MK Hospital Discharge Link Project Information
Extract from successful bid for Hospital Homeless Discharge Link Project Bid to inform
candidates interested in applying for the Link Worker post.
Project Title
Milton Keynes Hospital NHS Foundation Trust - Homeless Discharge Link Project
Outline of proposal
The project has 4 key strands as follows :1. Health and Homelessness Link Worker – 3 days pw - Employed by
Connection Floating Support plus 1 day pw Team Manager capacity
Key function is to work alongside MK Hospital staff with
responsibility for the discharge of patients. The Link Worker will be
involved from admission through to discharge. The focus would be to
explore all avenues of accommodation, facilitating referrals and
meetings to ensure that homeless patients are discharged with
somewhere to go and with access to any on-going health care
requirements. Assisting the patient to access appropriate benefits and
links to other relevant services.
2. Systems and Training – Creation of a Discharge Protocol which
would include identification of accommodation status at the point of
admission through to discharge. Provide training for staff, producing
an Induction Handbook for future reference. Training would
incorporate information on local resources and the referral process to
access them. Develop a robust monitoring system that would
accurately record homeless status Capturing outcomes of how effective
the project has been in reducing readmissions and improving health.
Essential information for future commissioning.
3. Personal Budget - A fund would be used when there is delay in
accessing accommodation and benefits, purchasing Bed and Breakfast
or Rent Deposit. It is anticipated around 50% of this may be retrievable
when housing benefit is in place with some backdate. NHS would
benefit by reducing the impact on bed spaces and financial resources.
A personal budget could also assist with taxi fares to health care
appointments, food, clothing etc
4. YMCA – This bid is in partnership with YMCA who provide hostel
accommodation.. The Link Worker will liaise directly to access
planned admission where possible. Move on support will be provided
by both parties. Purchase of 2 hours pw additional Project Worker
cover and 1 hr pw Management liaison is required.
Evidence of
assessment of local
need
Data provided by the Hospital Trust indicates 29 discharges between April 2012 - March
2013 where housing status was defined as NFA.
Milton Keynes operated a Winter Night Shelter during 2011 and 2012 over a 3 month
periods:20 11 – 2012 – 93 people
20 12 – 2013 – 78 people
Of the 78 this year – 28 had physical health problems and 26 had mental health
problems. This figure includes both rough sleepers and people who had insecure
accommodation at that time.
YMCA Hostel accommodated:
– 225 people in 2011
- 236 people in 2012
- 111 people have been provided this year to date.
Connection Outreach Service – 5 referrals since March 13 - all rough sleepers of which
half had ongoing physical and mental health problems.
MK Hospital Trust confirmed that currently there is no discharge policy or protocol in
place and hospital staff have not received any training on supporting homeless clients.
Beneficiaries of
proposed services
Homeless People in Hospital - will be the primary beneficiary with the potential to
improve their housing status and their overall physical and mental wellbeing. Reducing
their length of stay and readmission risk by having a more responsive and informative
link into the community.
Hospital staff - will have increased knowledge and confidence in assisting homeless
people.
The NHS and Trust - via a reduction in hospital costs and improved health of patients.
Homeless and Housing Services – will have a more structured planned discharge
approach to their service.
Society will benefit in that Homeless People may stay well and make a positive
contribution to their social environment.
Project timescales:Link Worker in post – end September 13
Discharge Protocol – end October 13
Staff Training – end November 13
Induction Manual – end November 13
Direct Contact with patient via ward visits – Immediate
We anticipate supporting all new homeless admission patients – estimated 18 over
project life period.
Expected outcomes
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Mark Thompson
10/09/2013
Reduction in homeless people returning to the street
Access to accommodation improved
Access to ongoing health care improved
Support to maintain any existing housing that may have been lost due to
hospital admission
Patients assisted with Repatriation to their home town if this is where better
Support networks are available
Reduction in Length of Stay of hospital admissions
Reduced hospital readmission
Hospital Discharge Protocol in Place
Hospital Staff Induction and Training to working with Homeless Patients
Referral Pathways to housing and homeless support services clarified