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This study aims to explore the role of discretion anatomy and multiplicity to show how discretion components, range, levels and goals can direct corporate social responsibility (CSR) and prevent corporate social irresponsibility (CSiR). This paper shifts the discretion perspective towards composition to enable a full assessment of the impact of discretion on CSR and CSiR.

This study overlays discretion and CSR theory onto the South African engineering context using professional competency standards set by the national accrediting body to develop a set of principles.

A model with 16 principles is proposed to establish relationships between the decision dynamics of technical professionals, social principles, social responsiveness and social outcomes.

The principles can be used by professionals to determine how their technical decisions can drive socially responsible acts and prevent socially irresponsible acts.

This paper integrates Wood’s (1991) and Frederick’s (2018) CSR perspectives with recent discretion theory developments. This paper centres high-discretion managers who typically occupy key positions in organisational structures where daily technical decisions can have generational social impact.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.