This work hasn’t been done before, and represents the first time that a national multi-centre clinical audit of ED care for homeless people has been carried out in the UK.
The first steps to improve care for homeless patients in A&E are being taken by the Royal College of Emergency Medicine (RCEM), the Royal College of Physicians (RCP), and the Faculty for Homeless and Inclusion Health (FHIH).
Two new reports from RCEM have found that, whilst care for the homeless in A&E is good overall, there are many ways in which care could be improved.
For example, care could be improved by providing more written information during an A&E visit, and signposting homeless people for help and support in the community.
The two new reports from RCEM, with the full findings and recommendations, can be downloaded from our website.
President of the Royal College of Emergency Medicine, Dr Cliff Mann said:
Homeless people represent some of the most vulnerable individuals in our society. It is surely a marker of a civilised society that care and concern for these people is reflected in the provision of appropriate healthcare services.
This first pilot audit seeks to quantify provision of these services and act as a catalyst for future improvement projects.
Homeless patients coming to our EDs this winter deserve the very best care. This work is the first step in contributing to raising standards in this area as a specialty. We are fighting to support our clinicians to reduce health inequalities for excluded groups.
The President of the Royal College of Physicians, Prof. Jane Dacre, said:
Homeless people deserve the best medical treatment possible. The RCP is committed to improving quality of care for homeless patients, and supporting clinicians to reduce health inequalities.
Crisis CEO, Jon Sparks said:
Homelessness can have a devastating impact on people's health. The average age of death for a homeless person in this country is just 47, compared to 77 in the general population. Despite this we know from our services that they often struggle to access the support they need when they go to A&E. That is why this study is so important: more needs to be done to improve the health of homeless people and ensure they can access the help they need. Otherwise we fear homeless people will continue to die much younger than the general population.
The reports by RCEM focussed on the needs of homeless people, including rough sleepers and members of the street community. The audit looked at how A&Es are organised and how homeless patients are cared for. Data were collected over two weeks in the run up to Christmas; 23 November – 6 December 2015.
Secretary to the Faculty for Homeless and Inclusion Health, Dr Nigel Hewett, said:
RCEM is working with the Faculty to encourage more ED's to improve their care of homeless people. An effective response to this complexity requires multi-agency coordination and links to appropriate services and support.
The RCP’s lead fellow for health inequalities, Dr Pippa Medcalf, said:
I am delighted that the RCEM is leading this important work to drive up the quality of care for some of the most vulnerable patients that are seen in emergency departments. The RCP is committed to improving care for homeless patients and I look forward to working closely with RCEM and Pathway over the coming months to raise standards, both in emergency care and beyond.
