Meeting the needs of homeless people attending the emergency department.

Homelessness is on the rise in the UK and, over the past few years, there has been a significant increase in the number of emergency department (ED) attendances and admissions by homeless people. Those attending the ED will often have multiple unmet health, housing and social care needs. While it is not possible to meet all these needs in the ED, emergency nurses should be equipped with the knowledge and skills required to communicate with, refer and signpost patients who are homeless. Under the Homelessness Reduction Act 2017, ED staff have a duty to refer homeless people, with their consent, to local authorities for assistance. This article details the barriers that homeless people may experience when accessing healthcare services and explains how these can be addressed. It also outlines the actions that emergency nurses can take to improve the care of homeless people in the ED at an individual and a systems level.

Nurse-led homeless intermediate care: an economic evaluation.

This article describes a homeless intermediate care pilot project that took place at a 120-bedded homeless hostel in South London in 2009. During the year, 34 hostel clients directly benefited from intermediate care. At the end of the year, the number of hospital admissions to the hostel had dropped 77% relative to 2008, and the number of accident and emergency (A&E) attendances had dropped 52%. Hospital 'did not attends' (DNAs) were 22% lower. An economic evaluation found that the pilot project was cost neutral overall, and there is some evidence that health outcomes improved. The project now has mainstream funding and has recently received a national community nursing award. Its success has been recognized nationally as an example of innovative practice in work with vulnerable groups (Department of Health (DH), 2010).

Piloting the community matron model with alcoholic homeless clients.

This article describes a 13 week trial of the community matron model undertaken with homeless persons in Lambeth in early 2007. Six patients were selected for 'demand management' at a 'wet' hostel in South London. A reduction in acute service demand (A&E attendances and inpatient admissions), and an increase in Euroqol EQ-5D 'quality of life' scores were the outcome targets of the community matron intervention. The article describes what was achieved for the six patients during the 13 week pilot, and the lessons that were learned as a result of undertaking the pilot roject Recommendations for future practice are made.