Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what estimate his Department has made of the (a) number of people experiencing homelessness discharged from hospital to the street and (b) the readmission rates of people discharged from hospital to the street.

There is currently no available data to identify the number of patients experiencing homelessness who are discharged to the street or equivalent, or to accurately measure readmission rates. We can make an assessment of the number of admissions where a patient has been recorded as being homeless at the point of admission through the Hospital Episode Statistics (HES). The following table shows the count of Finished Admission Episodes (FAEs) where the patient was recorded as being homeless at the point of admission, for the period of 2019/20 to 2023/24, in English National Health Service Hospitals and in English NHS commissioned activity in the independent sector:

Notes:

1. an FAE is the first period of admitted patient care under one consultant within one healthcare provider, and is counted against the year or month in which the admission episode finishes, however they do not represent the number of patients, as a person may have more than one admission within the period;
2. homeless can be defined in HES when RESGOR_ONS are 'U', where U means no fixed abode, or DIAG_4_CONCAT like 'Z590;
3. regarding the number of episodes in which the patient had a relevant primary or secondary diagnosis code that was recorded in any of the 20, or 14 from 2002/03 to 2006/07, and seven prior to 2002/03, primary and secondary diagnosis fields in a HES record, note that each episode is only counted once, even if the diagnosis is recorded in more than one diagnosis field of the record;
4. for ICD-10 coding, Z590 means homelessness, a non-billable, non-specific code for problems related to housing and economic circumstances;
5. the regional geography of the Government Office Region’s (GOR) area of residence of the patient, derived in HES from the patient's postcode, and despite GOR having closed on 31 March 2011, is maintained for statistical purposes, and following its closure is referred to simply as regions;
6. Z590 means homelessness, a non-billable, non-specific code for problems related to housing and economic circumstances;
7. a diagnosis of homelessness is at the discretion of the clinician responsible for care of the patient, based on whether or not they deem it to be relevant to the primary diagnosis for which the patient is being admitted, and some patients may prefer not to disclose that they are homeless when presenting at the hospital, and the information may not therefore be captured, and therefore the data presented here may undercount the total number of occasions when homeless people were admitted to hospital;
8. we have counted records where the patient was recorded as homeless at the point of admission, rather than at the point of discharge, because, while there is a Discharge Destination field in HES used to identify where patients go after leaving hospital, this does not include any value that identifies those patients who are discharged to the street, hence it is not possible to answer the first part of the question exactly as it is worded;
9. changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage, improvements in coverage of independent sector activity and changes in NHS practice, for instance apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data, and apparent increases in activity may be due to improved recording of diagnosis or procedure information; and
10. HES includes activity ending in the year in question and run from April to March, for instance 2012/13 includes activity ending between 1 April 2012 and 31 March 2013.