Legal advice does not only help individuals overcome problems, but also benefits society and the state. A Law Centre project that decisively proves this argument has just shared more evidence of this impact, in this case helping local authorities and the NHS.
Southwark Law Centre has published the year 2 evaluation [available for download below] of its Homeless Patients Legal Advocacy Service (HPLAS), which it runs in collaboration with Guy's and St Thomas' NHS Foundation Trust in south London.
The problem that the Law Centre and the hospital tried to solve is very common. Hospitals have a duty of care to their patients, so they are unable to discharge them if their housing or care arrangements are insufficient. This creates ‘bed blocking’, taking up valuable NHS resources. When patients are discharged but their home arrangements are inadequate, their health worsens and they end up being re-admitted to hospital. Avoiding this would benefit both patients and the NHS.
The partnership launched in January 2020 with the aim of helping homeless people to leave hospital as safely as possible. Patients who would not otherwise have been able to do so were able to access quality-assured legal advice from a single provider to address all their social welfare legal needs, such as entitlements to housing, benefits and social care.
The project has shown that when the legal problems of homeless patients are resolved, they have enough support to stay out of hospital, access accommodation so they do not have to return to rough sleeping, and take care of themselves.
In 2021, the Homeless Patients Legal Advocacy Service won a London Homelessness Award, was identified as a good practice case study by the Mayor of London and featured in City Hall’s Health Inequalities Strategy Implementation Plan.
In its second year, the service reduced the use of high-cost hospital resources, helped patients to obtain better health and housing outcomes and freed up capacity for the hospital’s homeless patients team to help more people:
- Before being referred to the service, 1 in 3 patients were sleeping rough, staying in at a night shelter or staying at a B&B. By the time they were discharged from hospital, only 1 in 7 patients were staying a night shelter or B&B, and none were discharged to sleep rough.
- Each ‘bed day’ (one person spending one night in hospital) is estimated to cost the NHS £500 on average. The service reduced the number of bed days among the patients it helped to a fifth of what they had been, a dramatic 81% reduction.
The project has shown the importance of health and legal partnerships in overcoming homeless by offering a holistic service. Southwark Law Centre is currently holding discussions with Lewisham University Hospital to set up a similar service there in 2022.
Ruth Mercer, the project’s lead solicitor at Southwark Law Centre, said:
“Working with hospital homeless teams helps us identify the most vulnerable clients who would not otherwise be able to access legal support, and enables access to detailed medical evidence to support immigration and housing applications.
“Patients who take part in the scheme show a significant and ongoing drop in inpatient admissions and A&E attendances, and are more likely to attend hospital outpatient appointments and seek help from other health professionals including GPs, addiction and mental health services.”
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