the NHS, than your other patients.
“When they leave, more than 70% will be discharged straight back onto the streets, further damaging their health and all but guaranteeing their readmission.
“Housing is key to a ‘safe discharge’ from hospital, as well as to reducing the ongoing burden on your service. There are steps you can take to help.”
Here is the Homeless Link guidance:
On admission, identify homeless patients and those living in homelessness services:
- Ask if people have accommodation, whether they can return and if they risk losing it
- Contact the patient’s support services – this can prevent them losing their accommodation
If a housing need is identified, know how to respond and who to refer them to
- Find out who to notify within the hospital and externally – is there a named contact?
- Know how to make a referral to the local Housing Options team
- Ask for training on the assessment and referral of homeless people
- Keep an up-to-date contact list of local agencies such as hostels, outreach and drug and alcohol services on each ward.
If homeless people discharge themselves:
- Alert local services
- Record the self-discharge and the reason
Ensure patients can access ongoing care
- Complete a social needs assessment
- Notify the GP and relevant agencies about follow up treatment
- Provide a copy of the discharge plan and medication
Help people return to their accommodation
- Let the housing agency know when the patient is returning to ensure they can get in
- Avoid out of hours discharge
- Help the patient get home – they may need travel expenses
I wonder if there is a champion in local hospitals ensuring that these good practice guidelines are being implemented?