A voice for change

We are in the grip of a homelessness crisis.  At least 280,000 people were homeless in England as of December 2019 according to the latest estimates from Shelter, an increase of 23,000 since 2016.  London is the most acutely affected, with a shocking 1 in 52 people now homeless in the capital. 

Government statistics also show that people on the streets are dying decades early, often of treatable conditions. According to the Office of National Statistics, in 2018 the average age of the 726 people who died while homeless was around 44, meaning that they typically died more than three decades too soon. A third of these deaths were caused by treatable conditions. The deaths also represented the highest year-to-year increase (22%) since figures began to be recorded in 2013. Hospital admissions in England relating to homelessness, meanwhile, leapt 130% in the five years to 2018-19. 

The COVID-19 crisis has underlined the centrality of appropriate health care to the support and recovery of people who have experienced homelessness. In recent years, across all of our homeless pathway services we have seen increasing numbers of people who, as a result of their long-term substance dependency and the length of time they have spent sleeping rough, present with serious health conditions for which they are not receiving the necessary health support. 

Mainstream support services have proven inaccessible to people facing multiple disadvantage, who find themselves struggling to navigate a 'maze' of services that are overly complex, inflexible and insufficiently coordinated to meet their needs. 

To achieve a sustained reduction in the number of premature deaths among rough sleepers, we need to learn from and address the systemic obstacles the people who use our services face – including listening to the first-hand experience of clients in order to inform the commissioning and design of future services. 

With more targeted investment and effective collaboration between health, social care and housing services, far more appropriate and effective services could be delivered.