(from l to r) UCLH clinical lead of the homeless team, Dr Nigel Hewett, Health minister Paul Burstow and UCLH chief executive Sir Robert Naylor
Homeless patients who visit University College Hospital are treated by a dedicated team and receive advice and guidance from a specialist care navigator – who used to live on the streets herself.
Paul Burstow, care services minister, learnt more about the service, now in its third year, during a visit to UCH today (May 28). On the same day charities Homeless Link and St Mungo released a report ‘Improving Hospital Admission and Discharge for People who are Homeless’ which revealed that 70% of homeless people are being discharged from hospital back onto the streets, damaging their health and costing the NHS money.
The service at UCH, known as London Pathway, is tailored around the needs of homeless patient and works closely with other services in the community. It has reduced total bed days relating to homeless people’s admissions by one third, and made cost savings of £100,000.
The service, set up with funding from UCLH Charity, includes:
- GP led ward round for all homeless patients, supported by a Pathway homeless health nurse practitioner, to co-ordinate all aspects of care and make plans with the patient for discharge
- joint working between medical staff and other agencies involved with the patient to plan for life after hospital
- support from befriending and mentoring Pathway Care Navigators, whose personal experience of homelessness makes them well placed to support, challenge and mentor homeless patients in the hospital
Josephine Mavromatis, UCLH’s care navigator says she now ‘thanks God every day for her life’ after years of being homeless.
Josephine slept rough for over 20 years after starting to drink at around the age of 16. She had some ‘terrible experiences’ during this period of her life and was a regular visitor to A&E throughout her 20s and 30s.
Florence Cumberbatch, specialist nurse for homeless patients and Josephine Mavromatis, care navigator
After suffering from fluid on the lungs she had to have part of her lung removed and was soon after diagnosed with TB. She became close friends with a community nurse who she describes as her ‘angel in disguise who came to free me’.
After recovering from TB, Josephine began to volunteer for the UCLH Find and Treat service – a mobile unit which gives homeless people the opportunity to be screened for TB. She began attending AA meetings and volunteered at her local branch of Mind, the mental health charity. She went on to relearn maths and English and did counselling, psychology and creative writing courses.
She said: “I was then introduced to London Pathway at UCH where I volunteered for a year and was taken on full time in March this year. It involves meeting homeless patients and actually being there for them, I think because of my past most of the patients I see have been in similar situations to me and so I can relate to them and them to me, more than a regular nurse or doctor. I am in a team of four and love working there. I am helping to train up another care navigator. Things are on the up and up for me and my life is miles apart from where I was all those years ago. I just thank God for my life every day now.”
Alex Bax, chief executive of Pathway said: “Our team at UCH was delighted to show the Minister our work with homeless people in the hospital. We told him about how we have helped staff overcome some of the huge barriers associated with caring for homeless patients and supported these patients in battling the multiple bureaucracies that surround their lives.
“We are working with a number of other hospitals to share our learning. With the right teams in place they can change an emergency hospital admission from just another crisis in a homeless person’s life, to an opportunity for change.”