Deaths of rough sleepers and people who are homeless

1. Deaths of rough sleepers and people who are homeless Jane Cook Health & Homelessness Adviser Rough Sleepers Initiative MHCLG

2. Ambition Rough sleeping strategy: Halve rough sleeping by 2022 End rough sleeping

3. Progress so far December 2018 Delivery plan published August/September 2018 2019 Rough Sleeping Strategy published • 2% decrease in rough sleeping nationally • Further £46m of RSI funding allocated • Additional RRP early adopters announced • 108 areas announced as part of year 2 RRP funding 11 Rapid Rehousing Pathway (RRP) early adopters RSI £30m allocated to LAs March 2018 Housing First Pilots announced First Taskforce Meeting February 2018 First Advisory Panel Meeting Rough Sleeping Cabinet meeting

4. This government has now committed over £1.2bn to tackle homelessness and rough sleeping over the spending review period to April 2020. In 2020/2021 we are providing a further £422m to tackle homelessness and rough sleeping. This marks a £54m increase in funding from the previous year. Rough Sleeping Homelessness £31m top-up 18/19 Homelessness Prevention Grant - £315m (LGDEL) Rough Sleeping Initiative - £76m 16 RSI Advisers (inc faith, police, justice, health and care leavers) Housing First - £28m X 1,250 by 2021  x 750 in 2019/20 Homeless Prevention DEVO (GM, LCR) £5.9 x 2,600  in 2019/20 Cold Weather Fund – up to £5m CAs driving  systems change across 16 district authorities Flexible Homelessness Support Grant (FSHG) - £617m Rough Sleeping SIB – £11.2m PRS Access - £20m X 1,037 13 HAST advisers (3 young people) 54 schemes across the country x 907 entered into housing (PbR, - outcomes total at March 19) HRA New burdens - £72.7m 26 local authorities participating in a Transitional Insurance scheme x 39 Local Letting Agencies Rapid Rehousing Pathway - £42m London Collaboration Project - £37.8m Move-On Fund - £100m x 78 Supported Lettings schemes An additional 20,877 additional PRS tenancies by April 2022 Contracts signed so far: £29.1m in London – 197 units £11.5 outside London – 246 units x 210 Navigators Promoting collaboration between London local authorities, with 13 currently on board x 31 SStS Hubs 11

5. RSI Strategy – commitment We will work to ensure that Safeguarding Adult Reviews are conducted when a person who sleeps rough dies or is seriously harmed as a result of abuse or neglect, whether known or suspected, and there is concern that partner agencies could have worked more effectively to protect the adult. We will consider how lessons learned from these reviews will inform improvements in local systems and services.

6. Safeguarding Adult Review (SARs) A Safeguarding Adults Review (SAR) is a Multi-Agency review process which seeks to determine what relevant agencies and individuals involved could have done differently that could have prevented harm or a death from taking place. The purpose of a SAR is to promote effective learning and improvement, not to apportion blame. Safeguarding Adult boards are responsible for SARs Care Act 2014

7. Health issues for people who are homeless • Present with complex and multiple health issues - tri-morbidity is common • Have high levels of mortality and morbidity • Mortality rates are 8 to 12 times higher than the general public • People who are homeless die much younger than the rest of the population • Mean age of death of a person who was homeless was 44 years for men (compared to 76 years in the general population) and 42 years for women (81 years for the general population)

8. Data – MOH / Centre of Investigative Journalismand ONS In December 2018 ONS estimated 597 deaths of people who are homeless in England and Wales in 2017, an increase of 24% over the last 5 years. Bureau of Investigative Journalism estimated that 800 people who were homeless in the UK died between 1st October 2017 and 31st March 2019 MoH reported that at least 235 people died over the last 6 months – on average one every 19 hours (14/9/19)

9. Reviews in place • Internal reviews with a procedure in place i.e. Haringey, Exeter • Areas setting up groups/panels to review deaths i.e. Lewisham • Adult Safeguarding Reviews i.e. Redbridge, Oxford, Milton Keynes • Thematic Reviews i.e. Leeds, Redbridge • Criminal investigation i.e. Redbridge ‘A multi-agency approach to reporting, recording and reviewing the deaths of homeless people with the aim of reducing and preventing premature death’ Haringey – Aim of Homelessness Fatality Review

10. Themes • Rough sleepers • Complexity of need • Frailty/vulnerability • Multi-disciplinary working • Health & wellbeing • Hospital discharge and use of AE • Thresholds of provider organisations • Whole systems approach – joint working • Leadership • Immigration status • Prevention and early identification • Housing and support

11. What is needed in a review • Timely • Accurate • Involve front line staff and strategic managers – get operational and strategic perspectives • Identify what works well and where the gaps are • Early conclusion and to embed the learning • Action learning with partners: • Understanding of roles, responsibilities and perspectives • Collaborative learning and problem solving • Commitment to change