Outline of this Study
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This systematic review examined the effectiveness of discharge programmes designed to prevent homelessness for people leaving hospitals, prisons and other institutional settings. The review synthesised evidence from 13 impact evaluation and10 process evaluations, to draw conclusions around their impact on housing stability, service access, health, and other outcomes, and identify key factors that influence successful implementation.

Findings in brief:
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• People being discharged from institutions are often at higher risk of homelessness, due to previous experience of homelessness, breakdown of accommodation arrangements and existing challenges to their health and wellbeing
  
  
• Discharge programmes significantly improve people’s housing stability, and also reduce the likelihood of hospital admissions and entering prison ‍EStudies did not provide evidence of the impact of discharge programmes on employment, income and service access, potentially saving healthcare costs
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• Coordination between service providers, a clear written discharge plan and training for frontline staff, are all key for successful discharge
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• There are significant international evidence gaps, particularly in effectiveness studies, and in relation to people leaving the armed forces and children leaving care
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Recommendations in brief
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• Commission rigorous evaluations of discharge programmes in UK settings, as current evidence from the USA may not transfer directly to the UK context
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• Ensure that discharge programmes offer assessment which are tailored to individuals' needs, involve service users in discharge planning, , and have a pathway into suitable accommodation ‍
• Establish clear communication and coordination between all relevant services, including hospitals, housing providers, social services, and community health teams
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• Invest in staff training: for case workers, to enable them to deliver tailored support.
   
• Secure sustainable and ringfenced funding: to enable effective recruitment, training, and embedding of good practice around discharge
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• Establish protocols which contain single points of contact and clear referral pathways with defined targets
  
  
• Work to develop partnerships with housing providers to increase availability for people with complex needs
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• Evaluate the impacts of effective discharge on employment, wellbeing, and cost-effectiveness, and explore effectiveness for different institutional settings and population groups, including care leavers and people leaving the armed forces.

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