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Hospitals
discharging homeless people onto the street
MORE than 70% of homeless
people are being discharged from hospital back onto the streets,
damaging their health and costing the NHS money, a report indicates.
The Hospital Discharge Project at Arrowe Park Hospital in Wirral
features as an example of good practice in the report, which has
been backed by Paul Burstow, Care Services Minister, during a visit
to a hospital in London.
The report, from Homeless Link and St Mungo's, has found that NHS
staff can improve health outcomes for homeless people and save the
NHS money by ensuring all patients have somewhere appropriate to
stay when they are discharged from hospital.
Improving Hospital Admission and Discharge for People who are
Homeless comes from an in-depth study of 85 homeless people,
hospitals, local authorities and homelessness agencies and is a
guide on the treatment of homeless patients. Best practice advice
for hospital staff includes:-
► NHS hospitals must identify people who are homeless or at risk of
becoming homeless: frontline staff need to ask the right questions
to find out if a patient is homeless or at risk of homelessness.
►
NHS staff should involve key
partners immediately, eg hostels, outreach teams, local authority
housing teams: every ward should have access to the homeless
persons' database and a list of up-to-date local homelessness
agencies, and should notify these contacts when they admit someone
who is homeless to avoid them losing their tenancy.
►
Local authorities, NHS and the
voluntary must sector must work together: finding appropriate
housing for homeless people will reduce readmissions to A&E, improve
patient experience and save the NHS money.
Commissioned by the Department of
Health, the report was produced to inform the National Inclusion
Health Board and delivers the Ministerial Working Group on
Homelessness commitment to identify what more must be done to
prevent people at risk of rough sleeping being discharged from
hospital without accommodation.
Some homeless patients who took part in the study reported having a
more positive experience. Many of these were at hospitals with
dedicated homelessness teams, such as Arrowe Park Hospital in
Wirral, and University College Hospital (UCH) in London.
The Hospital Discharge Project at Arrowe Park Hospital was set up in
response to a concern that homeless patients were being discharged
with little support, resulting in poor health outcomes, prolonged
homelessness and increased costs to the NHS.
Since it was launched, Arrowe Park has reported savings of £26,000
on No Fixed Abode episodes; a 26% reduction in the number of bed
days for these cases; and a fall of 33% in the number of episodes
resulting in emergency readmission within less than 28 days.
The project introduced link workers to support homeless patients,
and has worked to improve their discharge procedure for homeless
people by:-
► Ensuring homelessness is accounted for in discharge policy and
procedure.
►
Developing a discharge protocol
between the hospital and the local authority.
►
Raising awareness of homelessness
among hospital staff.
►
Developing links between the
hospital, community support and treatment services.
►
Supporting patients to appropriate
accommodation when discharged.
Jointly funded by NHS Wirral and
the Supporting People team at Wirral Council, the one-year pilot
started in May 2010 and due to its success it has now been extended
for another year. Full findings from the CHSEO analysis can be
accessed at:-
chseo.org.uk.
Matt Harrison, Interim Chief Executive of Homeless Link, says:-"The
homeless sector has been working to improve the health outcomes for
homeless people for years, yet they still experience some of the
poorest health in our communities.
The findings from this report are extremely disappointing. Failing
to meet homeless people's health and housing needs is costly to
individuals, but also to the NHS as life on the streets means they
continue to be readmitted to hospital.
No one should be discharged from hospital to insecure or
inappropriate accommodation, so every hospital should have an
appropriate system in place to improve the health outcomes of
homeless patients. We call on all agencies to take a step to end
homelessness by ensuring everyone has somewhere suitable to go when
they leave hospital, with support in place for their on-going
medical care."
Charles Fraser, CEO of St Mungo's and a member of the National
Inclusion Health Board, says:- "It is crucial that the NHS
does not lose sight of its responsibilities towards those in the
most parlous circumstances. This report must not only prod its
conscience, but stir it into action. The hospital sector has to
improve, and improve quickly, but we must not lose sight of the fact
that better facilities in the community will help hospitals get
their discharge practices right. There are examples of what can be
done, and proposals for what else needs to be done, and the funding
and commissioning system must support and enable them.
The excessive and disproportionate ill-health of homeless people
should be a source of shame, and should prompt urgent steps to
rectify it. This issue must not be left solely to the discretion of
local commissioners, but must be a specific priority for the NHS
Commissioning Board and for Public Health England in how they tackle
health inequalities. We at St Mungo's are very pleased that
the minister, Paul Burstow, is able to attend the launch of the
report, and we look forward to working closely with him and his
officials in implementing its recommendations."
Kathy Doran, Chief Executive of NHS Wirral, said:- "This is a
great example of partnership working across NHS Wirral, Wirral
Council and Wirral University Teaching Hospital. It's one of a
number of services in Wirral aimed specifically at improving access
to health services for homeless people and is part of a local
strategy to address the health inequalities caused by homelessness.
The outcomes speak for themselves and we're thrilled to see the
impact this is having on improving the lives of and support
available to homeless people."
Paul Bustow, Care Services Minister, says:- "We commissioned
this report to expose poor practice and share best practice. What it
reveals is too many hospitals simply discharging homeless people
back to the streets. Patching a person up and sending them out
without a plan makes no sense. The good news is the report
shows that there are hospitals doing brilliant work to join up care
and support and reduce the cycle of revolving door admissions. I am
challenging the rest of the NHS to learn from the best and make it
the norm."
Professor Steve Field, Chair of the Inclusion Health Board, says:-
"I am delighted that the government is responding positively
to this report, calling for more to be done to prevent homeless
people being discharged from hospital back onto the streets.
Inclusion Health is bringing partners together to identify what more
must be done to better reflect the needs of homeless people in the
commissioning of health services and to improve their access to and
outcomes from health services. This report sets the challenge to
improve hospital discharge arrangements for the homeless and
helpfully provides advice on how to do so.
The level of care provided at University College Hospital is what
hospital trusts around the country should be aspiring to. We will
continue to challenge all parts of the health system to deliver a
good service and improve health outcomes for those most vulnerable
to poor health outcomes." |
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4000
disadvantaged Merseyside youths recruited to take part in Triodos
New Horizons programme
YOUTH service provider
Greater Merseyside Connexions Partnership (GMCP) has started the
recruitment of around 4,000 young people to take part in the Triodos
New Horizons programme. The scheme will help young people in
Merseyside, many of whom are young offenders, have learning
disabilities, or are in or leaving care. The programme is run in one
of the most deprived areas of the UK where unemployment and youth
crime is above average.
The scheme is unique in the way it is financed. The Triodos New
Horizons programme differs from typical social services schemes, as
it is funded by private sector social investors, who provide at-risk
capital funding. These investors will be repaid on a
payment-by-results basis only when pre-agreed educational, training
and employment targets are met. This way, the project has a
3 way incentive to succeed. Firstly, investors see their money
being spent on eradicating youth problems, while potentially earning
a good return on their investment; secondly, four thousand
individuals at risk of being NEETs* (Not in Education, Employment or
Training) are given the opportunity to develop their skills and
enter into work; and thirdly, taxpayers do not have to pay anything
if the programme targets are not met.
Triodos Bank is the first bank in the UK bringing together private
investors and government funding to invest in social enterprises on
this scale. The corporate finance team acted as lead adviser on the
deal and, in partnership with GMCP, raised £1.5 million of funding
for the programme in the form of a Social Impact Bond. This was
invested in by a syndicate of leading UK social investors including,
among others, Big Society Capital, Bridges Social Entrepreneurs
Fund, CAF Venturesome and the First Arc Group. On behalf of
investors, Triodos will retain a role in the performance management
of the three-year scheme.
GMCP, a leading social delivery organisation with over twenty years
of experience in Merseyside, designed the New Horizons programme.
Together with local parties they will deliver the scheme. The
contract was awarded through the first round of the £30 million DWP
Innovation Fund, set up by the Government to support social
investment projects over three years from 2012. The projects will
support disadvantaged young people and those at risk. Via one-to-one
coaching, youngsters will develop the mental resilience they need to
overcome their personal challenges.
Dan Hird, Head of Corporate Finance at Triodos Bank, commented:-
"Triodos is pleased to have successfully structured this deal
which creates a unique partnership between private sector investors
and a longstanding social delivery organisation in GMCP. Our role
included investor readiness advice for GMCP and the development and
placement of a social impact bond which is capable of providing an
attractive blended financial and social return to investors."
Kieran Gordon, CEO of GMCP, added:- "The opportunity to tap
into private investment from socially minded investors has enabled
GMCP to develop and deliver innovative solutions for some of the
most disadvantaged young people in our area. Support for many of
these young people has been severely reduced due to cuts in public
funding; by making the case for investment it has enabled us to deal
with problems before they become the focus of crisis measures. The
partnership formed with Triodos Bank and, through Triodos, the
relationship we have built with investors is an exciting and we hope
a productive one in realising common goals."
Liverpool's award winning clinical
scientist leading the way for excellence in research
DEREK Middleton, consultant clinical scientist
at the Royal Liverpool and Broadgreen University Hospital has won
the award for Excellence in Research Award at the recent 2012
Healthcare Science Awards for his dedication and achievements in
clinical research for tissue typing (HLA typing) and
transplantation.
Derek is a world renowned clinical scientist in the field of HLA
tissue typing and transplantation, which has helped DNA
compatibility testing (HLA tissue typing) and techniques for organ
and stem cell transplantations to be carried out more safely and
successfully throughout the world.
Derek has excelled at translating clinical research into clinical
use. He is the author of over 300 publications and it was his
research that established that accurate HLA tissue typing would lead
to improved survival of donated organs in kidney transplants,
finally convincing transplant surgeons of the necessity of HLA
matching.
Derek was also the first director of an HLA laboratory to type KIR
genes' these produce proteins of great importance in the regulation
of the immune response; and analyse their clinical effects.
On his accolade, Derek said:- "I am honoured to receive this
award and would like to thank my colleagues for their continued
support and contributions developing the research for HLA typing and
transplantation. It's a privilege to receive such recognition
for the achievements we have made in the research for HLA tissue
typing and we will continue to strive to achieve research
breakthroughs to improve compatibility and survival rates for tissue
typing and transplantation."
Derek received his award from the Rt Hon Andrew Lansley CBE,
Secretary of State for Health and Professor Sue Hill OBE, Chief
Scientific Officer at the Department of Health.
POET PAT GETS
HER HAPPY ENDING PAT
Fearon, of Liverpool, has won the 2012 Novel Prize for her book
'Aftermath'. Her novel is a 'boy meets girl'
story set against the
backdrop of the Second World War. The aftermath of the title refers
to an ill-conceived passionate encounter and the lasting effect it
has on the characters' lives.
As her prize, Pat has had her novel published and receives 250
copies. The novel will be on sale this summer in all good bookshops.
Pat, who is a trained teacher, nurse and counsellor, drew on a
wealth of personal experiences to produce her prize-winning novel.
"As a counsellor you become very involved in the welfare of
other people, and when the sessions come to an end you wonder how
they will cope with any tragedy or unfairness they encounter in the
future. In the same way, I like to give my stories equivocal
endings – the reader is never quite sure if the main characters will
end up happy."
Pat is no stranger to hard work; she has been a nurse in care homes,
has counselled those with alcoholism, and volunteered at the
Everyman Theatre whilst working full-time. A member of the Dead Good
Poet's Society, Pat also runs therapeutic writing classes at the
Women's Health Information and Support Centre in Liverpool.
"I've retired about 4 times!" she joked.
Although she has written several novels, this is the first Pat has
entered into a competition. Having made several attempts to get
published, she had become disheartened. "Then I read the
United Press entry form, and thought, 'Why the hell not?'"
she said. She considers herself lucky to have support and
encouragement from her sons and grandchildren, and from Sarah
Maclennan; co-ordinator of the Dead Good Poet's Society. Any
UK resident can enter the Novel Prize. United Press runs
competitions to encourage new writers to 'have a go'
at writing. For details, call:- 0844 800 9177, or visit their
website.
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