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Figure 1. ACUTE HOMELESS LIAISON SERVICE. Outcomes. Create awareness of the issues relating to health and homelessness Gain knowledge of current legislation Overview of Acute Homeless Liaison Service The patients journey Discharge Protocols. Homeless Presentations. Glasgow 10,500.
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Figure 1 ACUTE HOMELESS LIAISON SERVICE
Outcomes • Create awareness of the issues relating to health and homelessness • Gain knowledge of current legislation • Overview of Acute Homeless Liaison Service • The patients journey • Discharge Protocols
Homeless Presentations Glasgow 10,500 Beds Provided 4,000
Defining Homelessness “Roofless”, in secure accommodation or involuntary sharing accommodation” Scottish Executive, 2001 • Sleeping rough • Hostel • B&B • Friend’s sofa • Supported accom • Drug/ Alcohol rehab • Temporary furnished flat • Family’s floor
ONS SURVEY Health Needs Assessment of Homeless People • 70% of those ages 24 - 34 have a drug dependence • 54% have hazardous drinking • 58% had a long standing physical health problem • 6% probable psychosis • 46% neurotic disorder • 80% registered with GP while only 65% of those use their GP • Commissioned by GGHB June 2000
“The measure of a country’s greatness should be based on how well it cares for its most vulnerable populations” Mahatma Ghandhi
Legislation in context Our National Health (2000) Health & Homeless Guidance (2001) Partnership for Care (2003)
THE TEAM • Diane Cassidy – H Grade - G Grade to be appointed • Based in I.R.I.S. Department (GRI) • Covering the following sites: • Glasgow Royal Infirmary • Western Infirmary • Stobhill General • Lightburn • Gartnavel General • Southern General • Victoria Infirmary • Liz Leggat – Administrative Assistant • North Division – Based in I.R.I.S. Department (GRI)
Rationale for the Acute HomelessLiaison Service “Improve access and care pathways into and out of hospital for Homeless people”
Acute Homeless Liaison ServiceGreater Glasgow NHS Aims & Objectives • Develop additional protocols regarding the attendance, admission and discharge arrangements for Homeless people across GGHB area. • Raise awareness with staff of the issues relating to homelessness • Redesign patient journey • Develop information and resources • Partnership with stakeholders • To ensure equity of service
The homeless patient’s journey through the health care system Injury/ill health Avoidance/delay of dealing with problem Admission to hospital Deteriorating health Discharge Recovery
The homeless patient’s journey through the health care system Turning point: place for contemplation Injury/ill health Avoidance/delay of dealing with problem Admission to hospital Deteriorating health Acute Homeless Liaison Nurse – assessment of need Discharge Recovery With continuity of care
DISCHARGE PROTOCOLS • Draft protocols in place with the following local authorities: • South Lanarkshire Council • West Dunbartonshire Council In discussion with the following: • Renfrewshire Council • North Lanarkshire Council • Glasgow City Council
Partnership working Acute Homeless Liaison Service Homeless Health Services Acute Services Community Health Services Social Work Services Voluntary sector
Remember this… • Homelessness can be • caused by ill health. • Homelessness • causes ill health. • Homelessness • exacerbates ill • health. • The long-term effects • of homelessness • include ill health. Figure 1