A Pathway team transforms the quality of healthcare received by homeless people admitted to an acute hospital. The team works across  the hospital, visiting all homeless patients, and working with ward staff and other clinicians to care for them.  The Pathway team provides expert support and advice to clinical colleagues on how to treat patients with multiple morbidities (especially alcohol and drugs issues, and mental health problems), and engages with the patients directly, helping them participate more fully in decision making about their care, and bringing focused but sensitive attention to planning for their discharge and after. The BMJ published an evaluation of the UCLH Pathway hospital team in September 2012.

 Pathway acute care needs assessment

Before establishing a  Pathway service in a hospital we recommend that a Needs Assessment exercise takes place.  A Pathway needs assessment consists of a structured review of patient data about homeless people, to understand the numbers and types of homeless patients being admitted and start to identify where particular problems or issues arise with their care.  Alongside the review of data, the Pathway team work with local medical staff, hospital management, primary care and statutory and voluntary sector community based services to map the relevant services around the hospital.  A needs assessment exercise concludes with a detailed local plan, setting out how a tailored local  Pathway service could best be established and including a practical implementation plan.

Pathway service development

Following a needs assessment, Pathway staff will work with local staff to recruit, train and launch a local Pathway service. There are now 8 teams across the UK.  Teams range in size from a 20 person team in south London spanning 3 trusts and 5 sites, to our newest 4 person team in Bristol. Each team has been adapted to serve the needs of the area, bringing together all the local health, homelessness and support services to work together to support vulnerable patients.

If you would like more information about setting up a Pathway service in your hospital, or hear about work in your area please contact us.