Written evidence submitted by Crisis [RSL 001]

 

Crisis is the national charity for people facing homelessness. We know that homelessness is not inevitable, and we know that together we can end it. Crisis is dedicated to ending homelessness by delivering life-changing services and campaigning for change.  

Every year we work directly with thousands of people experiencing homelessness across England, Scotland and Wales, including through our seven England-based Skylight Services in Tower Hamlets, Brent, Croydon, Oxford, Birmingham, Merseyside and Newcastle. We provide vital help so people can rebuild their lives and are supported out of homelessness for good. We use research to find out how best to improve our services, and to find wider solutions to end homelessness for good. 

A safe and settled home is the foundation on which people can thrive and build a better future for themselves. Making sure that everyone has a safe and affordable home benefits us all, creating a stronger, more productive society where everyone can play their part.  Increases in the cost of essentials like food and energy, alongside record high private rents is both pushing more people into homelessness, and keeping people trapped in homelessness for longer. Analysis by Heriott Watt in 2023 for Crisis revealed that nearly a quarter of a million households across England (242,000) were experiencing the worst forms of homelessness, including sleeping on the streets, spending night after night on friends and families' sofas or stuck in unsuitable temporary accommodation like nightly paid B&Bs.[1] The impact of this housing emergency is starkly illustrated by a recent report has found that there is on average at least one child experiencing homelessness in every classroom in London.[2]

Crisis is also seeing this reflected in our own services. Last year, Crisis saw a 12% increase in the number of people approaching its UK services – this includes a 43% increase in the numbers of people approaching our Brent Skylight service for support and a 39% increase in our Merseyside Skylight.[3]

The annual rough sleeping snapshot for England for 2023 reported a 27% increase in the number of people sleeping rough in comparison to the previous year. The number of people sleeping rough is now 61% higher than it was ten years ago and 120% higher than when data collection began in 2010.[4]

In London, where we have more detailed and up to date data, we have seen the numbers of people being forced to sleep rough continuing to rise. In total, 4,780 people were seen sleeping rough in London from July to September 2024, an increase of 18% from the same period last year. The numbers of people sleeping rough for the first time in London also rose – 2,343 people were seen sleeping rough for the first time in July to September 2024, an increase of 12% from the same period last year. The number of people considered to be “living on the streets” rose 42% from the same period last year, with 681 people considered to be living on the streets longer-term.[5]

This reflects trends across England where we are seeing a rise in all forms of homelessness. In 2023/24, over 320,000 households faced homelessness across England – the highest on record and an increase of 8% on the previous year. This means that more than the population of Nottingham are now homeless in England.[6] The number of households in temporary accommodation provided by their local council in England is also at a record high – it rose to 123,100 households in June 2024. This is a 16% rise in comparison to the same time last year.[7]

Summary of key points

 

  1. What are the causes of rough sleeping?

In order to understand the causes of rough sleeping, we must look at the causes of homelessness overall. There are several factors driving the increase in homelessness and rough sleeping – the severe lack of social housing, sky high rents in the private rented sector which are set to increase further[8], welfare that doesn’t cover the costs of rent and gaps in support services. In addition, we know that relationship breakdown, poor physical or mental health, poverty and domestic abuse all contribute to homelessness. And our research shows that racism and discrimination also have a part to play in driving people into precarious housing conditions and homelessness. Underpinning this is the lack of suitable and truly affordable housing, whether that’s through private renting or social housing, which is ultimately making it harder for people to find somewhere to move to when they are facing homelessness. This also makes it extremely difficult for local authorities and homelessness services to help people find affordable, settled housing when they are homeless or at risk of homelessness.

Lack of social housing

Social housing is the most affordable option for people on the lowest incomes, including people who are homeless or at risk. However, over the last decade in England more social housing has been sold or demolished than built each year so the numbers of social homes available continues to decline. Between 2012/13 and 2022/23 a total of 93,875 social rented homes were delivered but 212,590 social homes were lost through sales and a further 58,772 were lost through demolition. This means overall there has been a net loss of 177,487 social rented homes over the past 10 years.[9]

Government figures show 1.287 million households are on social waiting lists in England, as of March 2023. Nationally, 5.5% of households are on a housing waiting list but some regions are feeling the pressure more than others. 6.5% of households are on social housing waiting lists in the North East and North West and 6.4% in Yorkshire and the Humber region.

In London the situation is especially dire, with over 61,000 households currently stuck in temporary accommodation arranged by London boroughs and over 320,000 London households are on social housing waiting lists.[10]

Unaffordable rents in the private rented sector

Rents have been steadily rising in recent years. This year, average UK private rents increased by 8.7% in the 12 months to October 2024. And in London the situation is even worse, with rents increasing by 10.4% in October 2024 since last year and the average rent price reaching £2,172 per month.[11]

The severe shortage of social housing means that for many of the people we support the private rented sector is their main option for moving out of homelessness. However, we are finding it increasingly difficult to find affordable homes in the sector.

The uprating of Local Housing Allowance (LHA) to cover the bottom 30% of local rents in April 2024 was welcome, however the impact of the interaction of LHA with the benefit cap, the shared accommodation rate for under 35s and the continued high demand for private rented sector properties mean issues with affordability remain a significant barrier to supporting people to move on from homelessness. And the Government’s announcement that LHA will be frozen again until 2026 means even more low-income households will struggle to afford rising rents.[12]

It is very challenging for people to sustain employment while they do not have a stable home and this means that many people we support are impacted by the benefit cap. The high cost of rents in many areas of the country also means that for people affected by the benefit cap, even rents at the LHA rate are unaffordable because by the time they have covered their rent, they are left with almost no income to cover their bills, food and other living costs. This is especially the case in London and other areas of the South of England where rents are high.

Finding an affordable home in the private rented sector is even more difficult for under 35s who are only entitled to the Shared Accommodation rate of LHA. This is designed to cover the cost of a room in a shared house but in reality it does not even cover this, and means the private rented sector is largely out of the reach of people under 35. Our services report that they often see properties that are advertised at the one-bed LHA rate but that do not meet the standards of space or quality that would reasonably be expected and are effectively actually a room in a shared house with access to shared kitchen facilities.

Gaps in support services that help people keep their home

Previously, funding for support services, including supporting people to access help with mental health and addiction, was ringfenced. In recent years, the removal of this ringfencing, alongside cuts to funding and increasing pressure on local authority services has meant there has been a lack of support services that people who are homeless or at risk can access.

We also see issues where different services pass responsibility between them, with the result being that people fall through the cracks. Our partners Pathway, a homeless health charity, note that this is often the case in relation to health. While pressures on public services is undoubtedly a factor in this, Pathway emphasise it is also due to a lack of systemic incentives to work collaboratively to address people’s homelessness and improving system collaboration would represent a more efficient way to address homelessness, including on prevention. A result of this current way of working is also seen in people being discharged from hospital onto the streets, an urgent issue Pathway is campaigning on. 

  1. Why has rough sleeping increased over the last few years?

On top of the underlying causes that have been building for years, there have also been recent shifts in the housing sector that have driven up rough sleeping and homelessness in the last few years specifically. These include insufficient support to prevent homelessness for people leaving state institutions like asylum accommodation, hospitals and prison and overstretched local authority Housing Options services that are increasingly struggling to deliver their statutory responsibilities. This has led to a lack of upstream prevention. There is also a growing crisis in the exempt accommodation sector, which is putting more people at risk of rough sleeping.

Failure to Prevent Rough Sleeping

Demand for Housing Options services is at unprecedented levels – in 2023/24 more than 320,000 households faced homelessness. This is the highest on record and is an 8% rise on the previous year.[13] Record numbers of households are in temporary accommodation, which is leading to spiraling costs for local authorities. Analysis from the LGA shows that the percentage of councils’ total housing budget being spent on homelessness and temporary accommodation has more than tripled since 2015. In 2015/16, 18% of councils' total housing budgets were allocated to homelessness, whereas in 2023/24 spending on homelessness now accounts for 60% of total housing budgets. This means councils have less money to invest in and run homelessness early prevention services, all too often, in practice this has meant that the Homelessness Prevention Grant is used for responding to people’s homelessness after they have already become homeless, which is not the intention of any level of government.[14] The District Councils Network have also highlighted that pressures on councils’ budgets are putting vital prevention services at risk.[15]

This reflects what we are seeing in our London services, where our services report that many local authorities are not fulfilling their statutory duties to support single adults experiencing homelessness. This is leaving some people with no option but to sleep rough, including people who should be found to be in priority need and therefore entitled to the full housing duty. These are the unintended consequences of a broken homelessness system which is failing to work for people experiencing risk of, or actual homelessness and which is operating on the brink of total failure, unless we can work together, with sufficient funding, to reorganise the way all parts of the system respond to people’s needs and create the necessary system-change towards housing-led prevention of homelessness.

Further, while local authorities are contending with an array of issues, we are also aware that many of the people we are supporting are struggling to access face-to-face assessments, and there has been a significant shift since the covid-19 pandemic for our frontline staff spending significant amounts of time trying to get through to local authority housing options team on the phone. This is resulting in people failing to get help when they need it and sometimes forced to sleep rough and we try to get them access to the support they are entitled to. We are asking Government to instruct local authorities to return to face-to-face assessments for homelessness so that people can be supported as quickly as possible.   

There is evidence that one reason for the increase of rough sleeping over the last few years is the consequence of these wider homelessness pressures. In London, CHAIN figures show typically over 70% of those who present as new to rough sleeping only have one bedded down contact and over 80% of those leave the streets after that single contact without an accommodation offer and are not seen sleeping rough again. This suggests that people may be moving into other forms of homelessness and/or exploitation after being seen by outreach teams and highlights the importance of investing in support services to help people keep their home and prevent them from becoming homeless in the first place.

People being discharged from public institutions into homelessness

Across our services we’ve seen a sharp increase in the numbers of people approaching us for support after leaving asylum accommodation, with particularly significant increases across London. For all our services it’s been a real challenge to find suitable housing for people because of high rents in the private rented sector and the severe shortage of social homes.

Over the last year (July 2023 to July 2024) 3,709 people approached one of our three London Skylights for the first time. 52% (1,929) were sleeping rough when they first came to us for support. Over the same period, 1,661 people received intensive 1-1 support from one of our lead workers. 40% (675) of these were people with refugee status. Many will have come to us immediately upon having been evicted from asylum accommodation with nowhere to go.

After receiving a decision on their asylum claim, newly recognised refugees are given only 28 days before they are evicted from their Home Office accommodation and their financial support ends. This is simply not enough time for people to move onto mainstream benefits, find work and find somewhere new to live. For many years, the short “move-on” period, lack of support and failure of coordination between statutory services has led to newly recognised refugees struggling to find housing, secure a job or apply for welfare benefits in time, and the pressures are exacerbated when the Home Office makes a high volume of decisions.

The Government’s recent decision to temporarily extend this time to 56 days is very welcome and will give people and the services supporting them more time to find housing before their asylum support ends, helping to avoid people being unnecessarily forced into homelessness. Alongside this change, it remains vital that people have access to meaningful support to help them to find settled housing and to access benefits, employment and any other support services they may need to avoid homelessness and be able to start a new life.

As a result of the backlog clearance that took place under the previous government, according to data from the Ministry for Housing, Communities and Local Government, in the twelve months before the general election, there were 21,650 households in need of homelessness assistance when leaving Home Office accommodation in England. That compares to 6,190 households over the same period a year earlier (a 250 per cent increase). A year on, and there was an 84.6% increase (from the same time last year) in households owed a prevention duty who had a requirement to leave Home Office provided asylum accommodation.[16]

This has also led to increase in the numbers of new refugees who are forced to sleep rough after having to leave accommodation provided by the Home Office. Data from London Councils, which represents boroughs in the capital, shows that in January 2024, 311 people were forced to sleep rough in London after leaving Home Office accommodation, up 41% from November 2023 and 117% from October 2023. Far too many refugees face homelessness just weeks after getting a positive asylum decision, and there are likely to be some people whose experiences are not captured by the official statistics.[17]

Emerging crisis in the exempt accommodation sector

For many people under 35, the only viable housing option is some form of supported accommodation – even for those who do not have support needs. However, an emerging crisis in the exempt accommodation sector is leaving people facing eviction and at risk of rough sleeping.

When delivered well, supported housing provides good quality transitional housing that enables people to move on from homelessness. However, despite the good work of many providers, gaps in regulation and oversight have let rogue operators enter the market, leaving tenants receiving little or no support and at worst at risk of serious harm.

The Supported Housing (Regulatory Oversight) Act (2023) was passed with cross-party support to bring an end to poor practice and the exploitation of the Housing Benefit rules in the supported housing sector. It enables government to introduce regulations that will create a licensing regime and National Standards for supported housing. But more than a year on from the passage of the Act, we are still waiting for consultation on the implementation of these measures. This has left a policy vacuum which is putting people at risk of homelessness. 

Crisis and other homelessness charities are seeing the people we support put at risk of homelessness because of the way some local authorities are investigating the adequacy of support services in housing funded by exempt Housing Benefit. In these cases, we are seeing local authorities suspend Housing Benefit payments for protracted periods of time, leaving supported housing providers unable to operate. This is putting many supported housing projects at risk of closure and has already caused some services to close, leaving local charities trying to support and rehouse the people made homeless because of this, many of whom have significant vulnerabilities. For example, in one case a landlord providing supported housing for over a decade has had Housing Benefit stopped by a London Borough while it ‘investigates’ the service, resulting in the threatened closure of 110 units of supported housing.

This means that the supply of exempt accommodation is drying up further limiting the already scarce supply of accommodation for people who have experienced or are at risk of rough sleeping. Combined with the pressures highlighted above which are pushing more and more people into homelessness, there is a risk that many more people will face the harm of rough sleeping as we go into winter.

We recognise that to stop malpractice. We are concerned, however, that even where intervention is justifiable, local authorities are not always supporting residents effectively, which puts people at real risk of homelessness. 

To prevent people from being needlessly made homeless and good providers leaving the sector we are urging the Government to urgently write to all councils to provide clarification around the current approach to enforcing standards in the sector asking them to ensure that:

 

  1. How do we end rough sleeping for good?

Crisis warmly welcomes this Government’s commitment to get the country on track to ending homelessness and we know that with the right strategy in place it will be possible to reverse the extremely worrying trends we are currently seeing and make all forms of homelessness a thing of the past. The Government have already taken steps towards this, and we welcome the establishment of the Inter-Ministerial Group for Ending Homelessness and Rough Sleeping, chaired by Deputy Prime Minister and Secretary of State Angela Rayner; the reforms to the planning system to prioritise the delivery of more social homes; and the introduction of the Renters’ Rights Bill to swiftly end Section 21 evictions.

To support the Government to deliver on this commitment, we would urge the committee to extend the focus of this inquiry to include wider forms of homelessness. Rough sleeping is closely associated with other forms of homelessness in so far as people may end up facing rough sleeping after having experienced other forms of homelessness such as sofa surfing or living in unsuitable temporary accommodation. We know from efforts to tackle rough sleeping from previous governments that focusing on rough sleeping alone is not sufficient and to have a sustainable impact it is essential to focus on the wider factors driving people into homelessness in the first place. Without linking efforts to tackle rough sleeping to wider forms of homelessness, we ultimately miss tackling these broader factors and do not reduce the numbers of people who are end up being forced into rough sleeping.

We strongly welcome the Government’s commitment to deliver a Cross-Government strategy on homelessness and the steps they have already taken towards this, including the establishment of the Inter-Ministerial Group and the establishment of an Expert Group on Homelessness and Rough Sleeping, which Crisis sits on. To be successful it is essential that the strategy is truly cross-Government and has appropriate senior level buy-in across Departments, particularly those with responsibility for groups at higher risk of homelessness such as care leavers, prison leavers, people leaving Home Office accommodation and people being discharged from hospital. It is also vital that the Government’s homelessness strategy is closely linked to the long-term plan on housing. We ultimately won’t end homelessness without the homes to do so. The Government’s ambitions on housing and the steps taken in the budget to start funding social housing are incredibly welcome, but a key measure of success must be tied to reducing levels of homelessness in this country.

The Cross-Government strategy should set out a clear vision of what the Government is hoping to achieve on homelessness and be underpinned by a clear outcomes framework that sets out the actions and outcomes for each relevant Department to contribute to achieving that vision. We also believe the principles underpinning the strategy should be that it is informed directly by people with lived experience and it is evidence-based. The long-term solutions to homelessness are well known, and the strategy should not shy away from being ambitious. Based on the evidence, we therefore think the strategy should be focused on three key themes:

Provide access to settled housing as quickly as possible

To tackle homelessness successfully we need to rethink the way we respond to homelessness. Making temporary accommodation genuinely temporary and reducing, not increasing, the role it plays in our homelessness system should be at the heart of this. This means focusing on what more can be done to address the lack of access to genuinely affordable, settled homes in both the social and private rented sectors and ensuring that people who are at risk of homelessness can access these homes.

We must act with urgency to address the current situation but also with a view of what can be achieved longer term. As a first step, the Government must rapidly increase the supply of genuinely affordable settled housing available to people who are currently facing homelessness – this could include targeted funding for local authorities to bring long-term empty homes back into use to meet local housing need and for a targeted housing conversion programme that would enable councils and social housing providers to acquire existing private rented homes to convert them to more secure and affordable social housing. In addition, by extending priority need to people who are currently or at imminent risk of rough sleeping we can ensure people can access support quickly to move into a settled home.

We also need to see a long-term plan backed by sufficient investment to deliver new homes for social rent to meet current and future need. Research commissioned by Crisis and the National Housing Federation shows that we need an additional 90,000 social rented homes per year for the next 15 years to end homelessness.[18] And we must ensure that a higher proportion of social homes are allocated to people experiencing homelessness. Currently just 25% of new social lettings in England go to people who are homeless.

There is strong evidence to support the development of a housing led response to rough sleeping, based on evidence of the benefits for individuals of providing settled housing as a response to end their homelessness, rather than the expectation that people will spend time in hostels or other forms of temporary or transitional accommodation.[19]

The Government should be building on and expanding cases of best practise where there have been well evidenced reductions in rough sleeping and homelessness, including prioritising the national roll out of Housing First. The evidence for the effectiveness of this approach has been well established through regional pilots in Greater Manchester, the West Midlands and the Liverpool City Region, adding to the already strong existing evidence base from both the UK and internationally.

Housing First provides people facing the most complex challenges with rapid access to stable ordinary housing from where their other support needs can be addressed. Instead of a requirement to prove tenancy-readiness, clients must simply agree to maintain a tenancy, and they then receive coordinated and intensive support for as long as it is needed. This approach is underpinned by a set of operational principles that are grounded in evidence of what works and it has been shown to be the most effective response for people who have been sleeping rough for long periods and who have more complex support needs.

Housing First is one example of a housing-led approach to homelessness, which supports people to access settled housing as quickly as possible. This type of approach is being adopted in Scotland and Wales and Andy Burnham in Greater Manchester is taking a similar approach through the newly announced Housing First Unit, which aims to tackle the roots of the housing crisis and reduce reliance on temporary accommodation.

A substantial minority of people who sleep rough have low to moderate support needs and do not require the intensity of support provided by Housing First, though they would still benefit from a housing-led response for the following reasons: 

To be successful it is key that access to settled housing is provided alongside an appropriate level of support to meet each person’s needs, help them to sustain their accommodation and reduce the chance of them becoming homeless again in the future.

Ensure people have the support they need to keep their home and move out of homelessness as quickly as possible

We need to build a system where no one faces homelessness alone, because they can’t access support. Previously, funding for support services, including supporting people to access help with mental health and addiction, was ringfenced. In recent years, the removal of this ringfencing, alongside cuts to funding and increasing pressure on local authority services has meant there has been a lack of support services that people who are homeless or at risk can access. We need to rebalance this so help is available for people to rapidly get back on their feet if they face homelessness.

Rolling out Housing First nationally would help move people out of homelessness as quickly as possible. As well as the importance of providing people with secure and stable homes from which to rebuild their lives. Housing First provides intensive, person centred, holistic support that is open ended and it doesn’t place conditions on individuals. Crucially, this support is trauma informed and responsive to individual's needs. It’s proven to be incredibly effective at housing people that have struggled to be housed in the past under more traditional outreach programmes. However, while Housing First delivers positive outcomes for most people, evidence shows that Housing First does not work or is not the preferred choice of a minority of people with complex and overlapping support needs.

In Scotland, research has been undertaken to assess the forms that longer term supported housing should take, which concluded that the Government should take steps to ensure there is a supported housing offer for people experiencing homelessness who expressly do not want (or have not sustained) mainstream housing, including Housing First, and for young people who want to stay in shared and supported housing on more than a temporary basis. Crisis recommends that the Government should conduct further research if deemed necessary and consult on the extent to which suitable housing and support options are available for people with high and complex support needs and commission specific provision accordingly.

It is also vital that housing-related support is available for people with low to moderate support needs to ensure they have the support they need to sustain their tenancy. The impact of the end of the Supporting People ring fence and reductions in local authority spending on homelessness services and housing related support is well documented, but regrettably we are again this year seeing local authorities planning to cut back further on this non-statutory area of spending. This includes cutting back on services to help people not in priority need with the cost of deposits and rent in advance, which is vital to help people access homes in the private rented sector and move out of homelessness.  

Crisis has been calling on national government to restore ring-fenced funding for support services that help people in mainstream housing sustain their tenancies and to protect the viability of specialist supported housing for those who need it. It is critical that a restored budget for housing related support encompasses and goes beyond the support funding delivered through current homelessness service funding streams and prioritises floating support so the majority of people can live in mainstream, genuinely affordable housing.  

Prevent homelessness from happening in the first place

To achieve and sustain an end to homelessness, we need to fix the system for the long term so that wherever possible we are preventing people from becoming homeless in the first place. That means embedding prevention across all parts of government and redesigning systems so that they are robust enough to work for everyone. This will only be possible by taking a truly cross-government approach that thoroughly considers the impact of health, housing, welfare, immigration and justice policies on homelessness.

To keep people in their homes, we need a welfare system that protects everyone from homelessness by making sure welfare levels are connected to the real costs of essentials, including housing, and that opportunities to intervene early and prevent homelessness are not being missed when people have contact with the welfare system. The most effective action the Government could take in this area would be to uprate Local Housing Allowance so that it covers at least the bottom third of rents in a local area and scrap the benefit cap, or at a minimum review the level of the cap so that it does not cause anyone to be at risk of homelessness or prevent anyone from moving on from homelessness.

The impact of Home Office policies is evident in the high rates of migrant homelessness we see across the UK but particularly in areas like London. We’re seeing migrants who may be struggling to rent privately due to the Right to Rent scheme, who are rough sleeping due to having No Recourse to Public Funds and newly recognised refugees who are facing homelessness after leaving asylum accommodation.

To reduce the negative impact of Home Office policies on homelessness, the Right to Rent policy should be abolished because of how it encourages racial discrimination, even amongst those who have British citizenship. A High Court ruling in 2019 declared the policy unlawful and halted its roll-out beyond England. The penalty on landlords for failing to comply with right to rent checks can be up to £10,000, making it even more likely that in a competitive rental market landlords will avoid renting to people who they think might not have the right to rent. This leads to landlords refusing to rent to migrants with the right to live in the UK and British people of colour, based on their name and race.

The Government’s recent decision to temporarily extend the move on period for new refugees to 56 days is very welcome and will give people and the services supporting them more time to find housing before their asylum support ends, helping to avoid people being unnecessarily forced into homelessness. We urge the Government to make this change permanent, to bring it in line with the time local authorities have to support people who are facing homelessness. Alongside this, it remains vital that people have access to meaningful support to help them to find settled housing and to access benefits, employment and any other support services they may need to avoid homelessness and be able to start a new life. It is also vital that local authorities are always notified by asylum accommodation providers when someone is due to be evicted and people receive all of the documents relating to their new status and the ending of their asylum support and accommodation at the same time.

In Brent, Crisis delivers a Single Homelessness Prevention Service for refugees, which is commissioned by the council. This service works with people who have been granted asylum. The SHPS team accept referrals for people who have at least 20 days before they are evicted, in order to prevent them being evicted into rough sleeping. This 20 day period prior to eviction is intense (and still too short) as staff must ensure that clients have bank accounts and Universal Credit in order to secure a tenancy upon leaving the hotel. Beyond housing, staff also provide integration support such as supporting clients to register with a GP, as well as providing housing sustainment support for 8 months after housing has been secured.

And we know that No Recourse to Public Funds (NRPF) is also contributing to migrant homelessness, as people fall through the cracks and aren’t able to access any government support with housing costs. At Crisis, we believe no one should be homeless due to their immigration status, and that the Government must ensure that policies like NRPF are not contributing to homelessness across the UK nations. Having people sleeping rough with NRPF ultimately puts further strain on local services and makes it harder for them to secure housing for people in need.

Critical Time Intervention (CTI) is a model which supports people who are vulnerable to homelessness during periods of transition such as when people leave prison, hospital or asylum accommodation. It provides access to permanent housing alongside intensive, time-limited support to help people settle into their home and access mainstream support services. Crisis is piloting this intervention in relation to prison-leavers in Liverpool and Wales. Transition periods can be extremely challenging for anyone, including people at risk of homelessness, and yet, with proper support can provide an opportunity to secure a permanent housing solution for someone and help them build foundations for lasting support in the community. Where people are released from prison without a stable home, our CTI teams support them to navigate through systems and access housing and support, linking them back into communities and identifying priorities to reduce the risk of reoffending and returning to prison.

The Pathway model to prevent hospital discharge into homelessness is an effective approach to supporting people who are homeless, helping to prevent them being discharged to the streets, and connecting them with local services, such as a GP, to ensure that their health needs are supported. This model of support brings together multi-disciplinary services to avoid discharges onto the street. Discharging people from hospital into homelessness is as catastrophic for a person’s health as it is inefficient for the NHS, contributing to the revolving door of hospital readmissions. Pathway teams have been shown to be cost effective and to improve health outcomes for patients experiencing homelessness.

There are already examples of services providing intermediate care for people experiencing homelessness, or step-down accommodation, in London in conjunction with Pathway teams. These provide short-term care and support to help people recover when discharged from hospital, connecting them to accommodation, and avoiding unsafe discharges. Core components include a focus on recovery (with access to medical intervention), personalised support (i.e. support to attend appointments, make welfare applications), and coordinated planning to enable access to appropriate housing with support (i.e. Housing First). For example, 91% of patients referred to Lowri House, an intermediate care service commissioned by North East London ICB, had positive outcomes upon leaving (i.e. didn’t return to the street). Wider analysis shows that specialist hospital teams reduce rough sleeping on average by 50%, with the most successful by up to 82%.[20] One intermediate care project in Salford achieved a 100% decrease in people returning to rough sleeping following hospital.[21]

We’ve had success locally in our Brent Skylight with Built for Zerowhich is a way of working that uses information from local communities to build solutions that work for them. By involving more partners, including health services and non-statutory services, and collecting more detailed information about the people experiencing homelessness in an area it enables services to identify what system level barriers are preventing people from moving on from homelessness.

 

December 2024


[1] Homelessness Monitor 2023 | England | Crisis UK

[2] London Councils, ‘Emergency’ warning issued as London homelessness hits new records, 24 October 2024

[3] https://www.crisis.org.uk/about-us/crisis-media-centre/national-homelessness-charity-preparing-for-incredibly-difficult-winter-as-more-and-more-people-seek-urgent-support/

[4] Rough sleeping snapshot in England: autumn 2023 - GOV.UK

[5] Rough sleeping in London (CHAIN reports), updated 31 October 2024

[6] Statutory homelessness in England: financial year 2023-24 - GOV.UK

[7] Statutory homelessness in England: April to June 2024 - GOV.UK

[8] https://www.bbc.co.uk/news/articles/c77j4774ykyo

[9] Crisis press release, Over 12,000 social homes lost last year, as over one million households remain trapped on council waiting lists, 8 February 2024

[10] Social housing lettings in England, tenants: April 2022 to March 2023 - GOV.UK

[11] Private rent and house prices, UK - Office for National Statistics

[12] Low-income renters will struggle after UK housing benefit freeze, experts warn | Housing benefit | The Guardian

[13] MHCLG, Statutory homelessness in England: financial year 2023-24

[14] LGA, Councils' budget set aside for homelessnesshasmore than tripled in the last eight years, LGA warns, 1 July 2024

[15] Four-fifths of councils running out of accommodation for homeless people | District Councils' Network and “The last thing we want to do is to scale back preventative and value-adding services” – DCN Response to the local government finance policy statement | District Councils' Network

[16] Statutory homelessness in England: April to June 2024 - GOV.UK

[17] Hundreds of refugees sleeping rough in London amid ‘dramatic spike’ in homelessness | London Councils – Home

[18] National Housing Federation - Let’s fix the housing crisis

[19] Mackie,P., Johnsen, S., and Wood, J. (2017) Ending rough sleeping: what works? An international evidence review. Crisis: London

[20] Breaking The Cycle: Improving Hospital Care and Discharge for Patients Experiencing Homelessness – The Pathway Partnership Programme Annual Report 2022-23 – Pathway

[21] Salford Pathway team: first year report – Pathway