Homeless people are 60 times more likely to visit A&E

Author: Ingrid Torjesen

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Homeless people are almost 60 times more likely than the general population to visit A&E, visiting at rates similar to that of people in their sixties, a study* published in the British Journal of General Practice shows.

Researchers at the University of Birmingham analysed routinely collected data for almost 1,000 patients registered to Birmingham Homeless Healthcare Centre in Birmingham city centre. The data showed that nearly one in three had attended an A&E Department in the preceding 12 months, nearly one in eight had been offered support for substance dependence, one in five had been offered support for alcohol misuse, and there was a high prevalence of hepatitis C.

Lead investigator Dr Vibhu Paudyal, of the University of Birmingham’s School of Pharmacy, said: “The study provides compelling evidence about the health problems faced by homeless people.

“Participants, whose average age was 38 years old, had two or more serious chronic medical conditions, a rate comparable to people in their 60s. Substance abuse and alcohol dependency were common, as were mental health problems and hepatitis C.

“This study reinforces the need to further expand and diversify specialist services available to the homeless population, particularly preventative services. Further work needs to be done to minimise fragmentation of services and to improve access and experiences around homeless use of mainstream general practices.”

He added: “Ill health can be both the cause and consequences of homelessness. Hence, early and opportunistic prevention and treatment of mental health, substance and alcohol dependence can prevent ill health and, for many, the repeat cycle of homelessness."

The authors of this study, which was funded by Public Health England and West Midlands Combined Authority, urged GP practices to make registration of homeless people easier, and to provide signposting to specialist homelessness services, where they are available. They want mainstream health services to be flexible and tailored to ensure this population do not face challenges and barriers in accessing care.

Shelter estimates that there are over 320,000 homeless people in the UK, and the number continues to rise.


*Bowen M, Marwick S, Marshall T, et al. Multimorbidity and emergency department visits by a homeless population: a database study in specialist general practice. British Journal of General Practice 1 July 2019; bjgp19X704609. DOI: 10.3399/bjgp19X704609

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Editorial team, Wilmington Healthcare

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