1. Intermediate Care Network for Homeless Health Partnership working at its very best

2. Background
25% of all rough sleepers in England and Wales are in Westminster, accounting for 50% of rough sleepers in London.
Homeless people:
Access A&E 7x more than the general population.
Are more likely to be admitted to hospital as emergencies (which costs 4x more than elective inpatients).
Tend to have more co-morbidities than the general population. 1 in 5 rough sleepers who had contact with hospitals had 3 or more diseases
Is 40x less likely to be registered with a GP
Are likely to die much younger than the general population. The average age of death of a homeless person is 47 years old and even lower for homeless women at just 43, compared to 77 for the general population
Are over 9x more likely to commit suicide than the general population.

3. Our Response
Following on from various DH pilots in the preceding years, in October 2015 we introduced the Intermediate Care Network for Homeless Health. It consists of four elements:
Hostel beds – 11 booked in several hostels across Central London to take step-up and step-down patients to act as an alternative to hospital and provide a holistic approach to care.
Care navigation and in-reach (provided by Hestia) – There is a homeless navigator to co-ordinate the in-reach and intermediate care beds, and a care co-ordination team to case find patients in hospital and work with others to meet their post-discharge needs.

4. Our Response
GP Leadership and Street Outreach – GPs at the two homeless practices in Central London provide oversight of all of the streams and operate street outreach whereby rough sleepers are found and approached with a view to addressing their needs.
Homeless Health Team Redesign – Working with CLCH to ensure the Homeless Health Team is reconfigured (e.g. working in hostels and day centres and on the street) to support the other elements.

5. Patient Case Studies

6. Erica Elderly street homeless woman Critical lung issues
ICN stay meant she was able to engage with health service
Resulting in health improvements and in accommodation.