Intermediate Care Pathway
Direct inpatient admission for people experiencing homelessness who need rehabilitation, detoxification or both, without first needing a hospital admission.
A pilot pathway commissioned directly by the Department of Health and Social Care, running from November 2026 to March 2027.
Care pathway
Mildmay Hospital provides inpatient intermediate care for people experiencing homelessness who need rehabilitation, detoxification, or both. Patients can be admitted directly from the street, from hostels, or on release from prison.
Patients are cared for by our full multidisciplinary team, from admission through to discharge. Care is planned with each patient and tailored to their medical, nursing and therapeutic needs. Patients admitted for detoxification follow the same clinical model as the London Detox Pathway.
The pathway builds on a DHSC-funded pilot we ran from January to March 2026, which provided 300 bed nights and moved the large majority of patients on to more suitable accommodation.
How this pathway differs
The Step-down Homeless Pathway and Post-detox Recovery Pathway are for patients stepping down from an acute hospital admission or a medical detoxification. The Intermediate Care Pathway has no such requirement: it offers direct access to inpatient care for people who would otherwise be unable to reach it.
Aims
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Provide direct access to safe, structured inpatient care for people experiencing homelessness
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Support detoxification and rehabilitation, and help patients sustain engagement with treatment
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Plan safe discharges to onward rehabilitation, hostels or other suitable accommodation
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Work with outreach, substance misuse, housing and prison services to provide joined-up care
Admission criteria
The pathway is for adults experiencing homelessness who:
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need inpatient rehabilitation and/or detoxification
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have been risk assessed before admission
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are willing to follow Mildmay Hospital’s policies, including those on behaviour and substance use, in the same way as patients on our other pathways.
Low-risk patients being released from prison who have medical, nursing and therapeutic care needs may also be referred.
Discharge planning
We work with external substance misuse and homelessness services on each patient’s discharge, and make referrals ourselves where a patient lacks adequate support.
Onward transfer to residential rehabilitation is available for some patients, depending on availability and individual need. Other patients may move on to hostels or other accommodation, planned with their input and consent.
Referrals
Referrals are made by outreach teams working with people experiencing homelessness, and by prison services.
To discuss or make a referral, please contact our Admissions Manager by telephone at 020 7613 6347 or by email: admissions.mildmay@nhs.net
Funding and evaluation
This pathway is commissioned and funded directly by the Department of Health and Social Care. As a new initiative, it is being independently evaluated, and an external researcher may speak with staff and patients.
For wider policy context, see the government’s National Plan to End Homelessness.