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Health

Evaluation of the Out-of-Hospital Care Models programme for people experiencing homelessness

About the study

The Joint Principal Investigators of this project are Michelle Cornes (NIHR Policy Research Unit in Health and Social Care Workforce at King's) and Michela Tinelli (LSE).

In the photo above: members of the research team at the first project meeting, 21 October 2021, at the Virginia Woolf Building, King's College London. From left: Michela Tinelli, Jo Coombes, Michelle Cornes, Lizzie Biswell, Stan Burridge.

Aims

  1. The overall aim of the evaluation is to capture the learning from test sites from the OOHCM programme and to evidence the outcomes that are being achieved.
  2. Provide an understanding of the most effective way of implementing(scaling) out-of-hospital care across a wider range of areas – including how to shift to this position and the conditions needed to maximise the effectiveness and sustainability of the services.
  3. Describe how models are being integrated into the evolving health, housing and social care system, supporting D2A (the new NHS hospital discharge operating model), the NHS Long-Term Plan and Covid Care/recovery.
  4. Identify the challenges that remain to systems and service delivery that require changes outside the direct control of organisations in the locality.
  5. Further test the key components of effective and cost-effective models especially where they have not previously been brought together into a single system.

Background

Research suggests that out-of-hospital care is effective and cost effective in supporting safe, timely transfers of care for patients who are homeless (Cornes et al., 2019 & 2021). At present, access to out-of-hospital care is limited or non-existent for people experiencing homelessness. In 2020, the Department of Health and Social Care, Ministry of Housing, Communities & Local Government and Ministry of Justice allocated £16 million through the shared outcomes fund to “roll-out” and robustly evaluate the Out-of-Hospital Care Model (OOHCM) for people who are homeless. In the same year, a new hospital discharge operating model Discharge to Assess (D2A) was implemented across England to meet the demands of the pandemic and increase in hospitalisations. A key objective of the OOHCM programme is aimed at exploring how support for homeless patients can be integrated as part of the new D2A operating model.

Methods

A mixed methods approach comprising four work packages:

  • WP1: Basic Audit
  • WP2: Study of Positive Practice
  • WP3: Full Economic Evaluation
  • WP4: Discrete Choice Experiment User Preference

People with lived experience will be actively involved in all aspects of the evaluation as specialist advisors and peer researchers.

Funding

Department of Health and Social Care

Timescale

September 2021 – September 2023

Further reading

Shevon Simon writes on the Unit blog about her role as Homeless Health Team Leader at Princess Royal University Hospital in South East London.

See also our earlier project

Effectiveness and cost-effectiveness of 'Usual Care' versus 'Specialist Integrated Care': A comparative study of hospital discharge arrangements for homeless people in England (2015-2019)

Partners

LSE

London School of Economics

Project status: Ongoing

Principal investigators

Michelle Cornes

Visiting Professor

Keywords

  • homelessness

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