Our Emergency Departments at Gloucestershire Hospitals Foundation Trust see approximately 600 Homeless attendances a year. Like many trusts, we offered no ongoing support on discharge or complied with the Duty to Refer legislation under the Homeless Reduction Act (2017). The aim of the project was to initiate compliance with legislation and improve the overall care and support offered to homeless patients that are discharged from the Emergency Department.
By working closely with community services and local authorities we created referral pathways. These pathways were created with each of our service demands in mind. As a busy Emergency Department we often work under enormous pressure with limited computer space. To ensure compliance our pathways had to be simple and quick to do. We also had to consider information governance, data collection, staff workload and challenging unconscious stigmas regarding homelessness.
- We created department Guidelines, leaflets and a homeless patient checklist document
- We provided lots of teaching to staff in the department and gave presentations across the trust. We also used noticeboard presentations to share information with staff
- We worked with IT to ensure homeless patients are identified on admission
The results have shown that as we offered support to homeless people on discharge from the Emergency department they have a much reduced risk of re attending. The close multi agency working now happening has led to patients going into appropriate accommodation much sooner, leading to improved health and wellbeing in this vulnerable group. The pathways and checklist have been in use since Sept 2019. Since then, as compliance with the legislation has risen our attendance rate has reduced. This project went through the trusts Quality Improvement academy
QNI Abstract - Homelessness in ED
Shona Duffy
Homeless Specialist Nurse
Gloucestershire Hospitals Foundation Trust
Email: [email protected]
Twitter: @ShonaDuffy13
Inspired and supported by Dr Pippa Medcalf’s Homeless Inpatient Initiative.
Project co-managed by Sister Becca Shaw.