Cost to NHS of casualty care for homeless

Thousands of pounds of NHS money is being wasted each year treating homeless people in accident and emergency departments when it would be cheaper and more effective to send them to GPs.

Research published today by the homeless charity Shelter estimates that each inappropriate visit to a casualty department costs the NHS three times the costs of a visit to a GP. In one hospital alone, savings of pounds 60,000 could have been made.

The homeless often find it more difficult to be registered with a family doctor and the charity is calling for the system to be reformed so homeless people are not excluded.

The report compared health records of homeless and housed people who visited the casualty department at University College Hospital in London. Records of 1,873 homeless and 28,420 people with homes were analysed.

Nearly 6 out of 10 visits by the homeless to UCH were inappropriate and people would have been better served going to see a GP. This compared with figures of between 20 and 25 per cent for the general population.

Both the homeless and the housed used A&E most frequently following accidents and injuries. The main difference was the cause of these injuries - homeless people were almost four times more likely to have suffered an assault. Homeless people also had a much higher rate of infected wounds and these were twice as likely to be severe enough to warrant hospital treatment.

Mental-health problems were a substantial reason given by the homeless for attending A&E. While respiratory illness was lower than expected, asthma was twice as common among the homeless and many used the department to get prescriptions for their inhalers, one of the services which GPs are expected to provide.

t Go Home and Rest; Shelter; 88 Old Street, London EC1;pounds 10.50.