South East London Homeless Health Needs Audit

1. South East London Homeless Health Needs Audit South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

2. Homeless Link’s Health Needs Audit South East London Homeless 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. 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: http://www.homeless.org.uk/sites/default/files/site-attachments/The%20unhealthy%20state%20of%20homelessness%20FINAL.pdf South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

3. Homeless Link’s Health Needs Audit Toolkit South East London Homeless Health Needs Audit 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: Lucy.fraser-macnamara@lewisham.gov.uk

4. Why We Conducted the Health Needs Audit South East London Homeless 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: Lucy.fraser-macnamara@lewisham.gov.uk

5. Getting Started South East London Homeless Health Needs Audit • 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: Lucy.fraser-macnamara@lewisham.gov.uk

6. Conducting the audit South East London Homeless Health Needs 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: Lucy.fraser-macnamara@lewisham.gov.uk

7. What the data showed South East London Homeless Health Needs Audit • 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: Lucy.fraser-macnamara@lewisham.gov.uk

8. What the data showed South East London Homeless Health Needs Audit 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 South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

9. What the data showed South East London Homeless Health Needs Audit 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 South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

10. What the data showed South East London Homeless Health Needs Audit • 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 South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

11. What the data showed South East London Homeless Health Needs Audit • 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 South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

12. Next Steps South East London Homeless Health Needs Audit • 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. South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

13. Reviewing the Process South East London Homeless Health Needs Audit • 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 South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk

14. Homeless Health: Can you help? South East London Homeless Health Needs Audit Questions for me? South East London Housing Partnership Homelessness Coordinator:Lucy.fraser-macnamara@lewisham.gov.uk 0208 314 6008

15. Group Discussions South East London Homeless Health Needs Audit 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? South East London Housing Partnership Homelessness Coordinator: Lucy.fraser-macnamara@lewisham.gov.uk