Towards an integrated approach to homeless hospital discharge: An evaluation of different typologies across England

The purpose of this paper is to present the findings of a small-scale evaluation of the Department of Health “Homeless Hospital Discharge Fund” (HHDF) in England.

The paper is based on a mixed-method approach comprising 52 telephone interviews with project staff, 48 responses from an online survey with staff, outcomes data collected by projects, 30 semi-structured interviews with patients and nine in-depth telephone interviews with staff and commissioners.

Overall the 52 pilots funded under the “HHDF” provided positive health and accommodation outcomes for homeless people admitted and discharged from hospital. In contrast to previous studies patients described not feeling judged during their stay, however the admission process was a more mixed experience due to communication breakdown by hospital staff. Integrating housing and clinical staff in the hospital discharge projects produced better outcomes for patients and the availability of accommodation as part of the model allowed improved and more stable housing outcomes. We recommend integrated commissioning takes place for future funding of any hospital discharge projects.

The study was small in scale and carried out before some of the projects had become fully established. The data were self-reported and the quality and completeness varied between projects.

This is one of the few examples of hospital discharge outcomes for homeless people across a number of different localities and project models which examine the role of both health and housing professionals in the process.