Integrating homelessness support – developing a relational understanding

Abstract

PurposePeople experiencing homelessness often have multiple health and other support needs, requiring complex, coordinated support. Admission to hospital is potentially an opportunity to address these needs and begin integrating care, but so often it is a missed one. Our purpose in this research was to evaluate an ongoing, roll-out programme that offered government funding to 17 “test sites” across England to develop integrated care as part of post-discharge “step-down” support. In this paper, we examine senior stakeholder experiences of seeking to implement integrated care as part of specialist step-down care.Design/methodology/approachIn this paper, we focus on data collected in interviews with key stakeholders (N = 10) who managed the mobilisation of local out of hospital care models for people experiencing homelessness. Interviews were conducted and analysed from a relational perspective, that is focusing on relationships between interactants, through which, for example, identities, understanding and integrating practice emerge.FindingsA relational perspective on the data provides insights to better understand the complexity of integrating care at the point of hospital discharge for people experiencing homelessness.Research limitations/implicationsAlthough in depth, the data were limited to certain perspectives on the issues. Other perspectives and data collection from in-depth study of case sites would be invaluable in developing the empirical evidence base for a relational understanding of integrating care.Practical implicationsA relational perspective highlights the emergent and ongoing nature of integrating care in this context of support for people experiencing homelessness. The need for different system agents to work to be constantly enacting the desired support is crucial to understanding future system changes for integrating care.Originality/valueThis is the first paper developing a relational analysis of integrating care. It highlights a different theoretical perspective on the issues and important insights.