1. South East London Homeless Health Needs Audit
Introduce yourself and SELHP
South East London Housing Partnership
Homelessness Coordinator:

2. South East London Homeless Health Needs Audit
Homeless Link’s Health Needs Audit
The Homeless Link Health Needs audit was first developed in partnership with the Department of Health and nine pilot areas across England in 2010.
In 2015, with funding from Public Health England it has been updated to take into account changes to local commissioning environments and other relevant reforms impacting on homelessness and health.
41%
Long term physical health problems
28%
45%
Diagnosed mental health problem
25%
36%
Taken drugs in the past month 5%
Homeless Link’s The Unhealthy State of Homelessness
Homeless Link gathered data from 3355 people with experience of homelessness across 27 areas in England.
The research shows that the health of people who experience homelessness is significantly worse than that of the general population.
The Unhealthy State of Homelessness, Homeless Link:
South East London Housing Partnership
Homelessness Coordinator:

3. South East London Homeless Health Needs Audit
Homeless Link’s Health Needs Audit Toolkit
Aims of the Homeless Health Needs Audit
What the Audit Toolkit Includes
Increase the evidence available about the health needs of people who are homeless and the wider determinants of their health.
Bring statutory and voluntary services together to develop responses to local priorities and address gaps in services.
Give people experiencing homelessness a stronger voice in local commissioning processes.
Help commissioners understand the effectiveness of their services
Guidance on planning, collecting, interpreting and using data
Information for participants
Information for interviewers
Focus group topic guide
Survey prompts and explanatory notes
Guidance on using Limesurvey
Health Needs Audit Survey
South East London Housing Partnership
Homelessness Coordinator:

4. South East London Homeless Health Needs Audit
Why We Conducted the Health Needs Audit
Wanted to develop our data and evidence on the support needs of people experiencing homelessness across South East London
2015 DCLG Call for Evidence
Boroughs and services report increases in complex physical and mental health needs of clients
Homelessness Change Funding
Government investment in accommodation and health services
St. Mungos Charter for Homeless Health
Only Greenwich and Lewisham signed up, only 36% of JSNAs currently make reference to single homelessness, and only a quarter include detailed information on homeless health
Resources Needed
Staff resources
Coordinate the project
Conduct surveys and focus groups
Analyse data
Financial Resources
Incentives and refreshments for focus groups
South East London Housing Partnership
Homelessness Coordinator:

5. South East London Homeless Health Needs Audit
Getting Started
Steering Group
The South East London Homeless Health Needs Audit Steering Group were integral to the success of the health needs audit
Members of the Health Needs Audit Steering Group included:
Borough Single Homelessness Leads
Vulnerable Adults pathway commissioners
Borough public health colleagues
Voluntary Sector partners
Clients who had experienced homelessness
The Steering Group’s Role
Aims and Objectives
Deciding how we would complete the surveys
Tailoring the health needs survey
Time scales
Deciding how we would conduct the focus groups and who we would target
Ensuring project support
Deciding how we would use the data
Developing recommendations
South East London Housing Partnership
Homelessness Coordinator:

6. South East London Homeless Health Needs Audit
Conducting the audit
Conducting Surveys
There was a real commitment from the steering group to get surveys completed and support focus groups as a result surveys were received surveys from a wide range of services including:
Supported accommodation providers (young people, mental health and vulnerable adults)
Outreach teams
Day centres
NSNO
Food banks
Collating Data
Surveys were completed by staff or volunteers with single people with experience of homelessness in a one to one setting
Surveys were completed online, in paper format and then entered on line or on paper and returned for inputting
Focus groups were completed by the Homelessness Coordinator and a local authority staff member in:
Supported accommodation project
Youth Homelessness Service
Day Centre
NSNO
South East London Housing Partnership
Homelessness Coordinator:

7. South East London Homeless Health Needs Audit
What the data showed
Who we surveyed
219 surveys were completed across South East London
4 Focus groups were conducted with 23 people in South East London with experience of homelessness
Most commonly cited reason for homelessness was parents or family no longer able to accommodate or physical health problems
68% of participants were male, 31% female
The average age of participants was 40
81% were UK nationals
62% reported having a long term illness, infirmity or disability
South East London Housing Partnership
Homelessness Coordinator:

8. South East London Homeless Health Needs Audit
What the data showed
48% received support for their physical health problem, the majority were satisfied with the support they received
23% reported at least 1 time they needed medical treatment or assessment but didn’t receive it
63% currently smoke, 47% of which would like to quit
Reasons for not getting support – couldn’t get an appointment or the waiting lists were too long
South East London Housing Partnership
Homelessness Coordinator:

9. South East London Homeless Health Needs Audit
What the data showed
55% received support for their mental health the majority were satisfied with the support they received
21% reported at least 1 time they needed mental health treatment or assessment but didn’t receive it
34% self medicate
Most frequent reaons for not getting mental health assistance were: Drug and alcohol use, waiting to see if the problem got better on its own, nto being able to get an appointment and waiting lists being too long
South East London Housing Partnership
Homelessness Coordinator:

10. South East London Homeless Health Needs Audit
What the data showed
10% used Methadone, Subutex or substitute drugs
8% have a drug problem, 12% are in recovery
14% receive support for their drug use
16% of participants drink alcohol every day
9% report having a problem with alcohol, 14% are in recovery
13% receive support for their alcohol use
Most common forms of drug and alcohol support received by participants are information and advice, community prescribing, day programs, self help groups and harm reduction
South East London Housing Partnership
Homelessness Coordinator:

11. South East London Homeless Health Needs Audit
What the data showed
Access to Services GP
90% of participants were registered with a GP
4% were refused service by a GP
81% had visited their GP in the last 12 months
Dentist
58% of participants were registered with a GP
4% were refused service by a Dentist
A&E
37% of participants had visited A&E, 33% of those accessed A&E 3 times or more
Ambulance
22% of participants had used an ambulance, 41% of those using an ambulance did so 3 times or more
Admitted to Hospital
28% of participants had been admitted to hospital, 26% were admitted 3 times or more
The main reasons for A&E, ambulance and hospital admission were:
Physical health problems
Mental health problems
Accident
Not about not being able to access services as not many people were refused access to dental care, main reasons given for not being able to access services was no address or no ID
Despite high levels of GP registration there were still high levels of access to high cost emergency health care services – reflective of the high levels of physical and mental health prevalence in those that responded to the survey
GP frequency – 71% of these people visited 3 times or more
South East London Housing Partnership
Homelessness Coordinator:

12. South East London Homeless Health Needs Audit
Next Steps
Individual borough reports have now been written and boroughs are working on developing local recommendations for addressing homeless health
Recommendations have included:
Including data in local JSNAs
Continued work on the impact of homelessness on health
Work to develop health and wellbeing support and recording in supported housing
Once recommendations have been agreed final reports will be made publically available.
Lewisham, Bromley and Southwark all using them in their JSNA reviews
(Bromley extension to families and TA)
(who is doing what and how we can coordinate and share work on health and wellbeing)
South East London Housing Partnership
Homelessness Coordinator:

13. South East London Homeless Health Needs Audit
Reviewing the Process
What Went Well
Boroughs developed individual approaches to completing surveys
Offering multiple ways to submit surveys
Hosting focus groups in services
Incentivising focus groups
Providing information to clients on what we are doing and why
Challenges
Client involvement
Time scales slipping
Report writing and input
Completing surveys where there are limited homeless agencies
Lewisham, Bromley and Southwark all using them in their JSNA reviews
(Bromley extension to families and TA)
(who is doing what and how we can coordinate and share work on health and wellbeing)
South East London Housing Partnership
Homelessness Coordinator:

14. South East London Homeless Health Needs Audit
Homeless Health: Can you help?
Questions for me?
South East London Housing Partnership
Homelessness Coordinator:

15. South East London Homeless Health Needs Audit
Group Discussions
What is the experience of the Homeless Health Needs Audit amongst delegates?
Who would you involve in a local audit?
How would clients be involved?
What would you do with the data?
How can the collection of health data be improved in your project?
Does anyone have helpful resources to share regarding health and wellbeing?
Lewisham, Bromley and Southwark all using them in their JSNA reviews
(Bromley extension to families and TA)
(who is doing what and how we can coordinate and share work on health and wellbeing)
South East London Housing Partnership
Homelessness Coordinator: