{"title":"Situating and understanding hospital discharge arrangements for homeless people","authors":"M. Whiteford, M. Cornes","doi":"10.1108/HCS-03-2019-030","DOIUrl":"https://doi.org/10.1108/HCS-03-2019-030","url":null,"abstract":"","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"275 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2019-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76245950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.1108/HCS-09-2018-0022
Rose Glennerster, Katie Sales
Purpose The authors’ interest in the discharge of patients with no fixed abode (NFA) arose through repeatedly seeing patients discharged back to the streets. In 2017, the Royal United Hospital (RUH) treated 155 separate individuals with NFA, making up 194 admissions. Given these numbers, the best practice according to Inclusion Health’s tiered approach to secondary care services suggests that the hospital should be providing a dedicated housing officer and a coordinated discharge pathway. As this is currently lacking, the purpose of this paper is to establish a Homeless Healthcare Team (HHT) and design a hospital protocol for the discharge of NFA patients with strong links into community support. Design/methodology/approach The literature review identified six elements that make up a successful HHT, which has provided the structure for the implementation of the authors’ model at the RUH. Findings Along the way, the authors have faced a number of challenges whilst attempting to transform the model into a reality, including: securing funding; allocating responsibility; balancing conflicting priorities; coordinating schedules; developing staff knowledge and challenging prejudice. The authors are now working collaboratively with invested parties from the third sector, specialist primary and secondary care health services and local government to overcome these barriers and work towards the long-term goals. Originality/value Scarce literature exists on the practicalities of attempting to set up an HHT in a District General Hospital. The authors hope that the documentation of the authors’ experience will encourage others to broaden their horizons and persist through the challenges that arise.
{"title":"Establishing a hospital healthcare team in a District General Hospital – transforming a model into a reality","authors":"Rose Glennerster, Katie Sales","doi":"10.1108/HCS-09-2018-0022","DOIUrl":"https://doi.org/10.1108/HCS-09-2018-0022","url":null,"abstract":"\u0000Purpose\u0000The authors’ interest in the discharge of patients with no fixed abode (NFA) arose through repeatedly seeing patients discharged back to the streets. In 2017, the Royal United Hospital (RUH) treated 155 separate individuals with NFA, making up 194 admissions. Given these numbers, the best practice according to Inclusion Health’s tiered approach to secondary care services suggests that the hospital should be providing a dedicated housing officer and a coordinated discharge pathway. As this is currently lacking, the purpose of this paper is to establish a Homeless Healthcare Team (HHT) and design a hospital protocol for the discharge of NFA patients with strong links into community support.\u0000\u0000\u0000Design/methodology/approach\u0000The literature review identified six elements that make up a successful HHT, which has provided the structure for the implementation of the authors’ model at the RUH.\u0000\u0000\u0000Findings\u0000Along the way, the authors have faced a number of challenges whilst attempting to transform the model into a reality, including: securing funding; allocating responsibility; balancing conflicting priorities; coordinating schedules; developing staff knowledge and challenging prejudice. The authors are now working collaboratively with invested parties from the third sector, specialist primary and secondary care health services and local government to overcome these barriers and work towards the long-term goals.\u0000\u0000\u0000Originality/value\u0000Scarce literature exists on the practicalities of attempting to set up an HHT in a District General Hospital. The authors hope that the documentation of the authors’ experience will encourage others to broaden their horizons and persist through the challenges that arise.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"126 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74856004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.1108/HCS-08-2018-0021
Samantha Dorney-Smith, E. Thomson, N. Hewett, S. Burridge, Zana Khan
Purpose The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The paper then articulates the need for medical respite services in the UK, and profiles some success stories. The paper then outlines the considerable challenges that currently exist in the UK, considers why some other services have failed and proffers some solutions. Design/methodology/approach The paper is primarily a literature review, but also offers original analysis of data and interviews, and presents new ideas from the authors. All authors have considerable experience of assessing the need for and delivering homeless medical respite services. Findings The paper builds on previous published information regarding need, and articulates the human rights argument for commissioning care. The paper also discusses the current complex commissioning arena, and suggests solutions. Research limitations/implications The literature review was not a systematic review, but was conducted by authors with considerable experience in the field. Patient data quoted are on two limited cohorts of patients, but broadly relevant. Interviews with stakeholders regarding medical respite challenges have been fairly extensive, but may not be comprehensive. Practical implications This paper will support those who are thinking of undertaking a needs assessment for medical respite, or commissioning a new medical respite service, to understand the key issues involved. Social implications This paper challenges the existing status quo regarding the need for a “cost-saving” rationale to set up these services. Originality/value This paper aims to be the definitive paper for anyone wishing to get an overview of this topic.
{"title":"Homeless medical respite service provision in the UK","authors":"Samantha Dorney-Smith, E. Thomson, N. Hewett, S. Burridge, Zana Khan","doi":"10.1108/HCS-08-2018-0021","DOIUrl":"https://doi.org/10.1108/HCS-08-2018-0021","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The paper then articulates the need for medical respite services in the UK, and profiles some success stories. The paper then outlines the considerable challenges that currently exist in the UK, considers why some other services have failed and proffers some solutions.\u0000\u0000\u0000Design/methodology/approach\u0000The paper is primarily a literature review, but also offers original analysis of data and interviews, and presents new ideas from the authors. All authors have considerable experience of assessing the need for and delivering homeless medical respite services.\u0000\u0000\u0000Findings\u0000The paper builds on previous published information regarding need, and articulates the human rights argument for commissioning care. The paper also discusses the current complex commissioning arena, and suggests solutions.\u0000\u0000\u0000Research limitations/implications\u0000The literature review was not a systematic review, but was conducted by authors with considerable experience in the field. Patient data quoted are on two limited cohorts of patients, but broadly relevant. Interviews with stakeholders regarding medical respite challenges have been fairly extensive, but may not be comprehensive.\u0000\u0000\u0000Practical implications\u0000This paper will support those who are thinking of undertaking a needs assessment for medical respite, or commissioning a new medical respite service, to understand the key issues involved.\u0000\u0000\u0000Social implications\u0000This paper challenges the existing status quo regarding the need for a “cost-saving” rationale to set up these services.\u0000\u0000\u0000Originality/value\u0000This paper aims to be the definitive paper for anyone wishing to get an overview of this topic.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"68 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89769691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-17DOI: 10.1108/HCS-07-2018-0011
A. Owen
Purpose The current project aims to draft an NHS and care provider joint working protocol for patients with learning disabilities as they transition between care and NHS hospital services. The purpose of this paper is to present the rationale behind a joint working protocol and the progress of the project to date. Design/methodology/approach Working in partnership, Basildon University Hospital and Estuary Housing Association have sought to investigate the experiences in hospital of the people they support with learning disabilities. This has involved ongoing work examining patient pathways from both a hospital and care provider perspective as well as engaging in discussions with key stakeholders. It is hoped that these insights will feed into recommendations to form the joint working protocol. Findings Current findings are limited as this paper presents an interim report on an ongoing project. Initial findings around positive joint working practices are detailed. An emerging recommendation around improved information sharing between health and care provider in acute hospital settings is also discussed. Originality/value It is hoped that the project will improve experiences of people with learning disabilities in hospital locally, while inspiring other hospitals and care providers to adopt a joint working approach at a wider level.
{"title":"Improving equality in healthcare for people with learning disabilities: a joint working approach between housing and hospital","authors":"A. Owen","doi":"10.1108/HCS-07-2018-0011","DOIUrl":"https://doi.org/10.1108/HCS-07-2018-0011","url":null,"abstract":"\u0000Purpose\u0000The current project aims to draft an NHS and care provider joint working protocol for patients with learning disabilities as they transition between care and NHS hospital services. The purpose of this paper is to present the rationale behind a joint working protocol and the progress of the project to date.\u0000\u0000\u0000Design/methodology/approach\u0000Working in partnership, Basildon University Hospital and Estuary Housing Association have sought to investigate the experiences in hospital of the people they support with learning disabilities. This has involved ongoing work examining patient pathways from both a hospital and care provider perspective as well as engaging in discussions with key stakeholders. It is hoped that these insights will feed into recommendations to form the joint working protocol.\u0000\u0000\u0000Findings\u0000Current findings are limited as this paper presents an interim report on an ongoing project. Initial findings around positive joint working practices are detailed. An emerging recommendation around improved information sharing between health and care provider in acute hospital settings is also discussed.\u0000\u0000\u0000Originality/value\u0000It is hoped that the project will improve experiences of people with learning disabilities in hospital locally, while inspiring other hospitals and care providers to adopt a joint working approach at a wider level.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"45 5 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89190920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-11DOI: 10.1108/HCS-09-2018-0023
L. Wood, Nicholas J. Wood, Shannen Vallesi, A. Stafford, A. Davies, Craig Cumming
PurposeHomelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.Design/methodology/approachThis mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.FindingsThis collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.Research limitations/implicationsWhile the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.Practical implicationsThis model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.Originality/valueCoordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.
{"title":"Hospital collaboration with a Housing First program to improve health outcomes for people experiencing homelessness","authors":"L. Wood, Nicholas J. Wood, Shannen Vallesi, A. Stafford, A. Davies, Craig Cumming","doi":"10.1108/HCS-09-2018-0023","DOIUrl":"https://doi.org/10.1108/HCS-09-2018-0023","url":null,"abstract":"PurposeHomelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.Design/methodology/approachThis mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.FindingsThis collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.Research limitations/implicationsWhile the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.Practical implicationsThis model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.Originality/valueCoordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"7 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86706011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-05DOI: 10.1108/HCS-07-2018-0016
Zana Khan, S. Koehne, Philip D. Haine, Samantha Dorney-Smith
Purpose The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding. Design/methodology/approach This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures. Findings Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care. Originality/value The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.
{"title":"Improving outcomes for homeless inpatients in mental health","authors":"Zana Khan, S. Koehne, Philip D. Haine, Samantha Dorney-Smith","doi":"10.1108/HCS-07-2018-0016","DOIUrl":"https://doi.org/10.1108/HCS-07-2018-0016","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding.\u0000\u0000\u0000Design/methodology/approach\u0000This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures.\u0000\u0000\u0000Findings\u0000Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care.\u0000\u0000\u0000Originality/value\u0000The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"71 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82350125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health, social care and housing: facing a wicked problem","authors":"P. Dearnaley","doi":"10.1108/HCS-12-2018-029","DOIUrl":"https://doi.org/10.1108/HCS-12-2018-029","url":null,"abstract":"","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"11 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81910362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-15DOI: 10.1108/HCS-09-2018-0024
S. Roxby
Purpose Professional partnerships between housing and health are not impossible, but they take time, commitment and dedicated strategic leadership. The language and culture of the two sectors are sometimes complex and do not always match. There can be issues understanding each other’s motivation, ethics and terminology which can cause a barrier when working together. The purpose of this paper is to share the journey of how Wakefield District Housing (WDH) is working with the care and health sector to create sustainable partnerships that benefit both parties, getting to a stage where they could successfully integrate with healthcare providers in the Wakefield district. Design/methodology/approach The paper offers the reader an overview of how WDH’s membership of the Wakefield Health and Wellbeing Board enabled improved partnership working with NHS and other members, including the establishment of a Housing, Health and Social Care Partnership, the employment of dedicated senior staff, co-located multi-disciplinary teams and joint design of new services. Findings WDH has demonstrated that the organisation understands the challenges facing NHS colleagues, has acknowledged the complexities of the system that their partners work in and looked for solutions alongside them. The opportunities within partnership working are boundless and, if successful, the outcomes for tenants and the wider Wakefield population could be in excess of those envisaged in planning the project. Partnerships will almost inevitably encounter challenges along the way but if all partners keep their own and shared visions in mind, further success is within reach and all parties will get there faster by not going alone. Practical implications The paper offers useful guidance and ideas for other housing organisations aiming to improve their contribution to local integrated healthcare. Originality/value This paper provides an original perspective from inside the programme, offering practical, comprehensive and deliverable initiatives to improve health outcomes for local communities.
{"title":"Partnership in action: forging a new approach","authors":"S. Roxby","doi":"10.1108/HCS-09-2018-0024","DOIUrl":"https://doi.org/10.1108/HCS-09-2018-0024","url":null,"abstract":"\u0000Purpose\u0000Professional partnerships between housing and health are not impossible, but they take time, commitment and dedicated strategic leadership. The language and culture of the two sectors are sometimes complex and do not always match. There can be issues understanding each other’s motivation, ethics and terminology which can cause a barrier when working together. The purpose of this paper is to share the journey of how Wakefield District Housing (WDH) is working with the care and health sector to create sustainable partnerships that benefit both parties, getting to a stage where they could successfully integrate with healthcare providers in the Wakefield district.\u0000\u0000\u0000Design/methodology/approach\u0000The paper offers the reader an overview of how WDH’s membership of the Wakefield Health and Wellbeing Board enabled improved partnership working with NHS and other members, including the establishment of a Housing, Health and Social Care Partnership, the employment of dedicated senior staff, co-located multi-disciplinary teams and joint design of new services.\u0000\u0000\u0000Findings\u0000WDH has demonstrated that the organisation understands the challenges facing NHS colleagues, has acknowledged the complexities of the system that their partners work in and looked for solutions alongside them. The opportunities within partnership working are boundless and, if successful, the outcomes for tenants and the wider Wakefield population could be in excess of those envisaged in planning the project. Partnerships will almost inevitably encounter challenges along the way but if all partners keep their own and shared visions in mind, further success is within reach and all parties will get there faster by not going alone.\u0000\u0000\u0000Practical implications\u0000The paper offers useful guidance and ideas for other housing organisations aiming to improve their contribution to local integrated healthcare.\u0000\u0000\u0000Originality/value\u0000This paper provides an original perspective from inside the programme, offering practical, comprehensive and deliverable initiatives to improve health outcomes for local communities.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"72 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86256657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-06DOI: 10.1108/HCS-08-2018-0020
Angela Gazey, Shannen Vallesi, K. Martin, Craig Cumming, L. Wood
Purpose Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia. Design/methodology/approach This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage. Findings Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support. Research limitations/implications The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality. Social implications MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions. Originality/value There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.
{"title":"The Cottage: providing medical respite care in a home-like environment for people experiencing homelessness","authors":"Angela Gazey, Shannen Vallesi, K. Martin, Craig Cumming, L. Wood","doi":"10.1108/HCS-08-2018-0020","DOIUrl":"https://doi.org/10.1108/HCS-08-2018-0020","url":null,"abstract":"\u0000Purpose\u0000Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.\u0000\u0000\u0000Design/methodology/approach\u0000This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.\u0000\u0000\u0000Findings\u0000Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.\u0000\u0000\u0000Research limitations/implications\u0000The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.\u0000\u0000\u0000Social implications\u0000MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.\u0000\u0000\u0000Originality/value\u0000There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless.\u0000","PeriodicalId":43302,"journal":{"name":"Housing Care and Support","volume":"31 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2018-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87219888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-06DOI: 10.1108/HCS-07-2018-0013
A. V. Doorn, P. Dearnaley
Purpose The 2017 Naylor Review has been the subject of some controversy, with some of the press, social media and other critics portraying its recommendations as a “fire sale” or privatisation of the NHS. The purpose of this paper is to examine preceding reports into efficiency and best value of the NHS, the evidence behind the review recommendations, and analyse data into housing affordability for the capital’s NHS staff. It concludes by advocating for partnerships with housing associations to deliver social and financial value by utilising redundant NHS land to deliver the affordable housing that London and the rest of the UK so urgently needs. Design/methodology/approach The paper was developed using the content analysis of preceding independent reviews of NHS efficiency, published critiques of the Naylor Review and analysis of NHS produced data to consider the potential savings and opportunities for reinvestment in capital projects. Findings The paper identifies existing partnership models and examples of good practice and advocates the adoption of joint ventures and other forms of partnership to ensure that both best value is achieved from the sale of NHS assets, and publicly owned assets are reused for social purpose. Originality/value The paper uses existing data, analysis and context to map a route for achieving best value in managing the publicly owned asset base and reinvesting the proceeds of the sale of redundant properties into UK public services.
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