Warning of major rise in number of homeless people visiting A&E

Recorded visits to hospital A&E departments by patients classed as having no fixed abode has risen from 11,305 in 2011 to almost 32,000 last year, said the British Medical Association.

It added that, to make matters worse, homeless patients were presenting with increasingly complex physical and mental health conditions.

According to the BMA figures, some of the hospital trusts with the largest increases in A&E attendances by homeless people since 2011 include:

  • King’s College Hospital NHS Foundation Trust London – 1,563% increase
  • South Tees Hospital NHS Foundation Trust – 1,125% increase
  • Royal Devon and Exeter NHS Foundation Trust – 847% increase
  • Stockport NHS Foundation Trust – 310% increase

Admissions from emergency departments to hospital wards have also “rocketed”, it said, from 3,378 in 2011 to 9,282 in 2018.

The figures for attendance to A&E and hospital admissions represent a bill to the NHS of an estimated £47m over eight years, according to the union.

But the “true cost” to the NHS is “hidden due to shortcomings” in the mechanisms for recording homeless patients, it said. The BMA noted many trusts did not respond to its request for figures.

“The growing numbers of rough sleepers and vulnerably housed people in our society is a continuing tragedy”

Peter English

Ambulance services have also experienced a significant rise in demand from homeless patients. Only two of the 10 ambulance trusts responded to a request for figures as most did not keep the data.

Of the two that did respond, both reported a significant rise in the number of cases related to homeless patients. South Central Ambulance Service has seen cases rise from 268 to 1,834, from 2015 to 2018, while South East Coast Ambulance Service reported an increase from 54 to 339 since 2014.

As part of the investigation, a survey of GPs in England found that over a quarter said they had seen an increase in the number of homeless patients during the last five years.

Almost a fifth reported that their surgery was having to devote greater time and resources to homeless patients than they did five years ago.

BMA public health medicine committee chair, Dr Peter English, said: “If this was some disease causing all these problems it would be a much higher priority but because victims can be blamed and stigmatised it is easy for government to ignore.

“The growing numbers of rough sleepers and vulnerably housed people in our society is a continuing tragedy,” he said.

“Sadly, homelessness can be both a cause and consequence of having poor mental health”

Andrew Molodynski

As well as the evident physical toll, the BMA investigation explored the link between homelessness and mental health.

It found cuts to substance and addiction services, lack of mental health provision, inaccessibility of GP services, and the rising prominence of new psychoactive substances, such as mamba or spice, were all contributing to the growing crisis.

BMA mental health policy lead Dr Andrew Molodynski said: “There is a considerable link between homelessness and mental health as sadly, homelessness can be both a cause and consequence of having poor mental health.

“Without a home, it becomes even more difficult for people to seek treatment for their condition, many of whom have multiple and complex needs,” he said. “They are ultimately sentenced to a life on the fringes of society without ever receiving the care they need.

“Failure in access and the provision of mental health care, starting from child and adolescent services, means that all too often vulnerable young people and adults, some of whom do not have a support network, are at risk of ending up on the streets,” said Dr Molodynski.

He added: “Society is failing to protect far too many vulnerable individuals and that must change.”