Hospital Discharge and Homelessness: Local stakeholder perspectives, this report focuses on local stakeholder’s views about hospital discharge and the wider context for people who are experiencing homelessness within Stoke-on-Trent.
We (the CHAD team) were approached by VOICES to carry out this piece of research. This was on the back of previous research we had partnered on, which used an assets-based approach to explore city centre rough sleeping and street activity in Stoke-on-Trent (McCormack et al., 2016; Massie et al., 2018). VOICES commissioned this research to explore stakeholders’ views and experiences of the hospital discharge process for homeless people, with the hope of highlighting gaps and strengths across the system.
To explore this, we (the authors of this report) conducted and analysed interviews with 27 local stakeholders, with representation gained from the local authority, National Health Service (NHS) and third sector. In addition to the primary data collection, we held a wider stakeholder event where we presented the findings for discussion with a wider range of local stakeholders. This report includes a section on the feedback received at the stakeholder event. Learning from that event has been incorporated into the discussion and recommendations that are put forward in this report.
Background
It is widely accepted that there have been recent increases in homelessness nationally. Hewett (2019) argues that this rapid increase is driven by austerity, welfare cuts, lack of affordable housing and sustained cuts to local authority support services. He also recognises the influence of poverty and adverse childhood experiences (ACEs) as highlighted by Fitzpatrick et al. (2018).
The Department of Health (2010) estimated that the homeless population use up around 4 times more acute hospital services than the general population, at a cost of at least £85 million per year. For in-patient costs, the figure increased to 8 times when compared to the population aged 16-64; it was also reported that this client group are much more likely to be admitted as an emergency (Department for Health, 2010). More recent evidence shows A&E attendances of people experiencing homelessness have trebled since 2010/2011 (Lacobucci, 2019). Locally, Emergency Department attendances tend to be triggered by physical health issues, predominantly infections and exacerbations of long-term conditions (Morton, 2017).
Research by Pleace (2015: iv) also emphasised that, in addition to the personal cost of homelessness, there is a social and economic impact of homelessness, ‘as a downward spiral can involve ricocheting among public systems at great cost to the taxpayers’. In 2016, the Communities and Local Government (CLG) Select Committee called for a renewed government-wide homelessness strategy (CLG, 2016). The greatest proportional increase in homelessness was amongst those who had been homeless for two consecutive years, and it was noted that this suggested that current intervention methods were not effective in preventing long-term homelessness. The Committee found that levels of support for homeless people varied, and that many homeless people were not being provided with meaningful support and guidance.
Hospital Discharge and Homelessness: Local stakeholder perspectives, Fiona McCormack, Sian Parry and Chris Gidlow, November 2019, read the full report here.
