24 May 2024

The Homelessness Partnership BCP has named University Hospitals Dorset (UHD) Homeless Care Team (HCT) as its Hero of the Month for May 2024 due to its partnership approach to homelessness prevention.

Led by Hazel Allen, Consultant Nurse for Hepatology, and Pippa Atherton, Advanced Clinical Nurse Specialist, the dedicated team at Bournemouth and Poole Hospitals provide care for people experiencing homelessness and at risk of homelessness.

The HCT, which comprises three nurses and two care co-ordinators, works closely with BCP Council’s housing department, helping patients who are either experiencing homelessness or are at risk of losing their home, to recover from illness and trauma before moving into safe accommodation. In a victory for the HCT, funding recently secured means that all roles within the team, three of which were previously temporary, have been made permanent, securing a sustainable service for the future.

The need for a dedicated HCT in the BCP area is underpinned by national statistics. Across the UK, the NHS spends £2.5billion a year treating people experiencing homelessness. Those without a safe place to call home are at increased risk of physical and mental health issues – and dying from treatable conditions.

A new integrated care service is born

The concept of a HCT was piloted in Brighton in 2012 by Pathway, a homelessness and inclusion health charity. The six-month trial, funded by the Department for Health, delivered a significant reduction in admissions to A&E, developing an integrated care system for people experiencing homelessness, and in particular rough sleeping, in the city.

Consultant Nurse Hazel Allen explains how a similar service took root in the BCP area: “We started this journey five years ago, with support of Pathway and passionate local GP Dr Maggie Kirk, carrying out a needs assessment to identify costs and issues associated with people experiencing homelessness coming into Bournemouth hospital.

“Since then, with support from DOH funding, we have been able to grow the service, initially operated at Bournemouth Hospital, now present at Poole and together as a wider team, with excellent consultant and managerial backing, having built a successful business case for permanent funding. We are delighted that the Integrated Care Board and the hospital Trust have accepted the case and are investing in this as a future service, which is a big win for everybody. This is a perfect model for integrated care – it’s about that person’s journey not stopping at the hospital door.”

Overcoming stigma and inequality

The HCT commonly care for people who are in need of medical assistance as a result of infection, injury and substance misuse, as well as mental health issues and the deterioration of chronic conditions that haven’t been managed due to their homelessness.

Hazel Allen says: “People experiencing homelessness can also experience health inequality, because many find it difficult to engage with a traditional healthcare offer and significant obstacles have to be overcome before HCT colleagues can gain the trust of patients who are without a home.

“The HCT can facilitate therapeutic relationships so patients benefit from the care and treatment they receive while in hospital. Having a dedicated HCT means that we can overcome fear and lack of trust while engaging patients with partner services, including housing services, for the duration of their admission. Patients start to see familiar faces and begin to feel that we’re on their side, helping them to recover and supporting with their homelessness situation.”

Homelessness prevention in partnership

The HCT works closely with BCP Council’s Hospital Housing Advice Team (HHAT) which regularly meets with HCT colleagues at Bournemouth and Poole hospitals. HHAT Co-Ordinator and Senior Housing Options Officer at BCP Council, Stephanie Barker, says: “We have two housing options officers who conduct assessments with customers. Sometimes we are able to place people in emergency accommodation as well as looking at longer-term options such as supported accommodation, for example.”

BCP housing also has six self-contained ‘step-down flats’, designed for people leaving hospital and equipped to cater for customers with mobility issues. The team has a wealth of contacts and experience, providing intensive support to help with move-ons, and assisting customers to get on the housing register, look for private rented accommodation, providing help to apply for benefits or supporting with referrals to other services. People with substance misuse issues can be referred providers of specialist support, such as We Are With You.

Stephanie adds: “We arrange and facilitate hospital discharges – our great relationship with the HCT sees us working together to ensure best outcomes for people. Customers are allocated a Support and Inclusion Officer who goes out and visits them in emergency accommodation and can liaise with other agencies. We make sure people receive the support they need, whether to address issues or receive assistance to maintain their housing.”

The HCT has a proven track record of managing people’s journey from hospital into accommodation, reducing the number of frequent re-admissions. Hazel Allen sums-up: “Now, people come into hospital, receive the care they need and we will hopefully get them placed into accommodation. We engage with people so they’re in a better position and liaise with community services to carry on that care.”