On behalf of the Inclusion Health Team in the Department of Health, Pathway produced a service specification for specialist homeless medical respite care, click here to view.

On 13th May The UK Department of Health announced £10 million investment fund to help kickstart medical respite provision. Click here to read Pathway’s response to the announcement.

In September 2013 Pathway was delighted to be awarded just under £500,000 by the Department to launch the UK’s first medical respite centre. We are now building our delivery team and partners. Watch this space for news of our progress with the project.

Pathway has been developing the concept of medical respite care  for homeless patients since 2010. Learning from practice in the United States, and based on detailed analysis of patients seen by Pathway’s existing hospital teams we think London’s NHS needs to establish at least four medical respite centres across the city.

With funding from the Greater London Authority, UCLH Foundation Trust and with input from St Mungo’s and a range of other partners, during 2012 we put together a detailed prospectus setting out the case for medical respite care for homeless patients in London.  We are now working with colleagues across the NHS to try to find the best way to launch this new kind of provision.  We hope that the first medical respite centre for homeless patients in London will open within the next 12 months.

What is medical respite care?

A Pathway medical respite centre will offer short term rehabilitiation and convalescent beds to homeless patients coming to the end of an emergency hospital admission, where the patient would benefit from a further period of health-led care and support.  A Pathway medical respite centre will be medically led with a focus on recovery and convalescence. Average length of stay might be around 14 days, but some patients could stay much longer.  Each centre will be built as a ‘psychologically informed environment‘, operate to standards defined by the Faculty of Homeless & Inclusion Health, and be based on Pathway’s core values – high quality professional care coupled with dignity, respect and compassion.  There are over sixty medical respite centres for homeless people in the United States.  Barbara McInnis House is a medical respite centre in Boston, Massachussetts – follow this link for more information about that service.  There is also a short video about medical respite in Boston here.

What is the need medical respite responds to?

We estimate that between fifteen and twenty five percent of homeless patients admitted to hospital as an emergency would benefit from a period of time in a medical respite centre, at the end of their hospital admission. For people leaving hospital with a home to go to the NHS relies on friends and family to care for them while they get better.  If you are homeless, while you may be fit to leave hospital this doesn’t necessarily mean you have much chance of completing your recovery on the street, or in single persons hostel accommodation.

A short medical respite convalescent period will allow homeless patients to consolidate gains from the healthcare they have received during their hospital stay and give teams working with complex tri-morbid patients more time to plan with patients what are the best move on options for them. Based on published data from the United States we think four 32 bedded medical respite centres for London would save the capital’s health service money, and improve outcomes for our patients.

We estimate that in inner London alone around 1,000 homeless patients per annum would benefit from medical respite care and that four centres for London could save the NHS between £3 and £5 million per annum in avoided costs relating to hospital admissions and readmissions.  We believe that other UK cities with significant homeless populations should also examine the case for medical respite provision.

The executive summary of Pathway’s 2012 prospectus for medical respite centres is available here.

Pathway also formed an advisory panel of current service users to conduct a feasibility study into the Medical Respite model. Click here

If you would like  to find out more about our work on medical respite care, or if you would like a copy of the detailed 42 page Pathway prospectus for medical respite care please email info@pathway.org.uk