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Newcastle: Co-ordinating hospital discharge for rough sleepers

Support is provided to homeless people while they are in hospital. It ensures when they are ready to be discharged they will not return to the streets. Over the past two years no-one has been released without accommodation to go into.

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The challenge

For some patients, a stay in hospital can last weeks or even months. For those with unstable housing, there is a risk they may leave hospital homeless, or if they are already homeless, the lack of onward accommodation can delay their discharge or lead to them being released back on to the streets. That is both bad for their health and represents a missed opportunity in terms of engaging and helping rough sleepers.

The solution

Over a decade ago Your Homes Newcastle (YHN), the council’s arms-length organisation that runs the stock of council housing in the city, decided to act and invest in a dedicated homeless discharge service.

The Hospital Discharge and Homelessness Prevention Team has a support worker covering the two acute hospitals in the city and two that work with both in-patients and community mental health services.

Frontline NHS staff have agreed protocols to refer homeless patients, or those deemed at risk of homelessness, into the service. There is a dedicated nurse funded by the acute hospitals to support their patients alongside the YHN team.

YHN Senior Manager Support and Progression Suzanne Halliwell said: “While the person is under the care of the NHS our team can go in and arrange accommodation for discharge or make sure the individual does not lose their tenancy.

“We can register them for housing and start that process. It can be quite complicated and people sometimes just need some help. We also arrange for benefits to be paid where they are not getting them.

“We can start the tenancy before someone leaves hospital if needed. The key is getting the referral in early so we have time to arrange something.

“But if there isn’t time to get something long-term arranged the council does have a short-stay temporary accommodation centre which patients can be discharged into. More long-term accommodation can then be arranged from there.”

The impact

Over the past two years the team has helped 145 people – and no-one has left hospital homeless.

It is one of the factors that has helped drive down rates of homelessness in the city. Newcastle has one of the lowest numbers of rough sleepers out of the major cities in the UK. There are an average of six rough sleepers on the street every night.

“We are very proud of what has been achieved,” says Ms Halliwell. “The support is making a major difference to people’s lives.”

Lessons learned

Ms Halliwell said when offering discharge support of this kind it is essential to focus on those at-risk of homelessness as well as those that are homeless on admission – even when the risk may seem rather innocuous.

“Simple things like having a patient who lives on their own and has left the heating on can spiral out of control if there is no-one to go in and turn it off. They could end up with a bill for thousands of pounds if they spend a few months in hospital. That could be enough to end up with them losing their home.

“Or you may have someone who is having trouble with their tenancy and while they are in hospital they give their keys up. You need to be available and help these patients as well as those who have no home otherwise you just end up with more people on the streets, and that in turn increases their chances of being re-admitted to hospital.”

How is the approach being sustained?

Newcastle City Council has recently launched a new partnership – Street Zero – aimed at eradicating rough sleeping. The partnership brings together organisations from four sectors – public, business, charities and the community.

The public are being encouraged to make donations to the partnership, while a board has been appointed to help coordinate bids for government funding and oversee new initiatives to combat rough sleeping.

Newcastle’s Active Inclusion Service Manager, Neil Munslow said addressing the health needs of rough sleepers will be a key part of the work of the partnership. One of the options being pursued is introducing a health and social care element into the street outreach work.

“At the moment that work is focussed on housing, but the reasons that people are sleeping rough are complex. We need multi-disciplinary teams to help tackle this.”

To help progress the partnership work, a consultant has been appointed on a short-term contract. “There is always a temptation to get a front-line practitioner doing this kind of work, but we wanted someone with a change management background. The challenge is always getting policy converted into action.” added Mr Munslow.

Contact details

Neil Munslow

Active Inclusion Service Manager

Newcastle City Council

[email protected]