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Homelessness and the NHS

January 2016 marks the beginning of a new and innovative partnership between the Housing Team at Hodge Jones & Allen and the Pathway homeless healthcare team based at University College Hospital.

Pathway is a unique charity which helps the NHS improve care for homeless patients, from the moment they arrive in hospital through to the securing of suitable safe accommodation upon their discharge. Since 2014 HJA has provided pro bono legal advice to the Pathway Team at UCH through our attendance at their weekly multi-disciplinary team meetings.

It is certainly unsurprising, but homelessness and bad health often go hand in hand. In a study published in 2014 by the Homeless Link, it was found that 73% of homeless people reported some form of physical health problem with 41% of those being long term physical health issues. In addition to this, 80% of homeless persons reported some form of mental health issue, with 45% being diagnosed with one by a medical professional. It is therefore foreseeable that 35% of homeless persons had been to A&E in the last 6 months and 26% had been admitted to hospital in the same time frame. It varies from person to person whether these health problems have been caused and exacerbated by being made street homeless, or whether they were a factor in rendering such persons homeless; but without a doubt even in a post Hotak world, the most vulnerable in society continue to have a real fight to secure accommodation. We’re hoping this new Pathway-HJA partnership will be a fruitful means to protect the housing rights of these patients upon discharge from hospital.

The Homeless Link report uncovers the barriers many individuals face when it comes to getting treatment, as well as the pressure homeless patients place on the resources of NHS services. The report paints a picture of reluctance from local authorities to accommodate individuals with severe health issues (whatever the cause) – the very persons whom the homelessness legislation is designed to assist and protect.

In the report, it is stated “the data shows that rough sleepers and those living in squats, as well as those who were sofa surfing, were more vulnerable to drug and alcohol problems compared to homeless people living in temporary accommodation. This reinforces the important role accommodation and support can play in providing a stable base from which somebody can engage in treatment or receive help to address health needs.” Despite this, local authorities continue to argue that because such homeless applications allegedly have access to the same level of support, even if street homeless, they are not more vulnerable than an ordinary person when made homeless. Perhaps it is yet further clarification from the courts on the definition of vulnerability that is needed, or perhaps local authorities need to drop the disguised Pereira act and apply to correct and updated Hotak test.

It is still shocking that more than a third of homeless people who are admitted to hospital state that, upon discharge from treatment, they find themselves straight back onto the streets, with nowhere to go – and then sooner or later will be back in hospital having fallen ill again; and so the cycle continues. It is this cycle which the charity Pathway is seeking to break. They are unique in providing a holistic treatment to homeless patients, committed to the long-term welfare of their patients after discharge. By our Housing Team providing in-depth legal advice to the Pathway Team, we look forward to ensuring that the housing rights of some of the most vulnerable people in London are upheld when they face life after their hospital treatment.