H4 Hospital is run through 2 key advocates; a Homeless Housing Advocate and a Homeless Health Advocate. Advocates provide rapid response services within hospital to complete housing assessments, work with ward staff and manage discharge into safe accommodation. The Health Advocate works on a 1-1 basis with service users to enable sustainable self-management, facilitate access to suitable primary and local care, and support them into wellbeing activities.
The service works on a referral basis and training on when and how to refer can be provided in clinical and community settings.
See our animation video below which explains how this service was developed and now runs. A transcript for this video is available here.
- Rapid response to referrals of homeless patients in hospital to support discharge plan and further housing and health support needs. The focus is on early referral and far more cases are being flagged at point of admission that at point of discharge.
- Complex care planning and discharge liaison – this now takes place from within the Integrated Discharge Hub at Stepping Hill Hospital.
- Support and advice to clinicians and care co-ordinators regarding housing options; instead of continuing formal training the Hospital Advocate continues to build positive relationships with relevant staff and provide information and advice where specifically needed. Hospital Advocate also attends Integrated Discharge Hub team meetings to brief and support.
- Support and advice to housing workers (Housing Options Team and Temporary Accommodation Project Workers) to better support client health and manage transitions with hospital and other treatment. This happens both informally and through formal training afternoons within Temporary Accommodation.
- Focus on GP sign up and gaining permanent registration for all clients.
- Advocacy for clients across local housing organisations, including but not limited to Stockport Homes – H4 Hospital has successfully trialled supporting a client into the Private Rented Sector with a deposit and grant.
- Mediation and reconnection.
Health Management Actions;
- Intensive support around health management – this has developed especially to provide informed advocacy through complex assessments and pathways for mental health and substance misuse diagnosis and treatment.
- Intensive support for clients with complex needs to attend appointments and adhere to treatment advice in community/home setting.
- Provision for basic needs such as food and cleaning items. Transport has been a key enabler and we have come to recognise it as a necessity for clients to access support and care in all forms.
- Health management drop ins at temporary accommodation – this has developed in partnership with CGL (Change, Grow, Live) who deliver substance misuse support drop ins at each scheme monthly, either side of the Health Advocate surgeries.
- Wide range of positive engagement, training and skills development opportunities for all clients, leading to personal development and encouraging engagement in health support.
- September 2017 H3 Forum event focused on Health and Wellbeing and was a key opportunity for all clients to put forward ideas on how to improve their health, what support they need and what they are currently getting. This was held in partnership with CGL and 28 clients attended.