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Hospitals overstretched by burden of homeless patients

Researcher say hospitals are under extra pressure due to community service cuts

Mark Gould

Thursday, 12 December 2019

Hospitals in England are dealing with skyrocketing numbers of homeless patients with complex needs, according to new research.

Figures provided by hospital trusts in England in response to Freedom of Information requests by The Doctor, the house journal of the BMA, suggest that during 2018-19, over 36,000 attendances to emergency departments were by patients of ‘no fixed abode’. This represents more than a three-fold increase 2010/11 when there were 11,305 attendances.

The number of homeless patients being admitted to hospital has also soared – with at least 11,986 admissions recorded last financial year, compared to just 3,378 in 2010/11 from previous research.

The research also shows that hundreds of homeless patients are stuck in hospitals for three weeks or longer. Experts and frontline staff believe that cuts in social care and support services, as well as it becoming increasingly difficult for homeless people to get a permanent roof over their heads, have contributed to this.

A total, 49 hospital trusts told The Doctor that homeless patients had been in hospital extended periods during 2018/19, totalling 16,129 bed days.

Some of the longest stays included:

  • King’s College hospitals: 78 patients, totalling 4,383 days.  
  • Nottingham University hospitals: 5 patients totalling 563 days – including one patient who stayed at least 462 days.
  • Oxleas (Oxfordshire) NHS Foundation trust: 14 patients totalling 1,617 days.  
  • University Hospitals Birmingham: 18 patients totalling 1,272 days.

Dr Simon Walsh,  the BMA emergency medicine lead and consultant committee deputy chair, said the magazine’s findings were “soul-destroying and show the needs of homeless people continue to be ignored and the impact on hospitals not understood”.

“That being said, it will sadly not come as a surprise to many doctors who see the harsh reality of homelessness in hospital emergency departments every day,” Dr Walsh said.

“If anything, these numbers are just the tip of the iceberg and the true figures are likely to be far higher.”

Dr Walsh that problems in hospitals had been exacerbated by years of cuts to community service,  meaning more homeless people are overlooked or left to fend for themselves.

“Doctors and healthcare staff will continue to provide the best treatment they can but ultimately we need more resources made available in order to provide the specialist help that this extremely vulnerable population desperately needs,” he added.

Brighton based homeless healthcare charity Pathway helps the NHS create hospital teams to support homeless patients, to ensure they have the best coordination of care, so they can improve the outcome for patients.

The charity’s CEO, Alex Bax, said: “Homeless patients face the very worst health inequalities in our society – and are suffering more than anyone from the impact of nine years of brutal austerity politics in this country.

“However, there is robust evidence that we can make a difference now: Pathway teams are an example of how genuinely integrated, joined-up working, from staff across health, social care and other sectors like housing, can make a huge difference to the lives of patients, the working conditions of frontline staff and, ultimately, the pressure on NHS services.”

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