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Rough sleepers: access to services and support (England)

Published Friday, March 9, 2018

Rough sleepers are one of the most vulnerable groups in society, many with high levels of complex and interrelated needs. This paper provides an overview of the support and services - including accommodation, health, welfare, training, employment and voter registration - that are available for rough sleepers in England, and the challenges rough sleepers can face in accessing them.

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The number of rough sleepers in England is increasing. In autumn 2017 there were an estimated 4,751 people sleeping rough, an increase of 169% since 2010. Many rough sleepers have high levels of complex needs; mental health problems, drug and alcohol dependencies, and institutional experiences are common factors. The longer someone sleeps rough the greater the risk that physical and mental health problems will worsen. Rough sleeping is costly to society as a whole; rough sleepers are likely to have more frequent and sustained contact with public services compared to other citizens.

Access to accommodation

Local authorities have a statutory duty to provide advice and assistance to homeless people who are not in priority need in order to help them find accommodation. However, there is evidence of inconsistent standards in the advice and assistance provided. Some commentators have called for greater monitoring of local authority homelessness services. The Homelessness Reduction Act 2017, which comes into force in April 2018, will place new duties on local authorities to intervene earlier to prevent homelessness.

A number of initiatives to address rough sleeping have been rolled out nationally, including: No Second Night Out (NSNO), Streetlink and Reconnection. The Government is investing:

  • £20 million to support innovative ways to prevent and reduce rough sleeping;
  • £10 million to develop a national Rough Sleeping Social Impact Bond; and
  • £28 million to pilot the Housing First approach for long-term rough sleepers in three areas.

The Mayor of London has also put in place a range of measures intended to improve rough sleepers’ access to services and support in London, including a ‘No Nights Sleeping Rough’ taskforce and guidance to improve the provision of emergency accommodation in severe weather.

The voluntary sector and the Church play a key role in providing emergency and temporary accommodation for rough sleepers, although there is significant local variation in provision and access criteria. In 2016 there were around 1,185 accommodation projects in England for single homeless people.

Local authority and voluntary sector homelessness services are under pressure due to increasing demand for services and decreasing funding. Broader factors, such as a lack of affordable housing and welfare restrictions, are also having an impact. Furthermore, homelessness organisations have expressed concern about the future sustainability of supported housing funding.

Access to health services

Rough sleepers face particular health issues associated with homelessness and challenges in accessing health and dental services. It has been estimated that homeless people consume around four times more acute hospital services than the general population.

Health services and local authorities have a number of tailored services that are intended to meet the specific needs of rough sleepers, although provision varies across England. In London the NHS has taken steps to address the increase in tuberculosis (TB) amongst rough sleepers.

Concerns have been raised about the lack of suitable, specialist mental health support for rough sleepers. The Communities and Local Government (CLG) Select Committee called on the Government to develop an action plan to address the mental health needs of homeless people, including rough sleepers.

Access to welfare benefits

Rough sleepers may, depending on their circumstances, be able to claim mainstream social security benefits such as Jobseeker’s Allowance (JSA) and Employment and Support Allowance (ESA). More rough sleepers will come under the Universal Credit system as roll-out of UC “Full Service” continues.

There are “easements” that acknowledge that homeless claimants may face difficulties meeting the usual conditionality requirements for benefits – such as jobseeking. Nevertheless, concerns have been raised about the high rate of benefit sanctions amongst homelessness service users, and the impact of sanctions.

Local welfare assistance schemes may also provide assistance to rough sleepers, although schemes vary considerably in their scope and eligibility criteria. A National Audit Office report in January 2016 highlighted uncertainties over the future of local welfare provision due to pressures on funding. A 2016 report by the Work and Pensions Committee concluded that central and local government should co-ordinate better to fill gaps in the welfare safety net.

Food Assistance

A wide range of Church and other voluntary organisations (estimated to number more than 1,500) provide food assistance to those in need. Assistance may range from a hot meal provided by a ‘soup kitchen’ to a food package provided following referral to a ‘food bank’.

Training and employment

Rough sleepers, particularly those with high support needs, face huge challenges in gaining employment. Nevertheless, St Mungo’s homeless charity has reported that 80% of their clients said that work was one of their goals.

The Ministerial Working Group’s report Addressing complex needs: improving services for vulnerable homeless people (March 2015) highlighted some of the actions the Government has taken to support vulnerable homeless people into or towards work. Claimants sleeping rough may be able to get help to address specific barriers to moving closer to or into work through the Jobcentre Plus Flexible Support Fund (FSF). Many homelessness organisations, day centres, and hostels also provide employment advice, training and opportunities for homeless people.

Registering to vote

A rough sleeper with no fixed address who is eligible to vote can register to vote through a declaration of local connection. The Labour Party has urged the Government to do more to enable and encourage homeless people to vote.

The House of Commons Library briefing paper Rough sleeping (England) (02007) provides background information on the problem of rough sleeping and examines Government policy on this issue. Separate briefing papers cover Statutory homelessness in England (01164) and Homelessness: Social Indicators (02646). There are now significant variations in approaches to homelessness across the UK – these variations are outlined in Comparison of homelessness duties in England, Wales, Scotland and Northern Ireland (07201).


Commons Briefing papers CBP-7698

Authors: Hannah Cromarty; Neil Johnston; Steven Kennedy; Alex Bate

Topics: Benefits administration, Benefits policy, Health services, Homelessness, Mental health

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