Clare Reeder Mo Elmi c.reeder@nhs.net WORD ON THE STREET Clare Reeder Mo Elmi c.reeder@nhs.net

http://www.looktheotherway.co.uk/

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 A reason to do this teaching – needs assessment and the idea from both health professionals and service users was the need for education.

Background Homeless Hostel dwellers Night Shelters Rough sleepers Temporary accommodation B & B Homeless Staying with friends Hidden homeless Living in squats Sofa surfers

Key terms Intentionally homeless Local connection No recourse to public funds For example, if you are evicted from your home because you did not pay your rent. Or if you give up your home when it is reasonable for you to continue living there. have lived here for at least six out of the last twelve months, or three out of the last five years

Ward 47 male “NFA” - hernia repair – discharge planning

Ward 65 male – Korsokoffs – nursing placement no longer wants him – discharge planning

CHAIN ANNUAL BULLETIN GREATER LONDON 2017/18 Flow - People who had never been seen rough sleeping prior to 2017/18 (i.e. new rough sleepers). Stock - People who were also seen rough sleeping in 2016/17 (i.e. those seen across a minimum of two consecutive years). Returner -People who were first seen rough sleeping prior to 2015/16, but were not seen during 2015/16 (i.e. those who have had a gap in their rough sleeping histories) CHAIN ANNUAL BULLETIN GREATER LONDON 2017/18

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 (Nov 2017)

“Social exclusion is deprivation upon stilts” The Lancet Standardised mortality ratios in marginalised and excluded population 11.86 Female 7.88 Male “Social exclusion is deprivation upon stilts” Michael Marmot . “Social exclusion is deprivation upon stilts”

CHAIN ANNUAL BULLETIN GREATER LONDON 2016/17

Mo’s Story

Myths Turning up to a hostel Registering at a GP

Streelink and GP registration

Homeless GP Surgeries

Safe Surgeries

Current practice Bradford Leeds Manchester UCLH Royal London Kings Brighton Bradford Leeds Manchester UCLH Acute hospital ward rounds Homeless health nurse practitioners Care navigators

Latest Updates – positives….

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

Thank you