Intended for healthcare professionals

Feature Homeless Health

Keeping homeless patients off the streets

BMJ 2016; 352 doi: (Published 19 January 2016) Cite this as: BMJ 2016;352:i318
  1. Anne Gulland, freelance journalist, London, UK
  1. agulland{at}

What do you do when homeless patients are ready to leave hospital? Anne Gulland reports on how one consultant’s frustration led to a project helping ensure they have somewhere to recover

When Paul Wilson was discharged from hospital after surgery to repair a torn ligament hospital staff put him in a taxi and sent him home. Home was an alleyway near the Strand in central London.

“I had a bag of morphine tablets and a letter to show the police why I was carrying them, but that was it. The staff told me to go home and put my feet up. They knew I was homeless so how could I do that?” he says.

Wilson, now working as a homelessness consultant, says his story is typical of what many homeless patients experience on discharge.

“The treatment and care I got in hospital was fantastic but it was a busy hospital and they didn’t want to keep me in there any longer than they needed to,” he says.

He hears stories of doctors and nurses bending over backwards to keep homeless patients longer than necessary and mentions a homeless friend whose doctor ordered radiographs at midnight, just so he could be kept in hospital an extra night.

“You need a system in place where the hospital can make a phone call and talk to a dedicated person who knows housing law and knows the system. It’s not the doctor’s job to find a bed for a homeless patient,” he says.

This frustration at not knowing where to turn was experienced by Pippa Medcalf, a consultant physician at Gloucestershire Royal Infirmary, who became so fed up at having to discharge homeless patients on to the streets that she contacted a local homeless project, the Gloucestershire Emergency Accommodation Resource, to see …

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