Homelessness and health
The Scottish Government carried out research to understand the relationship between health and homelessness in Scotland. The research, titled Health & Homelessness in Scotland, compared the health usage data of people with and without experience of homelessness across Scotland between 2001 and 2016.
The research found a clear relationship between health care and housing needs, the animation below explores the key findings:
The findings provide an opportunity for health, social care and housing services to engage and explore new ways of sharing information to prevent homelessness and provide better care and support services at the earliest opportunity.
Further support
To help support discussions across health, social care and housing on the realtionship between homelessness and health in Scotland some further materials are available:
If you are interested in taking forward improvement work in this area the Place, Home and Housing Portfolio can offer support with Quality Improvement methodology, data measurement or evaluation, email his.phh@nhs.scot for more information.
Homelessness, health and COVID-19
COVID-19 and the associated control measures have led to a change in the way health and social care services are being delivered in Scotland. Before COVID-19 it was widely understood that people experiencing homelessness already faced significant barriers to access and the pandemic has the potential to exacerbate existing health inequalities.
In the summer of 2020 the Place, Home and Housing Portfolio carried out research into how people who are homeless were accessing services during the pandemic. This report describes people’s experiences that have been amplified by COVID-19, identifying the barriers and enablers to access and highlights the key components to be considered when designing or delivering health and social care services for people experiencing homelessness in the future.
Read the full report here: Homelessness, Access to services and COVID-19: Learning during the pandemic to inform our future (PDF)
NHS Fife & Shelter Scotland approach to supporting homeless patients attending hospital
Healthcare Improvement Scotland’s ihub provided support to Shelter Scotland and Fife Health and Social Care Partnership (HSCP) by conducting both a qualitative study and a health economics evaluation of an intervention within Victoria Hospital, Kirkcaldy (NHS Fife).
Read the executive summary here.
The intervention
Two full-time Shelter-funded staff with a combination of clinical and housing expertise within an acute hospital setting. The staff liaised with clinical staff to asses and provide support to patients prior to discharge and follow up with them post discharge if necessary, and local authority staff to help facilitate the provision of suitable accommodation. There were two hospital settings for the intervention: inpatient discharge at the hospital’s “Discharge Hub” from January 2018 to January 2019; and A&E discharge from November 2019 to February 2020.
The Evidence and Evaluation for Improvement Team (EEvIT) conducted a health economics analysis of the intervention.
Read the full economic evaluation report here.
Key qualitative study findings
The Place, Home and Housing portfolio interviewed service users and staff involved in the project to understand the challenges and barriers that exist, and what can be learned to inform the design of future intervention models.
Interviewees suggested that having both clinical and housing expertise within an acute setting enabled the spread of knowledge and awareness of homelessness and its associated health issues. The provision of support and advocacy on a range of patient needs gave reassurance to both patients and NHS staff that wider health and wellbeing needs including housing could be addressed.
The intervention team were accessible, no drawn out processes or forms to fill in to access them. Ease of access is important, as a clinician I don’t have a lot of time to fill in forms so knowing that the team are around and I could just call them worked."