Nathan's Secondment Story

Earlier this year I took a secondment working at the hospital as an Advocacy and Patient Discharge Coordinator as part of the Pathway Homeless team. The job wasn’t for me (sorry Greg!) but I wanted to outline the importance of that team and the work they do for the patients that are from the homeless sector.There are a lot of challenges for someone with complex support needs when they go into hospital, such as addiction issues and various physical or mental health needs. An alcohol dependent patient will need some Benzodiazepines to prevent (possibly fatal) seizures; a heroin dependent patient will need methadone prescribed whilst they are an inpatient which due to being a controlled drug can take time to arrange. Due to this, a lot of service users wait until the last minute to visit the hospital meaning that their conditions are more severe upon arrival.Referring to Pavilions within the hospital for support with this is essential and to encourage abstinence with support in the community after discharge. If pavilions aren’t available, they have the Opiate Dependency Policy to hand if needed.Most service users won’t have any money when they come to the hospital, so cannot buy some of the comforts that we all take for granted, such as a TV pass, which is at a very high cost (£20/3 days). This issue plus not having any visitors usually creates higher than average risk of early self-discharge.Quite often a patient is MFFD (medically fit for discharge) and due to the constant bed crisis the hospital is keen to discharge people so they can treat more people. It’s also stated all over the hospital that patients recover quicker in their own homes and beds. For our service users this isn’t always the case when considering the often poor living conditions in temporary accommodation, potentially problematic residents and no family or friends support. This is where the team excels in highlighting the social issues that affect the patient and sometimes the patient needs to stay in a bit longer until these issues can be addressed often with referral for support from the social work teams. The risk with discharging before these issues are addressed is that the already high risk of readmission is even higher.I will continue to work closely with the team and wish the best to Katie who has taken over from Justlife.