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HealthWatch inquiry illustrates our call for action to ensure the safety of homeless people leaving hospital

Blog posted by: Helen Mathie yesterday (Tuesday, 21 July 2015 - 11:20am).

Today sees the launch of HealthWatch England’s Safely Home report, the result from their national inquiry into what happens when people are discharged from hospital and care settings.

The inquiry was focussed on three patient groups: people with mental health problems, older people, and people experiencing homelessness.

Homeless Link has been following the inquiry closely, contributing evidence last year based on our work to raise awareness about poor hospital discharge and developing practical responses with local partners to improve the process.

Many of the issues highlighted in HealthWatch England’s inquiry are the same problems people experiencing homelessness highlighted to us back in 2012 when we worked with St Mungo’s Broadway to map current practice and areas for improvement. Poor co-ordination between services, discrimination from staff, and lack of support after being discharged were some of the barriers identified once more across all three patient groups.

Safely Home includes some personal accounts which are depressingly familiar about the impact of this on people who are homeless: being discharged before they felt they had recovered; leaving hospital without any accommodation to go to; and experiencing a sudden change in staff attitude once the patient had revealed their homelessness. This evidence provides a compelling picture of the human and financial costs that result from failing to provide the right care and support to patients.  

The risk is that with all these ongoing problems highlighted, health and care staff will give up trying to improve things. The NHS budget and staffing levels are under increased pressure once again, and as our Annual Review of Support to Single Homeless People 2015 has shown, there is less investment in homelessness services locally, and accessing accommodation which is affordable and suitable is harder than ever.  

However, we mustn’t let this become a get-out clause from tackling poor hospital discharge practice. There are many areas which have worked hard to make improvements, and Homeless Link found plenty of evidence of this in the evaluation carried out last year on behalf of the Department of Health, examining the impact of a £10m investment programme to improve hospital discharge for homeless people. It showed that putting measures in place locally improved patient outcomes, reduced readmission rates and brought subsequent savings to the NHS and local services.

However, we still face a challenge in maintaining the commitment, leadership, and often the investment needed in this work. Despite good outcomes, fewer than half of projects we evaluated had been continued, usually due to lack of funding. As Safely Home highlights, no singular body has responsibility for hospital discharge and we would welcome recommendations from HealthWatch England about how this accountability can be addressed given the systemic failures it has highlighted.

HealthWatch England has a unique role given the statutory powers they have in the health and care systems to hold bodies to account should poor practice persist, so we hope they will champion this issue through supporting local Health and Wellbeing Boards and Clinical Commissioning Groups to ensure a renewed focus on this issue.

We also greatly welcome the report’s promise of a new ‘collective plan’ with the Department of Health to track progress and we hope HealthWatch England will take up the offer of support from the homelessness sector and their clients to help shape and help deliver this.

Both our recent evaluation and the 2012 report made a series of practical recommendations for improving practice, and we hope these offer a helpful starting point to areas wanting to address what, as HealthWatch England point out, is an issue which has to remain a national priority and which we have to get right.


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

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