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Homeless NHS patients released to streets is ‘the system failing people’

Guardian study finds 8,758 discharges were made to no fixed abode in 2018 – but homelessness charity warn that hospitals remain “islands of good practice”

Thousands of homeless patients are being discharged right back onto the street, sparking fears that they are left to recover from major operations while rough sleeping.

The data, obtained by The Guardian, found that 89 NHS trusts in England made 8,758 discharges of patient to no fixed abode in 2018, up almost 30 per cent from the 6,748 figure in 2014.

The biggest rises were seen in London with Barts Health, Guy’s and St Thomas’ and King’s College while Greater Manchester’s Northern Care Alliance which saw a 206 per cent increase over five years.

They come in an ambulance and go back through the hospital doors perhaps to recover from something while sleeping on the street … So the likelihood and resilience from recovery can be harder. This is a sign of a system failing people.

The stats represent the number of discharges as opposed to be people and do not take into account readmissions.

Stephen Robertson, the chief executive of the Big Issue Foundation, our charitable arm, told The Guardian: “This is a sign of increasing demand and decreasing resources, and it is creating a humanitarian issue, which in the worst-case scenario is producing people living and dying on the streets of their country.

“They come in an ambulance and go back through the hospital doors perhaps to recover from something while sleeping on the street … So the likelihood and resilience from recovery can be harder. This is a sign of a system failing people.”

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Dr Nigel Hewett, the medical director of healthcare charity Pathway, added that “Hospitals don’t generally want to discharge people to the streets” and warned that many found it a struggle to avoid it. He also noted that the Homelessness Reduction Act placed a “new duty to refer homeless people in hospitals” on councils but that is yet to usher in a new age of collaboration with the NHS.

The health service responded to the figures with its updated discharge guidance and noted that “NHS staff work hard to ensure that when someone has completed treatment, any other services that they may need are in place before they are discharged”.

Next week, The Big Issue will be investigating how homeless people fall into modern slavery and how Big Issue vendors can be the “eyes and ears” on the street to help prevent it.

Mick Clarke, the chief executive of homelessness charity Passage, told The Big Issue that homeless people who are released from hospital are at risk of being targeted by slavers and traffickers.

“What needs to be improved is joining up services a little bit more, especially with hospital discharges and prisons,” he said. “There are some great hospitals out there that have protocols in place and would never dream of discharging someone on to the street and it’s the same for prisons. But a lot of the time they are a bit like islands of good practice so one of the big things is making sure that high standard is across the board.”

Read more on modern slavery in next week’s Big Issue magazine, available from vendors and The Big Issue Shop next week.

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