Strategic Planning and Homelessness: Joining the Dots
Introduction
This briefing outlines the key areas of focus for health and social care partnerships (HSCPs) and their delivery partners in relation to homelessness.
It takes into account the Public Bodies (Joint Working) (Scotland) Act 2014 which enables local authorities to delegate functions connected to homelessness to integration joint boards. In addition, reference is made to recent policy developments including the final recommendations of the Scottish Government convened Homelessness and Rough Sleeping Action Group (HARSAG) [1] and the Scottish Government’s action plan on homelessness [2] which followed the HARSAG recommendations.
Given this renewed focus on homelessness and the current round of strategic commissioning plans there is an opportunity to enhance collaboration between HSCPs, local authorities, health boards and the voluntary sector to redouble efforts to address homelessness.
Taking forward the recommendations of the Homelessness and Rough Sleeping Action Group
The HARSAG’s final report [3] makes a number of references to the role health and social care can play in preventing homelessness. Of the 29 recommendations articulated in the report, all of which were fully accepted by the Scottish Government, the primary recommendation relevant to HSCPs is recommendation 12:
“Across their full range of delegated responsibilities Health & Social Care Partnerships should work in a collaborative way with Local Authorities, Housing Associations and the Voluntary Sector to prevent and tackle homelessness. Local Rapid Rehousing Transition Plans as part of the Local Housing Strategies to be fully integrated into Health & Social Care Partnership strategic plans. These should be included in the Housing Contribution statement to ensure they are part of the planning framework.”
Further, where a Housing First pathfinder exists locally health and social care should begin to explore how they can fit in as a key delivery partner in relation to the support package provided. [4]
Following on from the above there is value in health, social care and housing colleagues teaming up to articulate how they plan to support HARSAG’s recommendations and the Scottish Government’s action plan on homelessness. It is clear from the Scottish Government’s action plan that health and social care is considered a key delivery partner, given the strong links between poor health and homelessness. These links were clearly demonstrated by the Scottish Government’s research into health and homelessness. This found that people with an experience of homelessness interact with health services far more frequently than people with no experience of homelessness from comparable groups from the most and least deprived areas of Scotland. [5]
Strengthening homelessness prevention within HSCPs
How homelessness and repeat homelessness is prevented through early intervention and joint agency working should be further developed within HSCPs.
In taking this forward it will be necessary to take into account how best to respond to the health needs of people who are homeless, or at risk of homelessness. To gain this understanding, data on homelessness and healthcare usage should be shared and analysed at a local level to support service redesign and strategic planning. This should build on the Scottish Government’s research into health and homelessness from 2018 [6] and earlier work carried out by NHS Fife and Fife Council.
Joint training between health, social care and housing front line staff has the potential to support advances in homelessness prevention work and develop a shared understanding of what effective homelessness prevention looks like. This will be particularly important given the Scottish Government’s intention to develop a homelessness prevention duty for local authorities and the wider public sector in the near future.
There are also opportunities through joint training to embed psychologically informed practice and roll out trauma training among staff across housing and health and social care. [7]
Developing strong Housings Options protocols for people with experience of care
Local authorities and their partners should develop strong Housing Options protocols for people with experience of care. This should include assessment of the health and social care needs of care leavers and a plan which sets out how these needs will be met. In line with the Care Review Intentions aftercare should be “designed around the needs of the person leaving care, supporting them to lead a fulfilling life, for as long as they need it.” [8]
Supporting sustainable housing for prisoners on release
HARSAG’s recommendations include ensuring that plans are always agreed to prevent homelessness for people leaving public institutions, including prison. Consequently, HSCPs and their partners should take into account the recommendations of the Scottish Government’s report into Housing and Re-offending from 2015. [9] As part of this there should be a specific focus on recommendations in relation to ensuring consistent housing support is available for all prisoners, applying the Sustainable Housing on Release (SHORE) standards. [10]
Assessing the health and social care needs of homeless people
Senior housing staff can help HSCPs take into account the health and social care needs of homeless people, homeless children and families as part of the strategic planning process. This should also be taken into account within locality planning and linked to any extension of the Housing Options approach, for example to the third sector or to health. [11]
Explore the value of integrating housing and homelessness services into HSCPs
The Public Bodies (Joint Working) (Scotland) Act 2014 allows for the delegation of various homelessness functions by a local authority to an integration authority. While this is not mandatory it is still important for integration authorities and strategic housing authorities to work closely together to improve health and wellbeing outcomes for homeless households. This should include joint working on the formation of homelessness strategies, which should in turn be connected to the strategic plan and housing contribution statement.
As part of this consideration should be had as to whether it would be advantageous to integrate homelessness responsibilities into HSCPs from the perspective of improving health and wellbeing outcomes for homeless people.
Conclusion
Given the scale of homelessness in Scotland, and the well-evidence association between homelessness and poor health, particular focus and improved joint working across HSCPs and their delivery partners is required on:
- Assessing the housing, health and social care needs of the local homeless population and planning how these needs will be met.
- The formulation and delivery of homelessness strategies which link through to strategic plans.
- Jointly commissioning advice and support services for people who are homeless or at risk of homelessness, making best use of the resources available, maximising opportunities to reduce rough sleeping.
- Developing a shared understanding of what effective homelessness prevention looks like across local authorities and HSCPs.
- Supporting the Scottish Government’s plan to end homelessness, in particular the Rapid Rehousing Transition Plans and Housing First pilots.
[1] Homelessness and Rough Sleeping Action Group: Final Report, Scottish Government, June 2018
https://www.gov.scot/publications/homelessness-and-rough-sleeping-action-group-final-report/
[2] Ending Homelessness Together: high level action pal, Scottish Government, 2019 https://www.gov.scot/publications/ending-homelessness-together-high-level-action-plan/
[3] Homelessness and Rough Sleeping Action Group: Final Report, Scottish Government, June 2018
https://www.gov.scot/publications/homelessness-and-rough-sleeping-action-group-final-report/
[4] p27, Ending Homelessness Together: high level action pal, Scottish Government, 2019 https://www.gov.scot/publications/ending-homelessness-together-high-level-action-plan/
[5] Health and Homelessness in Scotland: research, Scottish Government, 2018, https://www.gov.scot/publications/health-homelessness-scotland/
[6] Health and Homelessness in Scotland: research, Scottish Government, 2018 https://www.gov.scot/publications/health-homelessness-scotland/
[7] NHS Education for Scotland, National Trauma Training Framework https://www.nes.scot.nhs.uk/education-and-training/by-discipline/psychology/multiprofessional-psychology/national-trauma-training-framework.aspx
[8] https://www.carereview.scot/intentions/
[9] ‘Housing and Reoffending: Supporting people who serve short-term sentences to secure and sustain stable accommodation on liberation’, Scottish Government, 2015 https://www.gov.scot/publications/housing-reoffending-supporting-people-serve-short-term-sentences-secure-sustain-stable-accommodation-liberation/pages/14/
[10] Scottish Quality Standards: Housing Advice, Information and Support for People in and Leaving Prison (SHORE standards) http://www.sps.gov.uk/Corporate/Publications/Publication-5363.aspx
[11] Para. 245, Report on Homelessness, Local Government and Communities Committee, 2018 https://sp-bpr-en-prod-cdnep.azureedge.net/published/LGC/2018/2/12/Report-on-Homelessness/LGCS52018R6.pdf