Care of homeless inpatients: are we up to standard?
by Victoria Gaunt
Background
All admissions to Gloucestershire Royal Hospital (GRH) between January and April 2018 and coded as no fixed abode (NFA) were measured against secondary care standards set by the Faculty of Homeless and Inclusion Health (FHIH). As listed in the Standards, leaflets signposting local services were designed (with input from homeless patients), widespread education of hospital staff undertaken and a store of clean clothes provided and publicised.
Methods
The notes of 30 NFA admissions to GRH were examined. The average age was 38 years, 53% were admitted due to overdoses, 77% had drug or alcohol dependency and 63% had a psychiatric history.
Results
Only 13 of the 30 patients were referred to the housing officer. Of these, one self-discharged and the remaining 12 were provided with accommodation on discharge and referred to relevant outside agencies e.g. drug and alcohol services. 53 staff were surveyed before, and 50 after the interventions. 91% had contact with a homeless person and 38% had experienced a homeless person being discharged to the streets without support. There was improved awareness of the homeless guideline (45 to 58%), information leaflet (34 to 62%) and location of the clothes store (34 to 88%).
Conclusions
A specialist housing officer for homeless patients admitted to hospital is hugely effective in avoiding discharge back to the street. Crucially this relies on staff making the referral. Implementation of FHIH Standards is achievable in secondary care but must be accompanied by a robust on-going programme of education.