The Government has announced a £20m scheme to help single homeless people, after it was claimed that the homeless die on average 30 years earlier than the national average. The research from Sheffield University for the homeless charity Crisis claims the life expectancy of a homeless man is 47, while the national average is 77.
The LGiU and St Mungo’s recently held a high-level roundtable of council housing representatives and related partners to discuss how homeless people could be given a greater voice in service delivery decisions under localism. In collaboration with delegates, LGiU have highlighted 6 recommendations that local government can act upon today to better support its local homeless.
Homelessness is an increasing concern for local authorities. The latest homelessness statistics from the Department for Communities and Local Government show a 13% rise in households accepted as being owed “the main homelessness duty” since the start of 2011 compared with the same period last year. These official figures only capture those who have been accepted as being unintentionally homeless and in priority need. If the numbers of those ‘sofa-surfing’ or rough sleeping were included then the figures may be far higher. According to a St Mungo’s report launched in November, 3 out of 5 street outreach workers in England reported a rise in rough sleeping this year.
Homeless people and service use
Homeless people are often intensive users of council and health services. Research by the Office of the Chief Analyst at the Department of Health found homeless people are 5 times more likely to use A&E than the general population. Homeless Link’s last Health Audit found that 41% clients had used A&E at least once in the past 6 months. Furthermore:
- 8 out of 10 homeless clients have one or more physical health needs;
- 7 out of 10 clients have one or more mental health need;
- In the past 6 months, 4 in 10 had been to A&E at least once and 3 in 10 had been admitted to hospital. 8 out of 10 had been to see a GP at least once and 3 out of 10 had used an ambulance;
- Almost 1 in 3 regularly eat less than 2 meals per day.
Over a 12 month period it is estimated only 7% of the general population will have an inpatient hospital stay. The figure of 31% for homeless people is over 4 times this rate, although this is based on a 6 month period.
The support needs of rough sleepers may also be rising; 57 per cent of outreach workers believe that the number of rough sleepers in their area with mental health problems has increased over the last five years.
Are homeless people represented?
Despite being heavy users of services, particularly in relation to health, homeless people feel under-represented. Recent research undertaken by St Mungo’s showed that only 14 per cent of their staff and clients believed that homeless people are included in society.
Localism could be either an opportunity or a danger in this context. Small scale, local solutions should offer new opportunities to engage homeless people at a local level. However, a narrow geographic definition of communities could also be excluding; particularly for rough sleepers, who tend to move across local authority boundaries. Localism also raises questions about whose voices will be heard, and how councils can successfully mediate between different interest groups.
Our discussion highlighted a number of barriers to engagement with homeless people.
- Homelessness is not a ‘popular’ issue – a recent YouGov poll for St Mungo’s showed that only one fifth of people think that services for homeless people should be funded by the state. There is often a lack of understanding of the complex causes of homelessness by the general public. Rough sleeping is regularly presented as a community safety concern, rather than an issue for health and housing services. There is a need to reflect not just the distinctive challenges that homeless people face but also the ways in which homeless people are similar to the broader population.
- Councils only have a duty to house the statutory homeless. Other forms of homelessness, such as ‘sofa-surfing’ and non-statutory homelessness tend to be ‘invisible’, with some notable exceptions, for example, the London Borough of Camden’s excellent Pathways model.
- Preventative services like Supporting People are often the most effective in providing a safety net for people at risk of homelessness (and save money for a council in the long run), but these services are also discretionary, and therefore vulnerable to local authority spending cuts.
- Pressure to respond to non-statutory homelessness is frequently reactive, following an individual report of rough sleeping to an officer or councillor. Preventing homelessness, and addressing it as quickly as possible when it arises is more efficient and cheaper in the long-term for a local authority. However, it is difficult to demonstrate the savings clearly.
- It is often challenging for different council departments such as housing and adult social care to work together to address homelessness, particularly during times of budget cuts.
- Consultation with homeless people is frequently tokenistic and inadequate. Area forums tend to be dominated by the more articulate and vocal members of the local community, whose views are disproportionately represented. To engage with homeless people, a more proactive approach is needed. This could involve outreach work, or engaging better with intermediaries such as St Mungo’s.
- There can be a conflict in two tier authority areas between the county council, which holds the Supporting People budget, and the district, which has responsibility for the homelessness agenda.
How can better representation be achieved?
In the current economic climate it is likely that local government will need to respond to rising levels of homelessness. It is therefore important that the correct mechanisms are in place to ensure that the needs of people experiencing, or at risk of homelessness are represented at a local level.
Roundtable delegates highlighted a number of ways in which councils can improve representation of homeless people to ensure that their needs are taken into account in decisions about service delivery.
1. Know your community. There is still a lack of information about the needs of homeless people in many local authorities, due to the distinction between statutory and non-statutory homeless noted earlier. Engaging with local providers such as St Mungo’s can help to fill in the gaps and avoid tokenistic engagement. Ensure housing and homelessness needs are incorporated into the JSNA. The Joint Strategic Needs Assessment has formerly collated important health information about local communities as a basis for commissioning. This assessment will increasingly become the starting point for commissioning through the health and wellbeing board and it is important that housing need is included, in recognition of the strong links between health and housing. For more information about how to incorporate housing needs into a JSNA, please see St Mungo’s recent briefing,‘Improving the health of the poorest, fastest’: including single homeless people in your JSNA.’
2. Appoint a Champion for Homelessness at a Cabinet level. For many councils this is the responsibility of the Lead Member for Housing, but the issue is easily lost among other housing concerns. It is essential that councils identify who will lead on this agenda and that they receive appropriate training on the complex issues associated with homelessness.
3. Ensure Health and Wellbeing Boards include a homelessness champion.This may not necessarily be the lead member for housing, as long as responsibility is allocated to one member of the Board. Bearing in mind the close links between health and homelessness, it is important that this issue is represented on the new boards.
4. Map the cost of homelessness. Homelessness creates additional long-term costs for a local area due to increased reliance on other acute services. Milton Keynes Council is currently undertaking research to establish the true financial cost of homelessness to council budgets and services. In these challenging economic times, a strong argument based on efficiency is an effective way of presenting need. The LGiU’s recent report on the future of housing related support also demonstrated the value of using tools to calculate the financial value of services. Those councils who had assessed the value of services provided under the Supporting People programme had experienced a lower level of cuts overall than those who had not made this calculation.
5. Work with the voluntary sector. Working with advocacy groups in the voluntary sector to help them build their capacity can build better representation for people experiencing homelessness. The roundtable group noted examples of individuals who had formerly experienced homelessness and who were offered advocacy training and engaged in speaking to local councillors about their experiences. Their personal stories were powerful in advocating the importance of preventing and responding to homelessness in a coordinated manner. Cabinet members leading on homelessness have a responsibility to work with their local voluntary providers to share these stories and promote a better understanding of homelessness among other councillors and the local community. In Camden, where services operate across the borough, they operate their own Community Council structure, on which members, officers, service staff, beneficiaries and neighbours all sit.
6. Collect outcome information. Outcomes for individuals are often the most immediate form of feedback on service delivery. Although there is no longer a requirement for local government to collect outcomes for housing related support services, they are a valuable source of data for commissioning and for demonstrating service quality at a local level.