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Explore the average age of death, standard mortality ratios, and the extent of homelessness in London. Learn about the hidden homeless, their health challenges, and the importance of connecting them to support services. Discover the impact of the Homelessness Reduction Act and hear stories from affected individuals.
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WORD ON THE STREET Clare Reeder Mo Elmi c.reeder@nhs.net
Have a think… • Average age of death of someone street homeless • Standard mortality ratio for someone that is homeless • How many people sleeping rough in London
Background Hostel dwellers Night Shelters Rough sleepers Homeless Temporary accommodation B & B Staying with friends Hidden homeless Living in squats Sofa surfers
Key terms • Intentionally homeless • Local connection • No recourse to public funds
Ward 47 male “NFA” - hernia repair – discharge planning
Ward 65 male – Korsokoffs – nursing placement no longer wants him – discharge planning
CHAIN - Combined Homelessness and Information Network 2017/18
“Homeless people attend A+E six times as often…are admitted four times as often and stay three times as long because they are three times as sick” Professor Barry McCormick Former DOH • Trimorbidity of health • Mental ill health • Physical ill health • Drug and alcohol misuse Average age of death is 47
The Lancet • Standardised mortality ratios in marginalised and excluded population • 11.86 Female • 7.88 Male • “Social exclusion is deprivation upon stilts” • Michael Marmot
Myths • Turning up to a hostel • Registering at a GP
Current practice Bradford Leeds Manchester UCLH Royal London Kings Brighton
Homelessness Reduction Act Duty to Refer • The Homelessness Reduction Act 2017 (HRA) places a new statutory duty on Hospital Trusts, NHS walk-in centres and Accident and Emergency departments. • From October 2018, you are required to refer (with consent) any patient who is homeless, or at risk of homelessness in the next 56 days. • Homelessness may include patients residing in hostels or unsuitable accommodation, people in insecure accommodation or people sleeping rough.
People’s stories “I have been an inpatient at Charing Cross Hospital Mental Health Unit for 3 months and was discharged to the street last night” “He was discharged to the park after being beaten up and kicked in the head – if he wasn’t homeless – they would check he had somewhere to go” “When hospitals find out you are homeless – they treat you are like a disease”
The Faculty For Homeless and Inclusion Health http://www.pathway.org.uk/faculty/join/
https://www.pathway.org.uk/4403-2/ • http://www.nosecondnightout.org.uk/ • https://www.homeless.org.uk/search-services?field_geofield_latlon=london&field_geofield_latlon_op=5&field_homeless_england_type=5641&field_region_and_local_authority=All&field_homeless_england_type_1=All