Exploring the Impact of a Housing Support Service on Hospital Discharge: A Mixed-Methods Process Evaluation in Two UK Hospital Trusts

Author:

Holding Eleanor1ORCID,Foster Alexis1ORCID,Lumley Elizabeth1ORCID,Gilbertson Jan2ORCID,Roxby Sarah3,Portman Darren3,Holliday Judith4ORCID,Peace Arron1ORCID,Del Rosario Ismaelette5ORCID,Kahn Wajid6,Blank Lindsay1,Goyder Elizabeth1ORCID

Affiliation:

1. Sheffield Centre for Health and Related Research (ScHARR), School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Regent Court, Sheffield S1 4DA, UK

2. Centre for Regional Economic and Social Research (CRESR), Sheffield Hallam University, City Campus, Howard Street, Sheffield S1 1WB, UK

3. Wakefield District Housing, Merefield House, Whistler Drive, Castleford WF10 5HX, UK

4. Pinderfields Hospital, Mid Yorkshire NHS Foundation Trust, Aberford Road, Wakefield WF1 4DG, UK

5. Clinical Research, Mid Yorkshire NHS Foundation Trust, Unit 10 Clarke Hall Farm, Aberford Road, Wakefield WF1 4DG, UK

6. Research and Development, South West Yorkshire Partnership NHS Foundation Trust, Fieldhead Hospital, Ouchthorpe Lane, Wakefield WF1 3SP, UK

Abstract

Delayed discharge from hospital is a global healthcare problem with negative impacts on patient outcomes and the wider health system. Delays to discharge can arise when a patient remains in hospital even when they are medically fit due to nonmedical reasons such as a lack of appropriate housing or social care. However, whilst several nonmedical interventions have been developed to facilitate timely hospital discharge, there remains a lack of evidence on their impact. This study reports on findings from a mixed-methods process evaluation of a newly integrated housing and health service in two United Kingdom- (UK-) based hospitals (one mental health hospital and one general hospital). The service involved housing support coordinators (HSCs) being based within hospitals and supporting inpatients with their housing-related needs. We employed qualitative interviews with service users and hospital/housing staff (N = 16) and routine data analysis (n = 488) to understand the impact of the service and any challenges to service delivery. Service users faced different housing barriers, for example: 28.3% experienced homelessness (n = 136) whilst 80 (16.4%) faced challenges with their accommodation no longer meeting their physical needs. Service users received support for a variety of issues such as assistance with medical priority applications, support to apply for social housing, and referral to other support services. Healthcare professionals at all levels credit the service for improving hospital discharge processes and reducing stress on clinical staff, enabling them to concentrate more effectively on clinical tasks. Key to success is experienced housing staff providing patient-centred support, being integrated within a multidisciplinary team with management and oversight from the health service, and the availability of appropriate housing stock and wider services to support people after discharge. Our findings indicate that other hospitals may benefit from implementing similar housing and health integrated services.

Funder

National Institute for Health Research

Publisher

Hindawi Limited

Subject

Public Health, Environmental and Occupational Health,Health Policy,Sociology and Political Science,Social Sciences (miscellaneous)

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