Grant awarded to improve the health of people sleeping rough
Funding awarded to 6 projects to test models that improve access to health services for people with both mental ill health and drug and alcohol dependency needs
A Rough Sleeping grant of £1.9 million has today, Tuesday 22 October 2019, been awarded to 6 projects involving partnerships between Local Authorities (LAs) and Clinical Commissioning Groups (CCGs).
These 6 projects will test and evaluate models that improve access to health services for people who have both mental ill health and drug and alcohol dependency needs - who are currently experiencing, or at risk of returning to, rough sleeping. Learnings from these projects will help to inform national policy and local commissioning of health and support services.
The funding has been awarded to projects based in Lambeth, Newcastle, Westminster, West Sussex, Portsmouth and Leeds. They are expected to launch in February and run for twelve months.
In West Sussex, people who sleep rough will be directed away from A&E and supported to access more appropriate and suitable healthcare services. In Lambeth and Leeds, specialist teams will work on the street to support and co-ordinate the care of those experiencing rough sleeping. Portsmouth, Westminster and Newcastle projects include placing nurses and other specialist staff, such as care coordinators, in homelessness services to provide wrap around and intensive support.
All projects have been informed by people who have lived experience of rough sleeping.
People who experience rough sleeping have much poorer health than the general population. Many have both mental ill health and substance misuse needs, physical health needs, and have experienced significant trauma in their lives.
In 2018 there were an estimated 726 deaths of homeless people in England and Wales, an increase of 22% since 2017, driven largely by a significant increase in the number of deaths related to drug poisoning.
The numbers of people experiencing rough sleeping have increased by 165% since 2010, and on a single night in Autumn 2018 4,677 people were recorded as sleeping rough in England.
Of the people seen sleeping rough in London in 2018 to 2019:
• 50% had mental health needs
• 42% had alcohol misuse problems
• 41% drug misuse problems
The government’s Rough Sleeping Strategy, published in August 2018, sets out the vision for halving rough sleeping by 2022 and ending it by 2027. It recognises the need for action to support people sleeping rough now to move off the streets, including targeted support to enable access to health services.
NHS England has recently announced that it will be providing £30 million in additional funding for specialist mental health services in parts of the country with the highest levels of rough sleeping. At least 20 areas are expected to receive this funding by 2023 to 2024.
Rosanna O’Connor, Director of Drugs, Alcohol, Tobacco and Justice, Public Health England said:
"It is vital that people who experience rough sleeping get access to the health services they need. This grant is funding promising projects that will test models that help people who experience rough sleeping with substance dependency and mental ill health get the treatment and support they need.
"People sleeping rough on the streets have often been through very traumatic experiences and desperately need to receive appropriate treatment and follow up care. They should be able to look after their health problems instead of facing a ‘revolving door’ situation while their health deteriorates.
"The 6 projects being awarded funding all explore different approaches to supporting those experiencing rough sleeping. They will help us learn more about what works in improving access to treatment that is right for them and I look forward to the findings."
Nadine Dorries, Parliamentary Under Secretary of State at the Department of Health and Social Care (DHSC), said:
"Everyone should have a roof over their head and access to the care they need, no matter who they are. We are determined to stamp out the injustice of rough sleeping once and for all, but in the meantime we are committed to ensuring rough sleepers are supported with their health issues.
"This funding will help better equip local authorities to protect society’s most vulnerable, and ensure no one slips through the net."
Rough sleeping grant projects awarded funding
Supporting people experiencing rough sleeping to access mental health and substance misuse services by working with the peer advocacy group Groundswell and the Rough Sleeping Outreach Team in Lambeth.
The project will create specialist roles including a rough sleeping approved mental health professional and a substance misuse navigator to help those experiencing rough sleeping receive specialist mental health and substance misuse support.
Providing health interventions for those at risk of rough sleeping through weekly surgeries in the local day centre, night shelters and homeless hostels to improve their physical, substance misuse and mental health needs and engagement with mainstream health services.
Working with Groundswell, a multi-disciplinary team and those with lived experience of homelessness, the model will adopt a trauma informed approach that has been developed by psychological experts. It will provide wrap around health care for rough sleepers with co-occurring mental health and substance misuse needs to help improve health and access to health services.
Providing support and interventions to those experiencing or at risk of experiencing rough sleeping that have disengaged or have experienced challenges or barriers in accessing appropriate healthcare.
The team, made up of 2 link workers and 2 mental health social workers, will visit short term hostels and help those in need access relevant support services and will train hostel staff to help individuals manage their symptoms.
Creating a simpler route into the mental health and substance misuse services by providing the 3 main homeless providers with nurse navigators to provide treatment and care on the street and help high risk individuals enter community-based health systems.
Also providing 3 A&E hospitals with non-clinical navigators to develop treatment support plans for rough sleepers and help them find stable accommodation as well as supporting and training clinical staff.
Working with trauma informed healthcare navigators in a range of locations including on the street, at accommodation providers, homeless hostels, the city’s health bus and GP practices. The team will work intensively to support people experiencing rough sleeping with both mental ill health and substance dependency to access the health support they need.
[i] Deaths of homeless people in England and Wales in 2018, Office for National Statistics 2018