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 www.pathway.org.uk.  

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

Dave, male 54
Admitted for surgical drainage of infected leg and hand, Dave was an alcohol dependent intravenous drug user on methadone, who had poor engagement with community services, and no local GP. He required repeated surgical drainage over several days. He had difficulty with pain control due to high opiate tolerance, and this caused friction with ward staff.
The London Pathway ward team befriended him and provided liaison with ward staff, pain team and drug treatment team to ensure adequate pain relief. An hostel key worker was invited into hospital to discuss a possible rehabilitation placement on discharge. Dave was supported with his benefits claim.
He became abstinent from drugs and alcohol on ward, but finally decided against rehab placement. Negotiation with the community drug team and GP ensured that he had methadone and stable opiate analgesia prescribed on discharge for daily collection to minimise risk. He stayed out of hospital for a year after discharge.