Homeless Link
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Investment needed to continue homeless hospital discharge improvement

£10m of government grants have helped projects make progress, but could this be in vain without continued funding? 

Photograph: Spyros Papaspyropoulos (Flickr)

An evaluation of the Government’s £10m Hospital Discharge Fund shows the benefits of local agencies working together to improve discharge process for homeless people leaving hospital, but warns that progress could be undone without continued investment.

Homeless people experience some of the worst health in our society and are heavy users of acute health services. This is damaging to individuals and the public purse.

Following Homeless Link and St Mungo’s research in 2012 which found that 70% of homeless people receiving hospital treatment were being discharged onto the streets, the Department of Health announced £10m of funding for 52 projects to improve discharge procedures. 

Homeless Link was commissioned to evaluate this programme, and found improved outcomes:

  • 69% of homeless people had suitable accommodation to go to when they were discharged
  • This rose to 93% of homeless people in projects which combined NHS and housing staff
  • 72% were not readmitted within 28 days of discharge
  • 71% agencies reported improved data sharing across housing, the NHS, and voluntary sector 
  • 84% voluntary sector agencies reported good working relationships with the NHS
  • Patients reported higher standards of care, with non-judgemental treatment and improved support throughout and after their time in hospital
  • Staff reported improved working links across housing and the NHS, better access into accommodation and ongoing medical care, and some projects could already show cost savings through reduction in A&E use.
  • 4 in 10 (43%) pilots had already secured continued funding to sustain the service, in most cases with joint investment from the CCG and Local Authority

The most successful projects were those which combined health and housing professionals in the homeless person’s package of care, during and after the stay in hospital.

However, the grants funded 6 month-long projects, and many reported difficulties with this short time frame. Whilst some have been given additional funding from local commissioners, there is a real risk that the good progress could be undone without a long-term investment strategy for these approaches. 

Helen Mathie, Head of Policy for Homeless Link, said:

“The harmful relationship between homelessness, poor health and hospital admission is well documented and we’ve long been calling for joined up action to break this cycle. These projects provide a glimpse of what can be achieved when agencies work together and should provide a template for future health and housing planning.

“As well as making long-term savings through better efficiency and reducing repeat homelessness and hospital re-admission, better discharge policy also has a profound effect on individuals’ lives. We encourage health and housing commissioners to come together and ensure this good work can continue.”

Public Health Minister, Jane Ellison, said: 

"I am proud of the success of the £10 million Hospital Discharge Fund and the strides we have taken to improve the health of homeless people. These projects show joining up health and housing services can make a difference to the lives of homeless people and save the NHS money by, for example, reducing the use of A&E.”

Evaluation of the Homeless Hospital Discharge Fund

Homeless Link's evaluation of the £10m Department of Health Homeless Hospital Discharge Fund. 

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Why invest in improved hospital discharge process?

Homeless people are heavy users of acute health services and many are stuck in a damaging cycle of poor health and hospital re-admission. This briefing exaplains how getting the admission and discharge process right improves people’s health and saves money. 

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Channel website: http://www.homelesslink.org.uk

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