Healthcare for the Homeless

The London Pathway is changing it's name.  To reflect the fact that we now support homeless health teams outside London our Board of Trustees has agreed we should change our name to 'Pathway'.

Follow this link to our new web site at  

We ceased updating these pages in April 2013 and all the material from these pages has been copied across to our new web site.

Click the video to see Professor Aidan Halligan describe the development of the London Pathway.

The medical care of homeless people is a challenge for traditional health care delivery models. The relentless immediacy of the daily struggle for safe shelter and a warm meal relegates health needs to a distant priority. Common illnesses progress and injuries fester, leading to increased numbers of A&E visits and hospital admissions. Treatment plans that make sense for those with homes and family support are often unworkable for homeless people: bedrest is impossible, simple dressing changes difficult, medications hard to obtain and store, and adherence to regimens requiring multiple daily dosing is daunting. Recent work has calculated that homeless people in the UK attend A&E six time more than average, are admitted to hospital four times as often, and because their illnesses are often so severe, stay in hospital three times as long.

The London Pathway is:

  • A model of integrated, person-centred healthcare for homeless people
  • An organization to develop and champion health services for the homeless within the NHS
  • A network of support for healthcare workers engaging with homeless people

The London Pathway is a registered charity. (reg no 1138741.)   Click here to support our work and make a donation.

Winner of the the Health Serivce Journal 2012 award for Patient Centred Care.  Watch the awards ceremony here.

Andy Ludlow logoWinner of the 2010 Andy Ludlow Homelessness Award.  To watch a short film about the London Pathway and the other shortlisted projects click here.

Case Histories

John Smith is a 48 year old man who is homeless.  He collapsed in A&E in UCLH with alcohol withdrawal seizure and malnutrition, after paramedics had found him incontinent from urine and faeces in his hostel.  Upon admission, he was found to also have alcoholic fatty degeneration of liver; cerebral atrophy and symptoms of cerebellar ataxia; peripheral neuropathy due to brain and nerve damage; and scars of self-harm. 

An examination of medical records showed that since 1995 John Smith had attended A&E at UCLH 155 times, with increasing frequency; had been admitted to hospital 11 times; and spent a total of 62 days as an inpatient.  Yet, despite being on the homeless circuit for the last seven years, with periods of rough sleeping, he has never been deemed to have support needs and his contact with the health service has been sporadic.