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

Sue, female 33
Sue has a long standing heroin dependency with groin injecting and alcohol dependency. She was admitted with a chronic leg ulcer and a bleeding duodenal ulcer. At first she was reluctant to stay. She had a history of repeated admissions, premature self-discharge, poor engagement with support services and steadily deteriorating health.
The London Pathway team befriended her on the ward, following which she stayed long enough to see improvements in leg ulcer, stabilise on methadone and complete alcohol detoxification. During this time, she revealed a wish to return to her family in Scotland. The London Pathway team liaised with Scotscare and identified a means of funding the move home. A local drug treatment agency was identified
and the current GP prescriber in London agreed to provide a script to facilitate the handover.
Sue stayed in London for 3 days after her hospital discharge in order to collect a benefits cheque; she remained in touch by telephone. At the last minute, funding for the return home was problematic because Sue needed to travel by train in order to take her dog with her. A medical letter was emailed to Scotscare confirming that her leg ulcer required her to have the leg room afforded by train travel. After arriving in Scotland further liaison was needed between the local pharmacy and the prescribing GP over the methadone script.
Sue settled back with her supportive family and her dog. She remains drug and alcohol free and has started visiting a dentist to get her smile restored.