Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps his Department is taking to ensure that patients experiencing homelessness are able to access planned medical treatment, including surgery, where a lack of stable accommodation may otherwise prevent procedures from going ahead; and whether he has assessed the impact of housing insecurity on patients being delayed or excluded from non-emergency care.

Ill health can be both a cause and consequence of homelessness; the health and wellbeing of people who experience homelessness are poorer than the general population and people who have experienced rough sleeping die decades sooner than those who have not. We recognise the importance of understanding how housing insecurity can affect health outcomes and access to care and are working to tackle these and all other health inequalities including through our 10-Year Health Plan.

No one eligible for homelessness assistance should be discharged to the street after a hospital stay, as outlined in the Government's National Plan to End Homelessness and our published guidance, Discharging people at risk of or experiencing homelessness. To help make this happen, every acute hospital has access to a multidisciplinary care transfer hub to manage the discharge of people with more complex needs. These teams work together to plan a person’s discharge, so their health and care needs as well as housing situation are all considered, and the right support is in place when they leave hospital. We are also working with councils and integrated care boards (ICBs) to improve how existing funding streams can be used to fund intermediate care services tailored for those experiencing homelessness, to improve continuity of care and access to post-discharge rehabilitation, recovery and reablement. We are working very closely with the Ministry of Housing, Communities and Local Government in this area.

Public bodies specified under the Homelessness Reduction Act 2017 including hospitals, emergency departments and social services have a duty to refer service users who they think may be homeless or threatened with homelessness to local authority homelessness/housing options teams. To build on this, the Government is committing to a new Duty to Collaborate which will strengthen and improve co-operation, early identification and information sharing between health, housing, and social care services.

NHS England recommends consideration of specialist intermediate care pathways for those at risk of or experiencing homelessness; this is set out in the guidance, Intermediate care framework for rehabilitation, reablement and recovery following hospital discharge.

The Government has not made a formal assessment of the extent to which homelessness affects access to elective and planned medical procedures. We are seeking to improve data collection in this area, however. As part of the Government’s plan, Reforming Elective Care for Patients, NHS England's plan to reform elective services, ICBs and National Health Service providers is expected to improve the completeness and accuracy of coding and recording practices, including housing status coding, through the use of relevant SNOMED codes, a standardised clinical coding system used in health records. NHS England's Statement on information on health inequalities also reiterates the expectation that ICBs, trusts and foundation trusts should consider how recording housing status can support the upstream identification of health inequalities, in line with the National Institute for Health and Care Excellence’s guideline on integrated health and care for people experiencing homelessness.