First report on the work of the Royal Perth Hospital Homeless Team (RPH HT)
In mid 2016 Homeless Healthcare established its first in-reach program in collaboration with Royal Perth Hospital. The inreach program is modelled on the internationally renowned and evidence based Pathway program that operates in 11 hospitals in the UK. The core aim of the RPH HT is to improve outcomes for homeless patients by providing support, improved discharge planning and continuity of care. GPs and nurses from Homeless Healthcare work alongside RPH Homeless Team staff. This report provides a baseline profile of the health issues affecting RPH HT patients, and the patterns of hospital use (ED presentations and inpatient admissions) for this vulnerable population group. The report also describes the unique way in which the team provides more joined-up care for people who often end up in a revolving door between homelessness and poor health. Although early days, patient case studies included in the report illustrate the impact that the Homeless Team is already having.
The Homeless Team at Royal Perth Hospital is modelled on the Pathway UK initiative, which had developed an effective model of enhanced care coordination for homeless people admitted to hospital. There are now 11 UK hospitals with Pathway teams, and Perth is the first Australian hospital to establish something similar. In a visit to Perth late 2017, Dr Nigel Hewett (OBE) from Pathway visited Perth to see the work of Homeless Healthcare in action. He shares here an observation from a ward round with the RPH Homeless Team.
See also: Tackling Health Disparities for People Who Are Homeless? Start with Social Determinants
This paper published in late 2017 describes the raft of socially determined factors that contribute to the frequent hospital attendance of people experiencing homelessness. Three case histories of homeless patients seen by the Royal Perth Hospital Homeless Team (Western Australia) are presented. The cumulative healthcare costs for the three individuals over a 33 months period were substantial, but significant also is the potential to reduce hospital use when housing and tailored support are provided.