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Hospital discharge inadequate for homeless patients

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Homeless patients need better discharge facilities Homeless patients need better discharge facilities

A report by the QNI highlights the risk of unsafe hospital discharge for homeless patients.

Community nurses working in the QNI's Homeless Health Network identified poor communication between different services, medically appropriate or unsafe discharge and unsuitable accommodation to discharge people to as some of the biggest problems in discharging homeless patients. Other problems included lack of trust, management of long term conditions and lack of access to public funds.

The report outlines answers from an online survey completed by 184 community nurses in autumn 2014.

Crystal Oldman, the chief executive of the QNI, said: 'Hospitals frequently admit homeless people who are not registered with a GP and who have no other recourse to health services in times of crisis. It is not a sustainable solution to discharge them back into the community without adequate planning for their health and welfare there.'

The QNI has now received funding from the DH to analyse ways to make hospital discharge effective from a community health perspective.

'The new funding from the DH will enable us to identify excellence in practice concerning hospital discharge and to share how this works – not just for homeless patients but for everyone at this key "transition of care" period. The consistent message from community nurses is that discharge services have a great deal of room for improvement. This work will lead directly to changes in services that will improve patient care and patient safety,' said Ms Oldman.

The QNI will take the following actions to support community nurses and their homeless patients:

  • Sending the evidence in the new report to the national inquiry into hospital discharge for homeless people, led by Healthwatch England.
  • Identifying the barriers and challenges preventing effective discharge planning from hospital to home for all patients, and identifying best practice and key recommendations to improve discharge experience for patients, carers and their families. The 12 month project is funded by the DH and the QNI and will start in March 2015.
  • Undertaking a mapping of national specialist homeless health services, and providing a searchable online map, acting as a resource directory for professionals.
  • Creating brief online learning guides for health staff working with people who are homeless, to improve their knowledge.

The problems identified by the Homeless Health Network members reflect those found in the QNI's survey of district nurses published in June 2014, which also highlighted hospital discharge as a major cause of concern. In that survey 83 per cent of respondents said that discharge procedures were not satisfactory.

Community nurses stated that hospitals frequently discharged patients without letting community services know and without advance notice to prepare for them to be cared for at home.

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