The number of visits to hospital accident and emergency departments by homeless people has more than tripled since 2011, an investigation by the leading doctor’s union has discovered.
The analysis of data by the British Medical Association (BMA) found that recorded visits to A&E by patients classed as having no fixed abode has risen from 11,305 in 2011 to almost 32,000 last year.
Homelessness has doubled since 2010 and fears are mounting that not enough is being done to help those bearing the brunt of its impact.
An estimated 597 homeless people died in 2017 – a massive 24% increase over the last five years, according to the Office for National Statistics released in December.
The union’s investigation reveals that some of society’s most vulnerable people are being failed by the system – with health and social care cuts driving the problem.
Homeless patients are presenting with increasingly complex physical and mental health conditions, which makes matters worse.
Dr Peter English, BMA public health medicine committee chair, said solving the problem should be a much bigger priority for the government than it is.
He said: “If this was some disease causing all these problems it would be a much higher priority but because victims can be blamed and stigmatised it is easy for government to ignore.
“The growing numbers of rough sleepers and vulnerably housed people in our society is a continuing tragedy. To stand by silently as our NHS faces increasing strain and our society becomes increasingly unequal would be unacceptable.”
Some of the hospital trusts with the largest increases in A&E attendances by homeless people since 2011 include Kings College Hospital NHS Foundation Trust London, which has seen a 1,563% increase, and South Tees Hospital NHS Foundation Trust, which has had a 1,125% increase.
The BMA also looked at admissions from emergency departments to hospital wards and found the figures have also rocketed – from 3,378 in 2011 to 9,282 in 2018.
The figures for attendance to A&E and hospital admissions represent a bill to the NHS of an estimated £47m over eight years, but the true cost to the health service is difficult to ascertain due to shortcomings in how homeless patients are recorded, the BMA said.
The fact many hospital trusts did not respond to request for figures also made it difficult to calculate the total costs, but a 2016 report suggested people who experience homelessness for three months or longer cost on average £4,298 to the NHS per person, plus a further £2,099 to mental health services and £11,991 in contact with the criminal justice system.
A 2015 study by homelessness charity Crisis found the cost of a rough sleeper to society for 12 months was more than £20,000 – whereas a successful intervention to get someone off the street would cost, on average, just £1,426.
The investigation also found that ambulance services have also experienced a significant increase in demand from homeless patients.
However, eight of the country’s 10 ambulance trusts could not respond to a request for figures, as most admitted they did not keep the data. The two that did respond both reported a significant rise in the number of cases related to homeless patients.
The South-Central Ambulance Service, covering Oxfordshire, Buckinghamshire, Berkshire and Hampshire, has seen the number of cases relating to homeless patients rocket from 268, in 2015, to 1,834 in 2018 while the South East Coast Ambulance Service reported an increase from 54 in 2014, to 339 in 2018.
As part of the investigation, a survey of GPs in England found that over a quarter said they had seen an increase in the number of homeless patients during the last five years, with almost a fifth reporting more of the surgeries time and resources were being used on homeless patients than five years ago.
Cuts to substance and addiction services, inaccessibility of GP services, lack of mental health provision, and the rising prominence of new psychoactive substances such as mamba or spice are all contributing to the growing crisis.
Dr Andrew Molodynski, said one of the key factors is the “considerable link” between homelessness and mental health as homelessness can be both a cause and consequence of having poor mental health.
He added: “Without a home, it becomes even more difficult for people to seek treatment for their condition, many of whom have multiple and complex needs. They are ultimately sentenced to a life on the fringes of society without ever receiving the care they need.
“Failure in access and the provision of mental health care, starting from child and adolescent services, means that all too often vulnerable young people and adults, some of whom do not have a support network, are at risk of ending up on the streets.”
Molodynski said the government must do more to end the cycle.
“As well as addressing the current shortcomings in the provision of mental health care, there must be a wider approach that looks at prevention and the wider societal issues at play.”
A government spokesperson said: “We’re committed to ensuring people have a roof over their heads and access to the right health services.
“We expect local authorities to work closely with CCGs to commission services for everyone — and have introduced legislation to make sure they prioritise homeless people.
“We’re investing £1.2bn to tackle all forms of homelessness and our Rough Sleeping Strategy, backed by £100m, will provide support to help people off the streets and into homes. The Long Term Plan for the NHS also committed to spending up to £30 million extra over five years to meet the health needs of rough sleepers.”