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She’s gone home...

February 04 2013
A young homeless woman is discharged from hospital less than two days after nearly dying.

 

A young homeless woman was discharged from Charing Cross Hospital less than two days after nearly dying.

The teenager was admitted to Charing Cross Hospital around midnight on 29 December after taking an overdose. Christina Lawford, a volunteer shift leader at the Crisis Christmas centre that had welcomed Mary, had explained to the ambulance drivers that the young woman was vulnerable and had previously attempted suicide. She was unconscious on arrival and too unwell to be moved from A&E. The Crisis night shift team was asked to contact her next of kin.

The following day, the hospital reported that Mary was conscious but confused. However, by the early afternoon of 31 December, a psychiatrist had assessed her as not vulnerable and fit to be discharged, and when Ms Lawford arrived at the hospital, a nurse told her Mary had been sent “home”. Ben Maitland, the Head of Public Relations of Imperial College Healthcare NHS Trust, under which Charing Cross Hospital falls, said she was referred to the Robes Project in Bermondsey and given transport there.

Ms Lawford tracked Mary to the Lambeth HPU, which was due to close for the public holiday. The duty manager was concerned about Mary’s vulnerability and desperate to get her into emergency accommodation. The HPU team worked with Crisis to get Mary an emergency assessment and into accommodation.

Vicki Nash, Head of Policy and Campaigns at Mind, the mental health charity, said: "In a mental health crisis, your mind is at melting point and you need the right help and support, urgently. Recent research by Mind showed that only 14 per cent of people who had been in crisis in the last two years felt they got all the help and support they needed. Over a third said they were discharged from hospital or other services too early. This is not acceptable.

"We know that many parts of mental health services are under-resourced, under-staffed and overstretched, which is leading to poor care for many people when they need it most. We know that excellent crisis care exists, but we need it available to everyone, regardless of where they live. Good services can make a huge difference to whether someone recovers from the crisis."

We have previously reported people being discharged in pyjamas, discharged into snow and with head wounds. Research commissioned by the Department of Health (DoH) and produced last year by Homeless Link and St Mungo’s, suggested that hospitals discharge more than 70 per cent of homeless people straight back onto the streets. The UCH Pathway Homeless Team (see Pavement 60) was singled out for praise for having robust policies in place.

A DoH spokesperson said: "Through the Inclusion Health programme, we are working to tackle the poor health of people in vulnerable groups to ensure everyone gets the care they need, regardless of their needs or circumstances – this includes improving hospital discharge for the homeless.

"Last year we asked Homeless Link to look into discharge arrangements and are supporting trusts to ensure that their recommendations are implemented."

Helen Mathie, Policy Manager at Homeless Link, commented: “The homeless sector has been working to improve the health outcomes for homeless people for years, yet they still experience some of the poorest health in our communities. Last year we published a report with St Mungo’s that examined current practice around hospital admission and discharge. The findings highlighted that many areas were failing to meet homeless people’s health and housing needs. This is costly to individuals, but also to the NHS as life on the streets means they continue to be readmitted to hospital.
 
“At the time we called on all agencies to take a step to end homelessness by ensuring everyone has somewhere suitable to go when they leave hospital, with support in place for their on-going medical care. At the launch of our report Paul Burstow, Minister for Care Services, accepted our recommendations and the findings were reported directly to the National Inclusion Health Board.
 
“A key recommendation that came from our research was that no one should be discharged from hospital to insecure or inappropriate accommodation. As a result some of the working groups within the Inclusion Health programme are now looking at this. In the report we recommended how trusts could be held to account when homeless people are discharged onto the streets. We are also exploring with the Department of Health how a ‘post discharge tariff’ might be applied if homeless people are discharged with nowhere to go. We are also advising local Trusts and our member organisations on developing local discharge protocols. One example of where this work is happening is in Greater Manchester.
 
“We were extremely disappointed by the countless examples of homeless people being treated poorly and denied proper care by hospital staff that we found when carrying out our research. The Inclusion Health programme is also looking at staff development and training to help address these poor standards of care and we are continuing to advise on this work to ensure that this is addressed across England.”
 

Mary’s name has been changed to protect her privacy.

If you are feeling suicidal, please contact the Samaritans online (www.samaritans.org), by email jo@samaritans.org) or by phone (08457 90 9090).

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