Delivering health and care for people who sleep rough: going above and beyond

  • People who sleep rough have complex and multiple health and care needs that all too often are not met. They have some of the worst health outcomes in England.

  • The NHS alone cannot reduce poor health outcomes for people sleeping rough. Tackling rough sleeping involves improving people’s health, social wellbeing and housing situation as well as supporting them to find long-term solutions.

  • As part of current government efforts to reduce rough sleeping, there is a focus on improving health care for people sleeping rough. Our research explored how four different local areas are delivering effective health and care services to people sleeping rough and what other areas might be able to learn from them.

  • We found five shared principles that the four areas had in common. We think that any area can make progress if it: takes steps to find and engage people sleeping rough; builds and supports its workforce to go above and beyond existing service limitations; prioritises relationships; tailors the local response to people sleeping rough; and uses the full power of commissioning.

  • Local leadership is vital to crafting an approach that is relevant to a local place and population. Leaders need to model positive relationships and effective partnership working across a range of different organisations.

  • All the relevant government departments need to build on positive examples of cross-departmental working with secure, longer-term resources both for their own work and for local areas to plan and provide services effectively and sustainably. Guidance is important but so too is supporting local areas to learn from each other.



The Kings Fund – March 2020