Charity calls for NHS to commission services to improve health of homeless people

Health services need to be better geared to meet the needs of homeless people, the charity Crisis has said after research it commissioned showed that people living on the streets die 30 years younger than the national average.

Homeless people should be able to register more easily with a GP and be kept in hospital until accommodation and support are set up for them in the community, says the charity for single homeless people in its report.1

A review of death records in England between 2001 and 2009 identified 1731 as being those of homeless people. Analysis of the records showed that homeless people died at an average age of 47 years; it is 77 years in the general population.

In a foreword to the report, Aidan Halligan, chairman of the faculty for homeless and inclusion health and director of education at University College London Hospitals, said that the recently enacted Health and Social Care Bill, the NHS Outcomes Framework, and the Public Health Outcomes Framework all required the NHS to reduce health inequalities and tackle premature mortality.

He wrote, “The timing for action has never been more propitious. This comprehensive study provides an urgent prompt that improving healthcare integration, access and outcomes for homeless people will be crucial to the NHS meeting its new duties.”

The data on causes of deaths showed that homeless people were failing to access health services.

Drugs and alcohol were responsible for over a third (36%) of all deaths among homeless people, whereas the figure is 1.6% in the general population. And suicide (or death where intent was undetermined) accounted for 8.5% of deaths (0.9% in the general population).

Deaths from HIV and hepatitis were nearly seven times as common among homeless people. And homeless people were more likely than the general population to die at a younger age from chronic lower respiratory diseases, heart attacks, and heart disease.

As well as improving homeless people’s access to GPs, the report calls for specialist services for people who are homeless to be protected. It also says that new services should be commissioned by the National Commissioning Board and local clinical commissioning groups. These could include services to find and treat tuberculosis and help people with a dual diagnosis of alcohol misuse and mental healthcare needs.

Leslie Morphy, chief executive of Crisis, said, “Homeless people are among the most vulnerable in our society, and it is clear that despite significant investment in the NHS they are not getting the help they need to address their health issues. The government and health services must do more to improve the health of single homeless people and ensure they can access mainstream and specialist services. If they don’t, then we fear homeless people will continue to die much younger than the general population.”