healing the margins
a Christian and medical reflection on homelessness and hospital care in the UK
Pippa Medcalf looks at the health needs of those who are homeless and the challenges in addressing them.
In the heart of every British city, the growing visibility of homelessness serves as a stark reminder of social inequality. Beyond the sight of people sleeping rough is an unseen crisis: the disproportionately high number of homeless individuals attending hospitals. Their visits often reflect not just acute illness but also a deeper societal failure. This issue calls for both medical intervention and compassionate, faith-based action.
Jesus said, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ (Matthew 25:40) From a Christian standpoint, caring for the homeless is not merely charitable; it is a divine calling. From a medical viewpoint, failing to care for the homeless burdens the healthcare system and reflects systemic neglect. This article explores the dual perspective and how both disciplines can unite in action.
the medical reality: homelessness and hospital admissions
Homelessness takes many forms – rough sleeping, sofa surfing, temporary accommodation – but all are linked with poor health outcomes. According to NHS data, 1 people experiencing homelessness are:
- Six times more likely to attend Accident and Emergency (A&E) than the general population.
- Three times more likely to be admitted as inpatients.
- Far more likely to suffer from long-term physical and mental health conditions.
common health issues
- Mental health disorders: Over 70 per cent of homeless individuals have mental health needs, often exacerbated by trauma, addiction, and isolation.
- Substance abuse: High rates of alcohol and drug dependency, often intertwined with chronic pain and untreated psychological conditions.
- Infectious diseases: Tuberculosis, hepatitis C, and HIV are more prevalent among the homeless due to a lack of sanitation and healthcare access.
- Chronic conditions: Diabetes, heart disease, and respiratory issues are often worsened by poor living conditions and delayed treatment.
delayed and inadequate care
Many homeless people seek medical attention only in emergencies. A 2023 study by the King’s Fund found that homeless patients often arrive at hospital with conditions that could have been prevented or managed with earlier intervention. Discharge planning is frequently inadequate, leading to a revolving door scenario where patients return to A&E shortly after leaving.
Homeless Link, a UK charity, reported that over 70 per cent of homeless hospital discharges in 2022 were into no fixed abode, often straight back onto the streets. This lack of follow-up care leads to deteriorating health and increased NHS expenditure.
the Christian view: compassion, dignity, and action
Christianity has always held the care of the vulnerable at its core. The Bible is unequivocal in its command to love the poor and shelter the outcast.
biblical perspectives
- Proverbs 19:17: ‘Whoever is kind to the poor lends to the Lord, and he will reward them for what they have done.’
- Isaiah 58:6-7a: ‘Is not this the kind of fasting I have chosen: …to share your food with the hungry and to provide the poor wanderer with shelter…?’
- James 2:15-16: ‘Suppose a brother or a sister is without clothes and daily food. If one of you says to them, “Go in peace; keep warm and well fed,” but does nothing about their physical needs, what good is it?’
These verses emphasise that compassion must be active, not just emotional. The Christian response to homelessness must move beyond prayer and charity to advocacy, service, and policy engagement.
the example of Christ
Jesus Christ’s ministry was deeply intertwined with the poor, the sick, and the socially outcast. He healed lepers, dined with tax collectors, and lived with those considered unworthy. His actions challenge modern Christians to ask: ‘If Jesus walked through our cities today, where would he go? Who would he help?’
Undoubtedly, he would sit with the homeless in hospital waiting rooms, speak with them in shelters, and heal them, not just physically, but emotionally and spiritually.
bridging the gap: where medicine meets ministry
The divide between medical care and Christian compassion need not exist. In fact, some of the most innovative solutions are emerging from partnerships between healthcare providers, churches, and Christian charities.
hospital chaplaincy and faith-based care
Hospital chaplains – many of whom come from Christian backgrounds – often serve as bridges between medical staff and homeless patients. They offer:
- Emotional support and prayer
- Help with navigating services and benefits
- Follow-up care through community churches and shelters
Some National Health Service (NHS) trusts partner with local churches to provide discharge shelters, temporary housing, or referral services.
case study: Pathway Teams
Pathway, a UK-based initiative, sets up specialist homeless health teams in hospitals. 2 These teams – comprising doctors, nurses, social workers, and housing experts – manage homeless patients from admission through to discharge. They collaborate with shelters, housing offices, and addiction services to ensure a safe transition.
Since 2010, Pathway has been implemented in eleven hospitals and has shown:
- A reduction in repeat Accident and Emergency visits by 40 per cent
- Improved patient outcomes
- Lower long-term healthcare costs
This model demonstrates how systemic change can be informed by values of dignity and wholeness – key Christian principles.
how can Christians help?
The Bible calls believers not only to observe suffering but to respond. In the context of homelessness and hospital care, Christians can play an active, healing role.
- Support existing ministries
Many Christian charities, such as The Salvation Army, Housing Justice, and Church Urban Fund, run homeless shelters, advocacy campaigns, and medical outreach programs. Financial donations, volunteering, and prayer support all make a difference.
- Advocate for policy change
Contacting local MPs, joining advocacy campaigns, or supporting initiatives like Health for the Homeless can influence healthcare and housing policies that impact homeless individuals.
- Start community outreach
Local churches can:
- Offer warm meals and first aid training
- Host drop-in clinics with volunteer GPs or nurses
- Establish relationships with nearby hospitals to support discharged homeless patients
- Build relationships
More than anything, homeless individuals need to feel seen, known, and valued. Christians can offer companionship and conversation – simple acts that reflect the love of Christ.
As Mother Teresa is reputed to have said, ‘The most terrible poverty is loneliness, and the feeling of being unloved.’
conclusion
The intersection of homelessness and hospital care in the UK is a complex issue, but not an insurmountable one. From a medical perspective, homelessness leads to higher hospital use, worse health outcomes, and avoidable deaths. From a Christian perspective, this crisis is a call to embody Christ’s love for the marginalised.
The words of Jesus in Matthew 25 remind us that when we serve the poor and the sick, we are serving him directly. The NHS, though overburdened, has begun to adapt through initiatives like Pathway. Now, it is time for the Church to act – not only as a spiritual refuge but as a tangible source of healing and hope.
Let us be a Church that visits the sick, welcomes the homeless, and builds bridges between medicine and mercy.
