By Samantha Fairbanks, Learning and Evaluation, VOICES

Special thanks to Lee Dale, Expert Citizens

VOICES and Expert Citizens recently attended and helped to facilitate the ‘patient experience’ section of the monthly NHS board meeting. Each month a previous patient is invited to the meeting to give their honest experience of accessing NHS services, and this time around that came in the form of Expert Citizen Lee sharing his experience of accessing A&E during the period that he was experiencing homelessness.

Lee was asked to hold nothing back and be completely honest about his feelings around this, explaining how when he was homeless he tried to take him own life and that’s how he ended up in the A&E department. Lee felt that because his injuries were self-inflicted he was “shoved into a corner and forgotten about with nothing but a paper hat to be sick in”. He was then told at 11pm that he couldn’t leave until he signed a form saying he would attend a psychiatric appointment in Hanley the following morning at 9am. Lee signed this and left but did not attend the meeting the following morning.

The board asked Lee if the staff knew he was homeless at the time. Lee’s response was that they didn’t as they asked him if the address on their system was his (the address they had was an old one) and Lee agreed that it was, even though it wasn’t, just to get out of the room.

The A&E staff that had heard Lee’s story at a previous event (see article: Small change to systems change) were also at this meeting. They explained that they investigated Lee’s case and found that the old address that he was asked to verify was in a different city all together (a homeless hostel in Walsall) and this was not flagged when they discharged him at 11pm, with the added expectation of attending an appointment in Hanley at 9am the next morning.  Details were also given to the group of the actions and changes that have been implemented since hearing Lee’s story:

• A&E now have psychiatry treatment available in the hospital before the patient leaves, meaning more patients are having this interaction and getting the help they need.
• A flag/notification has been added to their electronic systems to show the staff if people have experienced homelessness in the past.
• Staff are being encouraged and supported to change the way they question patients to find out where they live, or if patients are currently experiencing homelessness, to establish in every case whether a person has an address to be discharged to, and to take appropriate measures when this is not the case.

Thanks to this meeting the A&E staff now have the contacts they need from the board members to further what they want to achieve, and the board members are aware of the problems people experiencing homelessness face in A&E and are aware of the significant changes and progress already made.

This is a fine example of what can be achieved when we listen to the experiences of the people that are affected by systems and services to provide the most effective care possible and keep people safe. Lee and everyone here at VOICES and Expert Citizens applaud this way of working and look forward to working alongside the NHS on future endeavors.