This report investigates a homelessness needs assessment at the Royal London Hospital.  It reviews the number of homeless people attending the hospital and makes recommendations for how a better care co-ordination approach could be implemented.  This study was funded by Barts and the London NHS Trust and the work was made possible by a grant to Pathway from the Health Foundation. The study would not have been possible without the participation and support of staff across the hospital and in the London Borough of Tower Hamlets.