London's homeless 'dying in hostels rather than hospices'

Homeless people in London who are terminally ill face the distressing process of dying in hostels rather than hospices due to a lack of community support, a study has suggested.

The report revealed hostel staff often end up caring for some of the sickest homeless people, despite not having palliative care training.

The research was published in the Palliative Medicine journal and was carried out by Marie Curie Palliative Care researchers at University College London.

It found that homeless people, who are more likely to die young from conditions often associated with mental health issues or substance abuse, are failing to get the support they need from the community.

Experts warned this resulted in “distressing” unplanned and emergency hospital admissions in the last weeks or days of their life.

Head researcher for the paper, Dr Caroline Shulman, told the Standard that one hostel provider, which was not named, has seen a 40 per cent increase in deaths in the past year.

But she added that the full number remains unknown because the NHS often does not hold medical records for people who do not have a residential address.

She said: “Unfortunately as health services do not routinely record when people are homeless it is very difficult on a local or national scale to know how many are dying without the care and support they need, although we do believe that it is a huge and growing issue."

Dr Shulman added: “Hostels provide temporary accommodation. They are not designed to meet the needs of seriously or terminally ill residents.

“Hostel staff often struggle to secure additional support from social services or palliative care services for their residents who have complex problems.”

In the report, one hostel staff member described how they had to check up on a dying resident three times per shift to monitor her health.

“It’s hard, particularly on weekends and nights when we only have two staff,” they said.

“It’s a big hostel, you really can only do so much. This isn’t an appropriate environment, but it’s the best we have.”

The report concluded that “services for homeless people with advanced ill-health are lacking”, resulting in an “emotional and practical burden” on hostel staff.

Experts called for more collaboration between health, housing and social services and increased training for those working with the homeless.

CQC inspector Professor Steve Field said: “As a GP I have seen how the lack of appropriate and sensitive services can mean that homeless people are denied the compassionate healthcare, dignity and respect that they deserve at the end of their lives.

“This research makes it clear that by working together, healthcare services and the wider system – such as housing, social services and the charity sector – have a vital role to play in improving the quality and co-ordination of care for homeless people as they reach the end of life.

“In the coming months CQC will be publishing a detailed report making recommendations on how we as a society can meet our responsibility to the most vulnerable people in our communities who are currently being let down at a time when they need help and support the most.”