What is the extent of inappropriate Accident and Emergency visits by homeless people, and what services are being provided in and around Liverpool to reduce the problem?

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What is the extent of inappropriate Accident and Emergency visits by homeless people, and what services are being provided in and around Liverpool to reduce the problem?

Background

Providing equitable healthcare supply to the homeless population is no easy task, and yet the extent of the problem is not accurately known due to there being no standardised measurement system. Yet medical practitioners have a duty of care to all members of the population who require healthcare.

Aims

This study looked at the causes and effects of homelessness on people who find themselves with no fixed abode and with possible addictions to illicit substances. It also looked at a series of studies to assess the extent of unnecessary Accident and Emergency admissions by the homeless for complaints which should have ideally been addressed by a General Practitioner – saving the NHS valuable resources. The study also looked at what is being done to reduce this problem.

Method

Medical databases were searched for articles related to the use of Accident and Emergency departments by homeless people, and the extent to which these visits were inappropriate. Local services aimed at the homeless in and around Liverpool were also visited to look at what is being done to ensure the homeless have access to primary healthcare via the appropriate channels i.e. through drop-in centres and General Practitioners.

Results

Results showed that in a small number of cases (around 10%), homeless people were likely to visit the Accident and Emergency department for reasons other than trauma or urgency such as sustenance problems or fears over their safety. Homeless people have also been known to enter A&E under the influence of alcohol, again causing problems for staff and wasting valuable resources. Services such as General Practice with Special Interest were also found, as well as drug rehabilitation teams and support workers who encouraged patients to register with the local GP.

Conclusion

Homelessness is a complex problem with a range of causes and implications. Patients need to be encouraged to engage with the correct services to address their problems from the ground up, as opposed to relying on acute medical care from the Accident and Emergency department whose resources are already overstretched by the public in general.

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