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World Homeless Day: Survey reveals discharge disparity for people experiencing homelessness

A survey published in RCP's Clinical Medicine journal has revealed that almost a third of people experiencing homelessness and occupying beds in London hospitals in February 2022 were healthy enough to leave, but their discharges were delayed because they had nowhere to go.

The audit found that 60% were deemed to need discharging to accommodation with high- or medium-level support.

However, with hospital teams identifying that as many as 24% were highly likely to be discharged to a destination that was suboptimal or unlikely to meet their needs – half of them had a delayed discharge.

This delayed rate for patients experiencing homelessness is almost double the already high rate of delayed discharges for the general population. Analysis from Quality Watch found that as of December 2022, one in six patients (15%) – over 13,000 people were in hospital due to delayed discharge at a time when the NHS is facing unprecedented demands. The latest figures show that the NHS is currently facing a record high waiting list of more than 7.6 million people – including 1.6 million people waiting for a test or scan.

Today marks World Homeless Day which serves as a platform to advocate for improved policies and funding that can help prevent homelessness. 

As the convenor of the Inequalities in Health Alliance, the Royal College of Physicians is calling for the government to implement a cross-government strategy which “pulls at every policy lever available” to tackle the social drivers, such as living in deprivation, that contribute to ill health and demands on the NHS. 

Dr Sarah Clarke, president of the Royal College of Physicians, said:

“At a time when the NHS is already facing unprecedented pressures, avoidable contributors to this demand are simply unacceptable.

“We know that social drivers, such as unemployment, living in deprived areas and poor building standards, directly contribute to ill health and we need a comprehensive approach to tackling this problem. 

“It is imperative that the government must also look at the wider impact of health inequalities in order to reduce the burden on the NHS and our workforce.”

The authors of the study said:

“Offering a range of housing, health, care and support services, including more intermediate- and longer-term accommodation with support options, provides an opportunity to enable safe, appropriate hospital discharges and tackle the immense inequality in health outcomes for people experiencing homelessness.”