Pioneering legal support project
The King's Health Partners Pathway homeless team is supporting people who are experiencing homelessness to achieve more stable – and therefore healthier – lives.
People experiencing homelessness attend A&E more frequently and are more likely to be admitted to hospital urgently because of issues like diabetes, excessive intake of alcohol and, or drug overdose.
To provide essential support for this patient group, a service run by a team from Guy's and St Thomas' NHS Foundation Trust and Southwark Law Centre was established in January 2020. The team offers legal support to resolve housing, immigration and benefits problems for those experiencing homelessness, which in turn leads to improvement in health outcomes. Since its launch, the service has supported 39 patients.
The patient group taking part in the scheme are more likely to attend hospital outpatient appointments and seek help from other health professionals including GPs, addiction and mental health services, leading to improvements in their health.
Hospital data from 17 of the patients supported by the project shows there was a 94% reduction in hospital admissions and 97% reduction in the length of hospital stay after six months. It also shows that this group of patients were more likely to attend their hospital outpatient appointments for ongoing care, with attendance increasing by 51%.
On how this legal support can impact health outcomes for patients, Melu Mekonnen, a housing manager for the Homeless Health Team at Guy's and St Thomas' NHS Foundation Trust, says:
Homeless patients whose immigration cases are resolved through this scheme for example, are entitled to be accommodated by their local authorities. In turn they are more likely to engage with health, drug and alcohol services and attend their outpatient hospital appointments.
As a result, they are healthier - more likely to eat nutritious foods, take their medications, carry out daily living tasks like preparing meals for themselves, and significantly reduce or avoid drugs and alcohol use.
Patients who attend their hospital outpatients' appointments are much less likely to attend the emergency department and to be admitted to hospital - freeing up beds for potentially life-saving treatments.
The Homeless Health Team, made up of nurses, housing workers, occupational therapists and social workers, support patients to find suitable long-term accommodation following discharge from hospital, and give advice and refer them to other services for ongoing support. However, the team are not legally able to provide legal advice on immigration matters.
Ruth Mercer, a solicitor with the charity, Southwark Law Centre, is an experienced advocate for people who are homeless and also trains the hospitals’ staff to recognise people who need legal representation, says:
The Homeless Health Team connects us with some of the most vulnerable clients we work with. They refer exceptionally vulnerable people, who have often been long-term homeless and living very chaotic lives due to legal issues, such as lack of immigration status or inability to access Local Authority homelessness services.
It's brilliant when we are able to take on someone's case and resolve their legal issues because it makes an absolutely massive difference for their day to day lives.
Once a homeless person has resolved their immigration status and/or housing issues they are able to find stability, access services and move on with their lives. It's a really big life change for them.
The Homeless Patients Legal Advocacy Service is funded by Guy's and St Thomas' Charity, through generous donations from the public.
To find out more about the team, visit the Guy’s and St Thomas’ NHS Foundation Trust website.