Multidisciplinary team Resources

People experiencing homelessness are generally not seen in traditional models of intermediate care. An out-of-hospital care model for those experiencing homelessness has been established in Leeds. This offers good quality accommodation in community settings with a multidisciplinary team to assess people’s health and social care needs and offer step up or step down from hospital care. This has demonstrated a reduction in emergency department attendances and unplanned hospital stays, as well as an opportunity for people to be included in a home first model. Unexpected outcomes include a reduction in street sex work for the women who have been engaged on the project, less engagement with the criminal justice system, a place to facilitate prison releases, and an environment where end-oflife care can be delivered and achieve preferred place of death. Future investment is needed for out-of-hospital care to be an equitable offer in the city available to all.

hronic obstructive pulmonary disease (COPD) is a progressive, life-limiting respiratory condition that primarily features symptoms of breathlessness, chronic cough, fatigue and reduced mobility (Collins et al, 2012).
Currently, the prevalence of COPD in the UK is over one million people (Health and Safety Executive [HSE], 2012), and it is the fourth leading cause of death worldwide (Halbert et al, 2003).

Rosemary Pudner describes the special care needed when dealing with diabetic patients with foot ulceration.