TY - JOUR
T1 - Homelessness, hospital discharge and challenges in the context of limited resources
T2 - A qualitative study of stakeholders' views on how to improve practice in a deprived setting
AU - McCormack, Fiona
AU - Parry, Sian
AU - Gidlow, Christopher
AU - Meakin, Andy
AU - Cornes, Michelle
N1 - Funding Information:
This research was made possible by The National Lottery Community Fund through VOICES.
Publisher Copyright:
© 2022 John Wiley & Sons Ltd.
PY - 2022/11
Y1 - 2022/11
N2 - Hospital discharge for people experiencing homelessness is a perennial challenge. The Homeless Reduction Act 2017 (HRA) places new responsibilities on hospitals, but it remains unknown whether this has affected discharge practices. This qualitative study explores stakeholders' views on the challenges around hospital discharge for people experiencing homelessness, in the context of a deprived English city. Semi-structured interviews were conducted with 27 stakeholders. Participants were purposively recruited from local authority, third sector and the National Health Service. Interviews were transcribed and thematic analysis conducted. Analysis generated three main themes. First, a need for better planning and communication with the third sector, particularly around medication, prescriptions and information sharing. Second, the need to improve awareness and ‘upskill’ hospital staff to work more effectively with people experiencing homelessness, including understanding their needs, the wider support available and HRA requirements. Third, there were calls for (re)investment in a different approach to better support this population, based on outreach and flexibility. The need for improved partnership working and investment was emphasised. Whilst recognising the challenges faced by hospitals, especially within the context of funding cuts, this study highlights the need to recognise the third sector's contribution in supporting people experiencing homelessness in the community. Developing site-specific checklists for practice before discharge (and as early as possible) may help to ensure appropriate measures are in place. Improving legal literacy in the context of what an appropriate discharge is for people experiencing homelessness may help develop staff confidence to challenge the focus on ‘quick’ discharges.
AB - Hospital discharge for people experiencing homelessness is a perennial challenge. The Homeless Reduction Act 2017 (HRA) places new responsibilities on hospitals, but it remains unknown whether this has affected discharge practices. This qualitative study explores stakeholders' views on the challenges around hospital discharge for people experiencing homelessness, in the context of a deprived English city. Semi-structured interviews were conducted with 27 stakeholders. Participants were purposively recruited from local authority, third sector and the National Health Service. Interviews were transcribed and thematic analysis conducted. Analysis generated three main themes. First, a need for better planning and communication with the third sector, particularly around medication, prescriptions and information sharing. Second, the need to improve awareness and ‘upskill’ hospital staff to work more effectively with people experiencing homelessness, including understanding their needs, the wider support available and HRA requirements. Third, there were calls for (re)investment in a different approach to better support this population, based on outreach and flexibility. The need for improved partnership working and investment was emphasised. Whilst recognising the challenges faced by hospitals, especially within the context of funding cuts, this study highlights the need to recognise the third sector's contribution in supporting people experiencing homelessness in the community. Developing site-specific checklists for practice before discharge (and as early as possible) may help to ensure appropriate measures are in place. Improving legal literacy in the context of what an appropriate discharge is for people experiencing homelessness may help develop staff confidence to challenge the focus on ‘quick’ discharges.
KW - health services
KW - healthcare disparities
KW - homeless persons
KW - patient discharge
KW - qualitative research
KW - social welfare
UR - http://www.scopus.com/inward/record.url?scp=85132316508&partnerID=8YFLogxK
U2 - 10.1111/hsc.13887
DO - 10.1111/hsc.13887
M3 - Article
AN - SCOPUS:85132316508
SN - 0966-0410
VL - 30
SP - e4802-e4811
JO - Health and Social Care in the Community
JF - Health and Social Care in the Community
IS - 6
ER -