Agenda item

Report of the Director of Adult Services and Housing

The Board received a Briefing Note of the Director of Adults and Housing along with a verbal update and presentation of the Head of Housing and Homelessness and the Housing and Homelessness Commissioning and Partnerships Lead, highlighting the work that is taking place in Coventry regarding homelessness and health.

During 2022/23, 5798 households in Coventry approached the council for housing advice.  Of these, 833 were at risk of homelessness and 1955 of these were homeless at the point of contact.  A total of 2495 households were accommodated in temporary accommodation in the city during 2022/23, an increase of 24% from the previous year.  1135 of these households accommodated in temporary accommodation included children.  As at 21^st February 2024, there were 1140 households in temporary accommodation provided by the council including 787 families and 353 single people.

Over the past 12 months there had been a sharp increase in the numbers of people rough sleeping in the city.  Between July 2023 and January 2024, 23 individuals found rough sleeping had been discharged from hospital.  The main reasons for those sleeping rough attending hospital were infections, deep vein thrombosis and abscesses/wounds.

In the past 3 years there had been 21 deaths in temporary accommodation due to ill health.

In Coventry, the Anchor Centre was commissioned to provide a specialist service for people experiencing homelessness and the Meridian Centre for people with no recourse to public funds.  The Anchor Centre accepted patients who had been rough sleeping, living in hostels, sofa surfing, or in temporary accommodation.

The city had a rough sleeping service working proactively with people rough sleeping or at risk of rough sleeping, often supporting individuals with complex health needs to access medical interventions.  The commissioned homelessness support services had specific KPI measures around accessing health care and GP registration.

CWPT employed a homeless pathway Mental Health social worker, who worked closely with the rough sleeping team as well as supporting those living in temporary and supported accommodation to access support and mental health interventions.  A palliative care team for the homeless had also recently been established to support people at end of life.

Until recently, hospital discharges had proved a problem as people were being discharged at night without statutory services being informed that they required accommodation.  Homeless patients also had a much higher rate of self-discharge from hospital, often linked to substance misuse.  The creation of a homelessness pathway lead role at UHCW in December 2023 had already had a positive impact.

Interventions in place in the city had evolved rather than being part of a planned programme of work, where key outcomes and outputs had been identified.  This meant at times, the approach was disjointed and reactionary and made future planning and prioritising in terms of service provision, consultation and intervention difficult.

It was a statutory requirement on the local authority to have a Homelessness and Rough Sleeper Strategy.  The current strategy expired in 2024 and work would shortly commence to renew the strategy, which would be used as an opportunity to consider how health outcomes for people who are experiencing homelessness could be improved.  It was proposed to use the https://www.nice.org.uk/guidance/NG214 guidance.  A self-assessment to establish a clear baseline of provision and services was the recommended starting point for the work.

The Cabinet Member for Councillor Welsh, Cabinet Member for Housing and Communities, welcomed the work being undertaken with rough sleepers and the homeless Coventry but the figures showed there was still a long way to go and there were barriers to accessing support.

The Board asked questions, made comments and sought assurances on a number of issues, including:

·  Homeless people and rough sleepers were being supported to enable them to access substance misuse services and Change Grow Live, the commissioned drug and alcohol service, work very closely with them.

·  Council’s rough sleeper services were based in Lamb Street where a joined-up approach was offered.  Services were also taken to the rough sleepers.

·  The creation of a homelessness pathway lead role at UHCW had been positive and part of the role was to work with the individuals to avoid self-discharge but also that if self-discharge did take place, what interventions and support services were available.  The impact of this work would be measured over the coming 12 months.

·  UHCW were helping to support the prevention of health issues by taking community nursing facilities out to the homeless and rough sleeping population.

·  The length of time people in transient situations can receive a decision from the Home Office regarding accessing housing or benefits was on average, 13 months.

·  HDRC funding and working in partnership to strengthen collaboration and bid for funding.

·  Across the West Midlands, drug related deaths were being investigated and collaboration with agencies was taking place to act more quickly and proactively.

Members welcomed the interventions and partnership working.

Members requested Health Determinants Research Collaborations/research be brought back to a future meeting of the Health and Wellbeing Board.

RESOLVED that the Health and Wellbeing Board:

1.  Supports the ambition to achieve greater alignment in the provision of healthcare, support and interventions when considering health inequalities and homelessness in the future with a key opportunity for doing so being through the Homelessness and Rough Sleeper strategy which is being refreshed in 2024.

2.  Uses the Strategy renewal as an opportunity to consider as a system how health outcomes for people who are homeless might be improved.  In progressing this, it was proposed to use the https://www.nice.org.uk/guidance/NG214 guidance that explored how local authorities were providing integrated health and social care services for people experiencing homelessness and ensure care, support and interventions were co-ordinated across different services.  Undertaking a self-assessment to establish a clear baseline of our provision and services was the recommended starting point for this work.