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Bex Pritchard @bex_pritchard Director of Operations at Crisis

Can hospitals prevent homelessness?

Homeless people’s experience of the health system is often poor. They report facing stigma, and are often left with nowhere to go when they are well enough to leave hospital. They report being seen as a problem “too difficult to solve”.

This can mean people ending up back on the street – even if they have an ongoing need for treatment.

The Government has spent £10 million to develop protocols for hospitals to avoid this discharge of homeless patients back onto the streets. All too often though, these are developed in isolation from mainstream arrangements.

New guidance about to be issued by NICE (the National Institute for Clinical Excellence) may go some way to solving these issues. It will say that homeless patients’ needs must be considered by every ward and discharge coordinator, where there is also a need for social care. Transitions between hospital and the community for people with social care needs is new guidance (to be published in November 2015) that all hospitals and local authorities providing social care are obliged to put into practice.

Although not all homeless people in hospital have social care needs, many do. We know a high proportion of rough sleepers have poor mental health and substance dependencies, but often fail to get the assessment and help they need. These new guidelines specifically mention the importance of checking early on in someone’s hospital stay that they have appropriate accommodation to return to; and they set out the requirement for joined up working, to ensure that temporary accommodation (at least) is made available to prevent homeless people being discharged back to the streets.

These guidelines could make a real difference for some homeless people – but they need to be widely disseminated and understood by everyone involved in the care and support of people moving into and out of hospital. If you’re interested and have friends or family working in the NHS or social care – make sure they know about them!