Improving the care of inpatients who are homeless: why we need to ask ‘have you got somewhere safe to go when you leave hospital?’ and use the Homelessness Reduction Act 2017 ‘duty to refer’ process

摘要

Introduction‘Homelessness’ is an increasingly important UK healthcare issue.Mean age of death of people who are homeless is 43–47 years andthere were 726 homeless deaths in England and Wales in 2018.1,2People who are homeless have complex health needs reflected inincreasing emergency attendances and admissions.1 One in threedeaths might have been preventable with timely treatment, yet‘homelessness’ is often not identified by clinicians as a health issueand is poorly documented in health records.1,3The Homelessness Reduction Act (HRA) 2017,4 which cameinto place in October 2018, imposes a legal duty on NHS trusts torefer people experiencing / at risk of homelessness to ‘their’ localauthority (LA) housing team for needs assessment, subject to theirconsent (‘duty to refer’ (DtR)).The aim of this audit was to investigate the prevalence andcharacteristics/needs of inpatients who are ‘homeless’ in one innercityhospital, and to evaluate the use of DtR.