A Day in the Life of The King’s Health Partners Pathway
The King’s Health Partners Pathway Homelessness Team at South London and Maudsley NHS Foundation Trust is a specialist inter-professional team, working with inpatients in mental health wards who are homeless or at risk of homelessness. They have been highly commended in the London Homelessness Awards 2019. We asked Dr. Zana Khan, GP Clinical Lead of the team, to tell us what an average day in their work was like.
It’s Wednesday 9th October, the day before World Homeless Day. In our Pathway Homelessness teams, whatever the day, we continue to work to end homelessness, improve health and wider outcomes for patients admitted to hospital.
The King’s Health Partner’s Pathway Homelessness team at the South London and Maudsley (SLaM) is one of three Pathway Homelessness Teams in South London, with sister teams located at Guy’s and St. Thomas’ and King’s College Hospital. There are 10 teams in the UK, one in Australia and more teams launching in 2019/20. We are the only Pathway team in a Mental Health Hospital.
I start early, around 8 am. I’m usually reviewing health records and emails, but today I’m finishing the latest draft of our Trust policy on implementation of Duty to Refer. The rest of the team arrive, John and Eamonn, our Advanced Mental Health Practitioners (both Occupational Therapists by background) and Cherelle, our Specialist Housing Worker. We start the day with a multidisciplinary case meeting. We review every patient on our caseload, discussing their history, the challenges they’re experiencing, outstanding actions or assessments and next steps. We review the case notes of new referrals and today we also discuss our response to the Homelessness Reduction Act consultation – that’s due next week.
Today we have several new patients and two without recourse to public funds. While Eamonn heads off to a ward round, John contacts Southwark Law Centre, a partner organisation who provide legal advice and support for our patients. We arrange to assess the new patients and gather our things to travel to the Maudsley. Although our team is based at Lambeth Hospital, we also take referrals from wards at the Maudsley and give advice to staff working in the community, and at SLaM’s other hospital sites in Lewisham and Croydon.
At the Maudsley, I run into our previous Clinical Director, Dr. Ranga Rao. It’s thanks to Ranga and Dr. Nigel Hewett from Pathway that the team was granted generous pilot funding from the Guy’s and St. Thomas’ and Maudsley Charities. The funding included a research evaluation, and as a result of everyone’s hard work, we now have recurring NHS Funding. Cherelle heads off to attend ward rounds, but before John and I can assess the new patients, we are meeting Dr. Nicola Byrne in her Information Officer and Quality Improvement roles with the SLaM Connect Team. They are improving IT systems to make it easier to complete initial assessments, referrals and complete handovers. We see their new physical and mental health digital templates which will incorporate a homelessness checklist and referral for Duty to Refer. Nicola tells us that the referrals to our team and Local Authorities can be automated, and we’ll be able to capture data on the number of referrals made. There’s still some work to do, but we believe that this innovation will be a national first.
John and I assess a new patient who has been admitted with a first episode of Psychosis. He was previously renting accommodation and had a job that he wants to return to. He has responded well to treatment but doesn’t have a local connection to the borough he wants to live in. I head off to start my afternoon surgery at Great Chapel Street Homeless Practice but have a call from John in the afternoon asking me to write a medical letter of support. The patient is keen to find his own private rental accommodation but lacks funds for the deposit. John feels a medical letter will help him advocate for the patient at the local authority in the morning. Meanwhile he’s linked him with a community mental health team and GP.
As I write the letter of support I’m reminded, again, that working in the NHS is a vocation, not a job. It is about justice and equity and helping people at a point when they are most vulnerable. An attendance to healthcare is an opportunity to address a range of issues, if we think about that early enough. Thinking in this way allows us to tap into a deep empathy to achieve the best outcomes with and for patients. Of course, this isn’t always easy in systems that feel they are about eligibility, efficiency and cost effectiveness. That means that we need to stand alongside patients, push back on systems and advocate for the holistic care our patients deserve.
The London Homelessness Awards ceremony, where the King’s Health Partners Pathway Homelessness Team at SLaM team will receive their commendation, is on Thursday 17th October at City Hall. For more information go to www.lhawards.org.uk