A&E attendances by homeless people tripled under Conservative-led governments, investigation finds

Cuts to addictions services and problems accessing mental health and GP support must be addressed by government to 'end tragic cycle' of harm and homelessness, doctors warn

Alex Matthews-King
Health Correspondent
Monday 21 January 2019 15:35 GMT
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Cuts to addiction services under austerity policies and over difficulty accessing mental health mean homeless patients can only turn to A&E
Cuts to addiction services under austerity policies and over difficulty accessing mental health mean homeless patients can only turn to A&E

The number of homeless people attending A&E and being admitted to hospital as emergencies has tripled under Conservative-led governments, an investigation has found.

Nearly 32,000 patients who attended A&E in 2018 were recorded as having “no fixed abode”, compared to 11,305 in 2011, according to information obtained by the British Medical Association (BMA).

There has been a similar increase in homeless patients who had to be admitted to hospital from A&E, rising from 3,378 in 2011 to 9,282 in 2018.

These are often complex patients who repeatedly attend for addiction or mental health issues which would be better treated at an earlier stage and in the community.

However the BMA warns cuts to public health budgets for addiction – despite rising harms from new drugs like black mamba and spice – and pressures accessing GPs and counselling mean A&E is often the only place homeless people can turn.

The BMA estimates the cost to the NHS over the past eight years has been more than £47m.

However, only 78 of 127 trusts and foundation trusts provided figures in response to the freedom of information requests, meaning that the true extent – and costs – are likely to be far higher.

BMA mental health policy lead Dr Andrew Molodynski said the link between homelessness and mental health is “considerable” and the failure to provide adequate support means vulnerable young people and adults end up on the streets.

“The government must do more to end this tragic cycle,” he said.

“As well as addressing the current shortcomings in the provision of mental health care, there must be a wider approach that looks at prevention and the wider societal issues at play.”

The investigation, published in The Doctor magazine, found increase in homeless patients was particularly acute in some big city hospitals.

George Osborne denies his austerity caused homelessness crisis: ‘It's not a lack of money’

King’s College Hospital NHS Foundation Trust in London saw a 1,563 per cent increase, while the rise was 1,125 per cent in South Tees.

Ambulance trusts also reported a six fold increase in cases related to homeless patients, but only two out of ten trusts in England actually record this data and responded to the BMA request.

Numbers of rough sleepers rose 20 per cent in the last year alone and child homelessness is at its highest for 12 years.

BMA public health medicine committee chair Dr Peter English said the rises were a tragedy and a sign of an increasingly unequal society.

“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,” Dr English added.

A government spokesperson said: "We're committed to ensuring people have a roof over their heads and access to the right health services. We expect local authorities to work closely with CCGs to commission services for everyone — and have introduced legislation to make sure they prioritise homeless people.

“We’re investing £1.2bn to tackle all forms of homelessness and our Rough Sleeping Strategy, backed by £100m, will provide support to help people off the streets and into homes. The Long Term Plan for the NHS also committed to spending up to £30 million extra over five years to meet the health needs of rough sleepers.”

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