Pathway is the leading homeless healthcare charity in the UK. Established in 2009 after an audit of homeless patient admissions data, a model for holistic management was developed with the aim of improving both health and social outcomes for this vulnerable group. There are now 10 teams in hospitals across the country, where in-hospital GPs and nurses hold multidisciplinary meetings to address the housing, financial, social and health issues of patients. We conducted an audit of Pathway patients between November 2014 and November 2015 to determine if patients experienced any reduction in A&E presentation, admission or bed days following Pathway care, and explored the factors that may have contributed to this. Reductions between 38–78% were seen in these parameters, where long-distance repatriation, food and clothing donation and accommodation arrangements were likely to have played a role. This article describes some of the actions undertaken by the UCLH Pathway team to ensure comprehensive and individualised care was provided to a truly heterogeneous population, with insight from Medical Director Dr Nigel Hewett. Although funding for such models of care may be inconsistent nationwide, this article aims to provide ideas and inspiration for the management of this complex and disadvantaged population.