A report detailing a year-long pilot project run by Pathway and UCLH, implementing homeless medical respite services at one of the UK’s busiest homelessness teams. Pathway2Home offered patients experiencing homelessness needing time to recover after treatment a stay in a medically-supported hostel environment. The service faced a number of practical and financial challenges, but was able to provide incredibly valuable support to patients. This report explores the problems the service faced, including issues around premises, staffing, demonstrating cost effectiveness, off-site methadone prescribing, risk assessment and safety issues. The report is accompanied by a quick read summary.