Introduction

  1. JUSTICE is a cross-party law reform and human rights organisation working to make the justice system fairer for all. Our vision is of fair, accessible, and efficient legal processes in which the individual’s rights are protected, and which reflect the country’s international reputation for upholding and promoting the rule of law.
  2. This briefing responds to the Public Accounts Committee Call for Evidence on Tackling Homelessness.[1] In doing so, it draws references from our 2024 report, ‘Beyond the Blame Game: a responsible and rights-centred approach to government contracting’, which was produced by a working party consisting of procurement and public law experts.[2] In that report, JUSTICE called for a shift in approaches to contracting out of services that impact individual rights, including homelessness vulnerability assessments. We recommended that the Government move away from “hands off” delegation with an excessive focus on short-term cost-saving, a towards an individual rights-based approach focusing on quality, rights respecting services that deliver true value for money.
  3. Our response also draws upon the findings of JUSTICE’s 2023 report examining the function and effectiveness of behavioural control orders, which found that that orders introduced by the 2014 Anti-social Behaviour, Crime and Policing Act (“ASBCPA) to tackle anti-social behaviour are having a disproportionate impact on those experiencing homelessness.[3]

Contracted out local authority homelessness assessments

 

  1. In designing the practical, evidence-based recommendations in our 2024 report, ‘Beyond the Blame Game: a responsible and rights-centred approach to government contracting,’ JUSTICE took evidence from lawyers, civil servants, academics, charities and politicians, including the previous chair of the Public Accounts Committee Dame Meg Hillier MP and the previous Lord Chancellor Sir Robert Buckland.  
  2. Our homelessness sub-group, which included senior academics, lawyers and homelessness charities, explored the practice of contracting-out homelessness vulnerability assessments. Under the Housing Act 1996, an individual has a priority need for accommodation if they are ‘vulnerable as a result of old age, mental illness or handicap or physical disability or other special reason’.[4] The local authority has an obligation to determine whether a homeless individual is ‘significantly more vulnerable than an ordinary person in need of accommodation and would be likely to suffer greater harm in the same situation’.[5]
  3. In assessing vulnerability, local authorities should have regard to advice from medical professionals, social services or current providers of care and support.[6] Whilst some local authorities conduct the assessment process of priority need, including by using in-house medical assessors, many have contracted out medical assessments. The sub-group gathered evidence on the contracting out of homelessness assessments of vulnerability to private providers. Our research focused on NowMedical, which seemed to be the largest provider of such services[7], though our findings may apply to other providers.
  4. Our sub-group raised serious concerns about the quality and utility of these assessments, which are often ‘paper-based’, meaning they are conducted without speaking to the individual concerned. NowMedical confirmed to us that it was charging local authorities a flat fee of £40 for a GP to provide a homelessness vulnerability assessment or £80 for a psychiatric report.[8] We assume that the low fees charged by companies such as NowMedical are only possible precisely because they do not speak to the individual. NowMedical states it is because they have not been instructed to do so by the local authority.  

The lack of a written contract and safeguards  

  1. Through Freedom of Information requests, JUSTICE discovered that many local councils who use NowMedical to provide homelessness vulnerability assessments have not signed a contractual agreement with them. Of 19 local councils who confirmed they use NowMedical, only two said they even required agreement of their own standard terms and conditions. Most said they had no separate contractual agreement. 
  2. NowMedical confirmed to us that it has ‘no standard terms and conditions’ and that the assessment process is set out on its website.[9] However, its website provides limited information about the process: It states that there is an ‘ultra-secure case portal[10] and that vulnerability reports will be provided within one working day. It also states that the reports are prepared by ‘UK-registered doctors and psychiatrists specialising in housing medical assessment’, include references to relevant legislation and case-law, and are a ‘precise assessment of housing needs’.[11]
  3. The lack of a contract is concerning given the importance of these assessments to vulnerable, homeless individuals in the assessment of priority need for housing. Local authorities should not be using private providers to provide these assessments without a written contract in place, which sets basic safeguards and standards for the assessments.  
  4. Our Working Party recommended that, when contracting out a service where individual rights are likely to be affected, public authorities should have a specific written contract setting out the key requirements of the service, which in the context of assessments such as these should include speaking directly to the individual concerned (see further below). It should not automatically sign up to a provider’s standard terms and conditions.  

Not speaking to the individual concerned  

  1. JUSTICE is also concerned that homelessness assessments (including psychiatric reports) by NowMedical are conducted solely on the basis of paperwork (such as medical records) provided by the council,[12] and homeless individuals are not being spoken to before the assessment provider reaches a conclusion about their vulnerability.[13] NowMedical confirmed to us that it was ‘very rare for a local authority to request that an applicant is examined in person’.[14] Individuals who are homeless feel confused, hurt and upset by a process in which a doctor assesses their condition and consequential vulnerability without having met or even spoken to them.[15] 
  2. The courts have also raised concerns about the lawfulness of local authorities basing decisions on assessments conducted without speaking to the individual concerned. The Court of Appeal, in 2019, found that Lambeth Council had preferred NowMedical’s assessment over a consultant psychiatrist’s even though the NowMedical psychiatrists ‘were less highly qualified than her and (more importantly) they had never met or interviewed Mr Guiste’.[16] A County Court judge, in 2017, found that the council’s opinion ‘formed directly from the NowMedical opinions’ was ‘fundamentally flawed’ and that it might have helped had someone from NowMedical taken the time to see the Appellant or indeed considered her medical records’.[17] In 2021, a County Court judge stated that NowMedical’s doctors ‘are not experts...they had not seen or interviewed the appellant...it is not a question of giving weight to the issue, but a question of not considering it at all’.[18] Our homelessness sub-group members raised similar concerns. 
  3. In response, NowMedical confirmed to us that their assessments did notconstitute expert evidence (which a diagnosis by a GP would be, but a medical assessment is not)’. They told us that they were ‘not required to meet with or examine homelessness applicants’. [19]
  4. The Court of Appeal in Shala did state that ‘there is no rule that a doctor cannot advise on the implications of other doctors’ reports without examining the patient’.[20] However, the Court in Shala also stressed, absent a medical examination of the individual, a doctor’s comments on the reports of other medics cannot constitute expert evidence of the individual’s condition. It can only assist the authority’s decision-maker in understanding the medical records. 
  5. As Shala indicated, to give a full assessment, doctors may need to consider either examining the individuals themselves or obtaining the individual’s consent to talk to others who treated them. In any event, the authority’s decision-maker must take into account that the doctor is not giving expert evidence of the condition of the patient and, in assessing medical records, has neither examined the individual concerned nor talked to the medical practitioners who produced the contemporaneous records.[21]

Wider concern about the quality and value of assessments  

  1. Our homelessness sub-group considered that the vulnerability assessment reports were often very brief (so appeared to have been done very quickly), poor quality and based on insufficient evidence. This raises concerns about the value for money and quality of these assessments, given that they do not even provide a diagnosis of the purported condition or evidence the consequences of that diagnosis on the individual concerned.
  2. The evidence we heard mirrors concerns raised by lawyers who told the Bureau of Investigative Journalism that NowMedical ‘churns out findings very quickly’ and ‘diminish[es] or downplay[s]the severity of applicants’ conditions.[22] The barrister Nicholas Nicol has set out that, in his view, medical advisers are using a ‘template containing standard wording’ and often fail to properly address key issues.[23] 
  1. NowMedical, in response, again told us that all its doctors and psychiatrists were ‘fully qualified’[24], ‘subject to annual appraisal and revalidation by the General Medical Council’ and ‘only advise on matters within their areas of expertise’.[25] They told us that it was important that assessments were ‘concise and easy to understand’ and that speed was important given the individuals are homeless. They said that ‘speed and brevity should not be taken as negative indicators of quality’.[26] Since they only ‘opine on available medical records – rather than to diagnose an applicant’, given their qualifications, they told us ‘there is no reason that this must be a time-consuming exercise’.[27]
  2. However, there is a difference between being concise and providing limited responses which risk, in our view, not properly engaging with an individual and their condition(s). The Court of Appeal has emphasised that the consideration of whether someone’s mental illness made them vulnerable is ‘self-evidently a very serious matter’ requiring ‘careful consideration of all the relevant evidence and an adequately reasoned conclusion’.[28] Our homelessness sub-group suggested there could be greater use of peer review of assessment reports, as a way of local authorities getting independent feedback on their quality. 
  3. One of the most important aspects of these assessments is the ability to provide supporting medical evidence. A 2016 Freedom of Information request provided examples of homelessness medical assessments prepared by NowMedical for Harrow Council.[29] The assessment reports themselves are very short and have minimal justification for the conclusions reached. The information provided by medical assessors is limited and often refers to the lack of evidence provided, such as in the following examples:  

 

  1. The experience of our homelessness sub-group was that, although more recent reports may contain more detail regarding the diagnosis of the individual than the above examples, the findings and reasoning are similar. Because individuals are not spoken to prior to the assessment report being finalised, they are unable to provide information about issues which the assessor highlights are missing. There may, for example, be good reason for the absence of such information on file or it may be a mistake. 
  2. NowMedical said, in response to this, that they do refuse to provide assessments where local authorities have provided ‘insufficient evidence’ and request further information from councils where appropriate. They estimate 10% of cases are sent back for further information. They state that the above evidence from Harrow Council is designed to assist the Council in following up on ‘evidential gaps’, as is the Council’s duty as ultimate decision-maker.[31] However, we are concerned that the above assessments led to negative decisions about individual’s vulnerability as a homeless individual. The case-law cited above, and the evidence of our homelessness sub-group, also suggests that further enquiries are often not made by councils before reaching a decision.  
  3. We question the value and purpose of outsourced assessments as they currently stand. NowMedical maintains that this is an assessment of a vulnerable individual by a qualified, medical expert. However, it concedes that it is not diagnosing the applicant with any condition. Its service is ‘solely to opine on available medical records – rather than to diagnose an applicant’.[32]
  4. The value of these outsourced homelessness assessments is unclear, especially when such information could often be obtained directly from the individual’s medical representative. A diagnosis of the purported condition, and the evidenced consequences of that diagnosis, seems the minimum which such an assessment should usefully provide the council.[33]

Lack of oversight  

  1. It is of particular concern that there is a lack of data and information available about the process and outcome of homelessness assessments. Of the 19 local councils who responded to Freedom of Information requests and confirmed that they used NowMedical, we highlight the following: 
  1. This demonstrates a lack of data from local authorities on the outcome and process for contracted-out homelessness assessments. Consequentially, if local authorities are not keeping accurate data of how many cases with contracted-out assessments are being overturned, let alone for what reason, then they will be unable to identify areas of repeat concern to address with the provider. NowMedical told us that they were ‘not notified when a local authority’s decision is challenged by an applicant’ or of the case outcome, unless a case was sent back to them for review.[37] It is also worrying that basic information about the assessment process, such as the type of assessment and whether it was paper based, was not available to a number of councils. 
  2. In addition, when local authorities are granted contracting-out powers by central government, it is important the central government oversees the use of such powers and ensures that they are being used responsibly.[38] This should include ensuring that there is accurate data on how such contracting powers are being used and, where serious concerns are raised, taking steps to investigate the use of such contracting powers. 
  3. However, the House of Commons Library has set out, ‘there are no comprehensive lists showing which authorities have outsourced which services, or which companies are contracted by which authorities’.[39] In 2020, the Ministry of Housing, Communities and Local Government did not have information about which local authorities contract out their statutory homelessness duties.[40]  There are also less strict requirements for local authorities uploading public contracts onto the ContractsFinder website,[41] which is especially difficult to navigate when one is unaware whether the service has been tendered or contracted. 
  4. The Ministry of Housing, Communities and Local Government issues guidance regarding how local authorities should use contracted-out homelessness functions. However, this is fairly limited to clarifying the housing authority’s ultimate responsibility for the discharge of its functions, stressing the need to comply with Equality Act duties and insisting that ‘housing authorities should ensure they have adequate contractual, monitoring and quality assurance mechanisms in place to ensure their statutory duties are being fully discharged’.[42]  It does not provide further detail about how authorities can oversee outsourced functions, such as what kind of mechanisms they should employ to ensure they discharge statutory duties.
  5. In light of these findings, we consider that there is a strong case for the Ministry of Housing, Communities and Local Government to commission an independent review into the use of contracted-out assessments, the apparent lack of contractual safeguards, the experience of vulnerable homeless individuals and the lack of available data to scrutinise such contracted-out powers. 

Disproportionate enforcement of anti-social behaviour measures against those experiencing homelessness

Disproportionate enforcement of anti-social behaviour measures against those experiencing homelessness

  1. In our 2023 report, JUSTICE identified serious problems with the way that civil behavioural control orders introduced by ASBCPA are being used in relation to those experiencing homelessness.[43] These orders include Community Protection Notices, (“CPNs”), Public Space Protection Orders (“PSPOs”) and Dispersal Powers (“DPs”). The use of orders in this manner, and the failure of the Government to monitor enforcement, worsens the challenges faced by those experiencing homelessness, and creates further barriers for people to access help and support.

The Orders

  1. DPs provide the police with the power to require a person to disperse from a particular area for a particular period of not more than 48 hours, if they believe that a person’s conduct is likely to contribute to the harassment, alarm distress or crime and disorder. Failure to comply with a DP is a criminal offence, subject to a maximum penalty of three months’ imprisonment, a fine of up to £2,500 or both. Currently, they can only be used by police officers where there has been advance authorisation by a senior police officer.[44]
  2. CPNs can be imposed by a local authority or the police if they are satisfied that a person’s conduct is “unreasonable” and is having a “detrimental effect”, of a “persistent or continuing nature,” on the “quality of life of those in the locality”. CPNs are imposed without judicial oversight. ASBCPA requires that they be preceded by a Community Protection Warning although in practice, this often does not happen. They can contain conditions preventing a person from doing something and requirements that obligate them to do something.  Breach of a condition or requirement is a criminal offence, punishable by a fine of up to £2,500. Breach of a CPN can also lead to the imposition of a Criminal Behaviour Order, which contains similar conditions and requirements and carries with it a prison sentence of 5 years if breached. [45]
  3. PSPOs regulate the use of public space by imposing restrictions or requirements on the activities that can be undertaken in specific geographical areas, on the basis that such activity has a “detrimental effect on the quality of life” of those in the vicinity. They are enforced by the police or a person authorised by the local authority, against any person who enters that space. Breach of a condition is a criminal offence and can be prosecuted. Alternatively, individuals can pay a Fixed Penalty Notice which discharges criminal liability. There is no provision to appeal the imposition of a PSPO or a Fixed Penalty Notice associated with it.[46]

Problems with Enforcement and Discriminatory Impacts on those experiencing Homelessness

  1. Criminalising homelessness or behaviours associated with homelessness via the use of Behavioural Control Orders is not the answer to tackling homelessness. In recent years, successive governments have justified the expansion of Behavioural Control Orders on the basis that conditions imposed by them can require individuals to access rehabilitative programmes. However, via our Working Party and engagement with stakeholders from across the justice system, including local authorities, the police and frontline organisations supporting those experiencing homelessness and those who are victims of anti-social behaviour, JUSTICE determined that this system is not working.  Enforcement bodies are rarely able to facilitate access to such programmes owing to lack of capacity and resources in their region, meaning that orders are mostly punitive in their impact. In any event, to fully address the root-causes of homelessness, interventions are required further ‘up-stream’ and access to support must be provided outside of the criminal justice pathway.
  2. The current approach of using Behavioural Control Orders against those experiencing homelessness is damaging, dehumanising and pushes individuals further from support. In particular, JUSTICE found that DPs, PSPOs and CPNs:
    1. Are being unfairly and discriminately used to criminalise those experiencing homelessness in circumstances where their behaviour is not in and of itself, anti-social. Data collated from Freedom of Information requests and lived experience testimony show that they are routinely enforced for innocuous behaviours associated with homelessness such as “leaving personal belongings on the street”, remaining seated on the ground”, “sleeping in a public space”, andbeing in possession of a drinking vessel”.[47] This is despite previous Statutory Guidance prohibiting their use in this way.[48] DPs have been routinely enforced against individuals whilst they are asleep and therefore not causing any harm.[49] The use of orders against this population further entrenches the inaccurate stereotype that those experiencing homelessness are routinely engaging in anti-social behaviour when in fact, they are more likely to be victims of it. In a twelve-month period, 77% of those experiencing street homelessness had been victims of some form of violence or anti-social behaviour, and 30% had reported being deliberately hit or kicked.[50]
    2. Disproportionately impact those experiencing homelessness. The conditions that are imposed within the orders are significantly more likely to interfere with their daily life and/or prevent them from accessing essential support services. For example, it is common for orders to contain geographical restrictions, preventing individuals from accessing certain parts of the town/city. All too often these restrictions are imposed in a manner that restrict individuals from accessing vital support services such as foodbanks, mental health and addiction support services, and cut them off from positive mentors or social connections. In some cases, it can put them in physical danger by dispersing individuals to less well-lit or secure areas. Furthermore, due to the non-routine lifestyle that many individuals experiencing homelessness are forced to lead, it can be very difficult for them to comply with conditions to attend particular programmes or services such as alcohol and drug interventions, without further assistance.[51] The inability of individuals to comply with the conditions due to economic and social factors led to the feeling amongst our JUSTICE Working Party members and experts that we spoke to, including those from enforcement bodies, that those experiencing homelessness are often set up to fail.
    3. Are being used inconsistently across the country both in terms of the types of order relied upon, the behaviour that they are used to target, and the conditions imposed by them. Vague, overlapping statutory definitions in CPNs, PSPOs and DPs contributes to this problem. It means that in some parts of the country, individuals – particularly those who are experiencing homelessness – are being criminalised for behaviour that others living elsewhere are free to undertake. This is problematic not only for legal certainty and the rule of law, but also means that there is an inconsistent impact on those experiencing homelessness.
    4. Are not capable in and of themselves of resolving anti-social behaviour. In some instances, the enforcement of orders can further exacerbate the problem by breaking down relationships of trust between the public and enforcement bodies (the police and local authorities). Research by Sheffield Hallam University has identified examples where individuals who have been wrongfully subject to CPN, PSPO or DP enforcement practices have been influenced to commit anti-social behaviour in retaliation.[52] The report also featured worrying accounts of enforcement officers using physical and verbal violence against individuals experiencing homelessness.[53]
    5. Impose significant burdens on enforcement bodies, including local authorities and the police, in terms of training and enforcement which enforcement bodies are unable to meet. Enforcement bodies struggle to undertake robust investigations, monitor compliance and provide services to satisfy the positive requirements contained within CPNs and PSPOs.
  3. Furthermore, data collection relating to the use of CPNs, PSPOs and DPs is extremely poor. There is no centralised record of the number of orders imposed, the behaviours that they are imposed in relation to, the conditions they impose, the rate at which they are breached or the penalty for breach. More worryingly, there is no adequate record in respect of the individuals they are imposed against, e.g., whether those individuals have protected characteristics.  This means it is unclear how enforcement bodies are monitoring or ensuring compliance with the Public Sector Equality Duty in their investigations and enforcement processes. This is particularly concerning given that those experiencing homelessness are more likely to be experiencing multiple disadvantages which can include health related concerns such as substance use disorders, mental ill-health and neurodivergent behaviours. Our Working Party heard multiple examples of ASBCPA powers being used inappropriately in ways that are harmful to those with mental ill-health or intellectual disabilities.[54]

JUSTICE Recommendations

  1. We encourage the Committee to call for:
    1. A comprehensive, Government-led review of the orders under the ASBCPA. The review should determine, amongst other factors, what discriminatory practices arise relating to the use of Orders, including in respect of those experiencing homelessness, how this is measured and whether / how such practices can be overcome. It should also examine what measures / services outside the justice system are required to support those affected by the Orders (both victims and those subject to the orders) to ensure that the Orders achieve their stated aim. The review should be multidisciplinary, involving not only the police and local authorities but those with lived experiences (as victims and recipients), those that support victims and recipients and subject matter excerpts in the criminal justice system and beyond.
    2. Provision to be made within the ASBCPA to prevent orders being imposed on those experiencing homelessness and to make clear that homelessness in and of itself is not anti-social behaviour.
    3. Reinstatement of prohibitions relating to the use of ASBCPA orders on those experiencing homelessness, within in statutory guidance. JUSTICE also recommends that wording be inserted into the ASBCPA that enforcement bodies must have due regard to, and comply with, statutory guidance when enforcing orders.
    4. Increased investment for local authorities and the police to enable them to provide quality training on the issuing and enforcement of orders, and to establish robust investigation and monitoring procedures to ensure that orders are being used lawfully.
  2. Invest in local authorities to provide them with the means to tackle the root causes of anti-social behaviour and homelessness and to utilise maximum diversion away from criminalisation. This includes investment in support services relating to mental ill-health, substance use disorders and associated issues such as bereavement support, domestic abuse services etc. Where orders are used, local authorities and the police should be supported to have multi-agency partnerships in place to ensure that the conditions imposed by the orders are appropriate and that wrap around support is provided to assist an individual to access relevant programmes.
  3. Enforcement bodies must be required, by legislation, to collect and publish data relating to the use of 2014 Act Orders in their areas. This should be collected and published by Government in a centralised place.  The data should include information about the protected characteristics of the recipients of orders.

November 2024

 

 

13

 

 


[1] Public Accounts Committee, ‘Tackling Homelessness: call for evidence’, November 2024.

[2] JUSTICE, Beyond the Blame Game: A responsible and rights-centred approach to government contracting,’ 2024.

[3] JUSTICE, ‘Lowering the Standard: a review of Behavioural Control Orders in England and Wales’, 2023.

[4] Housing Act, section 189(1)(c)

[5] Shelter, Who has priority need when applying as homeless’

[6] Ministry of Housing, Communities and Local Government, Homelessness Code of Guidance for Local Authorities,’ at para. 8.26, updated
10 June 2024.

[7] According to their website, NowMedical are ‘the UK’s leading provider of housing medical advice’, advising over 150 local authorities,

housing associations and organisations across the United Kingdom. NowMedical, ‘Who we are’, NowMedical confirmed to us that they have

21 doctors and undertake 50,000 cases per year.

[8] Evidence provided by NowMedical to JUSTICE.

[9] NowMedical evidence provided to JUSTICE.

[10] NowMedical, ‘How it Works’.

[11] NowMedical, ‘Vulnerability for Priority Need’.

[12] NowMedical told us they often now receive an applicants’ full medical records and this is a ‘development we strongly welcome’.

[13] The Bureau of Investigative Journalism found in 2019 that, in most cases, NowMedical’s reports were produced ‘solely on the basis of the council’s paperwork; the doctors working for NowMedical rarely meet the person involved, and do not regularly access their full medical records or talk to their GP’. Maeve McClenaghan, ‘How a doctor who has never seen you can say you’re fit enough to sleep on the streets’, The Bureau of Investigative Journalism, 18 December 2019.

[14] Evidence provided by NowMedical to JUSTICE.

[15] How have they come to this decision, when they have never met my daughter?’ Susan asked. ‘There’s something very, very wrong with this system. It is unjust’. Maeve McClenaghan, ‘How a doctor who has never seen you can say you’re fit enough to sleep on the streets’, The Bureau of Investigative Journalism, 18 December 2019.

[16] Guiste v London Borough of Lambeth [2019] EWCA Civ 1758, para 64. Mr Guiste’s lawyers had recommended that NowMedical speak to Dr Freedman but this was ‘not achievable’.

[17] Thomas v Lambeth BC, Central London County Court, Case No: C40CL397 (16 March 2017), para 25.

[18] Giles Peaker, Recitation is not application’, Nearly Legal, (21 November 2021).

[19] Evidence provided by NowMedical to JUSTICE.

[20] Shala & Anor v Birmingham City Council [2007] EWCA Civ 624, para 23.

[21] Shala & Anor v Birmingham City Council [2007] EWCA Civ 624, para 22 – 23.

[22] Maeve McClenaghan, ‘How a doctor who has never seen you can say you’re fit enough to sleep on the streets’, (The Bureau of Investigative Journalism, 18 December 2019).

[23] The most fundamental element in considering vulnerability under section 189(1)(c) is the impact of homelessness on the patient in question. I have rarely seen a NowMedical report in which this is ever mentioned, let alone considered, save in one respect, namely the patient’s ability to access medical care or support, e.g. repeat prescriptions. NowMedical invariably concludes that such care or support would remain easily accessible, which leads me to think that they are probably unaware of the research detailing the practical difficulties which arise when homeless. Even when they mention the effect of homelessness, they never state what they think those effects are’. Nicholas Nicol, ‘Standard NowMedical Arguments’,

[24] All of our doctors hold higher medical qualifications such as membership of the Royal Medical College, and our psychiatrists are recognised specialists and members of the Royal College of Psychiatrists. They are respected practitioners who diligently carry out their responsibilities’. Evidence provided by NowMedical to JUSTICE.

[25] Evidence provided by NowMedical to JUSTICE.

[26] Evidence provided by NowMedical to JUSTICE.

[27] Evidence provided by NowMedical to JUSTICE.

[28] Troy Guiste v London Borough of Lambeth [2019] EWCA Civ 1758.

[29] Containing both positive and negative outcomes.

[30] WhatDoTheyKnow, ‘Freedom of Information Request: Now Medical assessments’, (1 December 2016).

[31] Evidence provided by NowMedical to JUSTICE.

[32] Evidence provided by NowMedical to JUSTICE.

[33] NowMedical told us that they ‘would very much welcome changes that would result in more complete medical information being received from local authorities and applicants’.

[34] Both councils who confirmed this information used NowMedical for less than 10 assessments per year.

[35] Again, both councils who confirmed this information used NowMedical for less than 10 assessments per year. Both councils had no individuals successfully challenge the decision.

[36] The two councils which did respond confirmed it was s189(1)(c) Housing Act priority need homelessness cases for vulnerable individuals.

[37] Evidence provided by NowMedical to JUSTICE.

[38] For homelessness assessments, for example, it is the Local Authorities (Contracting Out of Allocation of Housing and Homelessness

Function) Order 1996.

[39] Mark Sandford, ‘Briefing Paper: Local Government: alternative methods of service delivery’, (House of Commons Library, 9 September 2019), p11.

[40] Ministry of Housing, Communities and Local Government, Freedom of Information Response 7273673, (8 June 2020).

[41] If the contract value is at least £30,000 compared to £12,000 for central government. Cabinet Office, ‘Guidance on the Transparency requirements for Publishing on Contracts Finder’, (18 January 2023).

[42] Ministry of Housing, Communities and Local Government, ‘Homelessness code of guidance for local authorities’, (31 May 2024).

[43] JUSTICE, Lowering the Standard: a review of Behavioural Control Orders in England and Wales’, p.64, paras 3.69 – 3.80.

[44] Anti-social Behaviour Crime and Policing Act 2014, Part 3.

[45] Ibid., Part 4, Chapter 2.

[46] Ibid., Part 4, Chapter 1.

[47] See Manifesto Club, PSPOs: The use of busybody powers in 2022’, 2023; and JUSTICE, ‘Lowering the Standard: A Review of Behavioural Control Orders in England and Wales’, 2023

[48] Statutory Guidance published by the Home Office in 2014, was revised in 2017 to state that PSPOs “should not be used to target people based solely on the fact that someone is homeless or rough sleeping”, and that “particular care should be taken to consider how use of [CPNs] might impact on more vulnerable members of society”. The most recent version of the guidance was revised in March 2023 to remove this wording. See, Home Office, Anti-social Behaviour Crime and Policing Act 2014: Anti-social behaviour powers: Statutory guidance for frontline professionals’, 2023

[49] V. Heap, A. Black and C. Devany, ‘Living within a Public Spaces Protection Order: the impacts of policing anti-social behaviour on people experiencing street homelessness’, (Sheffield Hallam University, Helena Kennedy Centre).

[50] Crisis, ‘Crisis Reveals Scale of Violence and Abuse against Rough Sleepers, 23 December 2016;

[51] JUSTICE, ‘Lowering the Standard: a review of Behavioural Control Orders in England and Wales’, p.80, para 3.111.

[52] V.Heap, A. Black and C. Devany, ‘Living within a Public Spaces Protection Order: the impacts of policing anti-social behaviour on people experiencing street homelessness’, (Sheffield Hallam University, Helena Kennedy Centre).

[53]Ibid.

[54] JUSTICE, ‘Lowering the Standard: a review of Behavioural Control Orders in England and Wales’, pp. 50 – 60; paras 3.43 – 3.56.