Evaluation of the Out-of-Hospital Care Models Programme for People Experiencing Homelessness
About the study:
The Joint Principal Investigators of this project are Michelle Cornes (NIHR Policy Research Unit in Health
and Social Care Workforce at King’s) and Michela Tinelli (LSE).
Aims:
- The overall aim of the evaluation is to capture the learning from test sites from the OOHCM programme
and to evidence the outcomes that are being achieved. - Provide an understanding of the most effective way of implementing(scaling) out-of-hospital care across
a wider range of areas – including how to shift to this position and the conditions needed to maximise the
effectiveness and sustainability of the services. - Describe how models are being integrated into the evolving health, housing and social care system,
supporting D2A (the new NHS hospital discharge operating model), the NHS Long-Term Plan and Covid
Care/recovery. - Identify the challenges that remain to systems and service delivery that require changes outside the
direct control of organisations in the locality. - Further test the key components of effective and cost-effective models especially where they have not
previously been brought together into a single system.
Background:
Research suggests that out-of-hospital care is effective and cost effective in supporting safe, timely
transfers of care for patients who are homeless (Cornes et al., 2019 & 2021). At present, access to out-of-hospital
care is limited or non-existent for people experiencing homelessness. In 2020, the Department of
Health and Social Care, Ministry of Housing, Communities & Local Government and Ministry of Justice
allocated £16 million through the shared outcomes fund to “roll-out” and robustly evaluate the Out-of-
Hospital Care Model (OOHCM) for people who are homeless. In the same year, a new hospital discharge
operating model Discharge to Assess (D2A) was implemented across England to meet the demands of the
pandemic and increase in hospitalisations. A key objective of the OOHCM programme is aimed at exploring
how support for homeless patients can be integrated as part of the new D2A operating model.
Methods:
A mixed methods approach comprising four work packages:
- WP1: Basic Audit
- WP2: Study of Positive Practice
- WP3: Full Economic Evaluation
- WP4: Discrete Choice Experiment User Preference
People with lived experience week will be actively involved in all aspects of the evaluation as specialist advisors and peer researchers.
Funding:
Department of Health and Social Care
In the photo above: members of the research team at the first project meeting, 21 October 2021, at the
Virginia Woolf Building, King’s College London. From left: Michela Tinelli, Jo Coombes, Michelle Cornes,
Lizzie Biswell, Stan Burridge
Project Team
Elizabeth Biswell, Stan Burridge, Dr Michael Clark, Jo Coombes, Professor Michelle Cornes, Janet Robinson AKC