Hospitals and helping people experiencing homelessness this winter

12 Dec 2022

As the cost of energy and food, rents and mortgages continue to rise, we are concerned that a significant number of people may find themselves homeless for the first time this winter. All healthcare professionals and organisations can help prepare for and respond to it.

Earlier this year the Department for Levelling Up, Housing and Communities reported an 11% increase in households facing homelessness between 2020/21 and 2021/22. This was still below pre-pandemic levels, but was driven by a 121% increase in eviction notices.

With inflation still as high as it is, that rate may well increase: in September, the Kerslake Commission on Homelessness and Rough Sleeping said rises in the cost of living could have a catastrophic impact. We hope that the government is monitoring the situation and will protect these people from having to sleep on the streets. But the health and care system must prepare for the worst.

Duty to refer

All hospitals, emergency departments and urgent treatment centres in England have a legal duty to refer someone who they believe to be experiencing homelessness, or to be threatened with becoming homeless within 56 days, to a local housing authority of their choice. But all health and care services, whether they are subject to the duty or not, are well placed to identify and refer someone.

The person making the referral should make sure the person being referred consents to it, understands the purpose of the referral, and consents to information and contact details being passed on.

You should make sure your organisation has processes in place, that you understand them, and that your colleagues do too. If you know someone being treated by your organisation is experiencing homelessness you should check that the process has been followed.

NICE has produced a guideline on integrated health and social care for people experiencing homelessness. It includes recommendations on multidisciplinary service provision.

While there is no duty to refer in Northern Ireland, Scotland or Wales, you should similarly ask someone you believe to be experiencing homelessness, or to be threatened with homelessness, if they want you to refer them to a local authority.

Vulnerable groups

Some groups of people are at particular risk of homelessness and may need more support. They include children and younger people, people leaving prison or care, people at risk of or experiencing domestic violence, and refugees.

If you think the person you are concerned about is under 18 you should contact the police. For other vulnerable people, you should make sure that information is communicated to the local authority if the person has consented to the referral.

StreetLink (England and Wales)

The StreetLink website, mobile app and phone service enables anyone to connect people sleeping rough with the local services that can support them.

If you are concerned about someone over the age of 18 that you have seen sleeping rough in England or Wales, you can use this website to send an alert to StreetLink. The details you provide are sent to the local authority or outreach service for the area in which you have seen the person, to help them find that person and connect them to support.

The Simon Community provides a 24 hour helpline in Northern Ireland and Scotland.

Again, if you think the person you are concerned about is under 18 you should contact the police.

—– This statement was produced in partnership by Faculty for Homeless and Inclusion Health, Pathway, Royal College of Emergency Medicine, Royal College of Physicians, Royal College of Physicians of Edinburgh, Royal College of Physicians and Surgeons of Glasgow.