Homelessness is both a Housing and a Health Crisis
Homelessness is not only a housing crisis but also a health crisis, underlining the urgent need for solutions that go beyond housing alone.
Jan 93 min read
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Services for people who are homeless
Mildmay Hospital plays a crucial role in supporting people who are homeless.
We provide specialised inpatient care for those who are ‘stepped down’ from acute hospitals, and medical treatment and post-detox rehabilitation/stabilisation in a safe, recovery-focused environment.
Our unique care pathways are vital for people who sleep rough, live in hostels, or are at risk of returning to the streets.
People who sleep rough experience some of the starkest health inequalities in London.
The average age of death of a person who sleeps rough in England is under 50 years old.
People who sleep rough also experience higher levels of multiple, complex co-morbidities than other groups including substance misuse and physical and mental health problems.
Their lack of stable accommodation is a further barrier to engagement with treatment and healthcare which in turn creates a revolving door of homelessness, addiction, ill health and early death.
Rough sleeping is on the rise:
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The number of people estimated to be sleeping rough on a single night in autumn 2023 is 3,898, which has risen for the second year in a row but remains lower than the peak in 2017.
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The number of people estimated to be sleeping rough on a single night in autumn 2023 has risen by 27% since 2022. This is a decrease of 9% since 2019, which was before the introduction of COVID-19 related measures and is 18% lower than the peak in 2017. It is an increase of 120% since 2010 when the snapshot approach was introduced.
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The rate of people sleeping rough on a single night in England in 2023 is 6.8 people per 100,000. This has increased since 2022 (5.4 per 100,000), though remains lower than the peak in 2017 (8.5 per 100,000)
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Rough sleeping has increased in every region of England compared to the previous year.
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The largest increase in the number of people estimated to be sleeping rough is in London. Rough sleeping in the capital increased by 19% between March 2023 and April 2024 compared to the previous year. December 2024 data from Shelter revealed that one in 47 Londoners are currently homeless, and cases of homelessness have surged by 54% over the last decade..
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Nearly half (46%) of all people sleeping rough on a single night in autumn are in London and the South East, which is similar to previous years.
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A small number of local authorities have driven increases. Twenty local authorities (7% of all areas) drive over half the increase in the number of people sleeping rough on a single night. In just over two-fifths of local authorities (42%), the number of people sleeping rough decreased or stayed the same compared to 2022.
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The majority of people sleeping rough in England are male, aged over 26 years old and from the UK. This is similar to previous years.
Data from gov.uk
At Mildmay, we provide essential inpatient care for people who are homeless or at risk of homelessness, who are transitioning from acute medical treatment.
Our services offer a safe place for recovery, focusing on those who are most vulnerable and in desperate need of medical support.
This vital work is delivered alongside our long-standing commitment to HIV care, ensuring that all our patients receive compassionate, specialised treatment.
We offer inpatient rehabilitation care for people who are homeless or rough-sleeping, helping them safely recover after detoxification.
Our focus is on providing compassionate, recovery-oriented care in a safe environment for those who have been sleeping rough, staying in hostels, or are at risk of returning to the streets.
Patients are typically referred to Mildmay after completing detox treatment at acute centres in London, such as the Addiction Clinical Care Suite for homeless individuals at Guys and St. Thomas’s Hospital, one of our key partners in this programme.
Mildmay is a provider in the Pan-London Substance Misuse Programme, part of the Homeless Health London Partnership.
Feedback:
"Hey Team,
I just wanted to pass on some feedback from two patients today.
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Patient has said they are grateful, finally feels safe and appreciates the warm and friendly welcome to your hospital.
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Patient said the team were great, and they loved their time spent at the hospital (they didn't want to leave!)"
🙂
Homeless Health Lead Nurse
Out of hospital care
Central London Community Healthcare
Healthcare challenges of people who are homeless
People who are homeless experience some of the worst health problems in society. The longer a person experiences homelessness, particularly from young adulthood, the more likely their health and wellbeing will be at risk. Co-morbidity (two or more diseases or disorders occurring in the same person) among the longer-term homeless population is common.
34
times more likely to have tuberculosis
50
times more likely to have Hepatitis C
12
times more likely to have epilepsy
6
times more likely to have heart disease
5
times more likely to have a stroke
2.5
times more likely to have asthma
Goals and outcomes
Our aims are that:
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No rough sleepers die on the street
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No one is discharged from a hospital to the street
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There is equal and fair access to healthcare for those who are homeless.
Data courtesy of Pathway
Our purpose is two-fold
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To deliver better care and health outcomes for homeless patients
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To make more efficient use of all available health resources by freeing up NHS acute beds and providing medical respite/rehabilitation for this vulnerable cohort, improving the likelihood of a safe and full recovery.
Our funding
90% of funding for patients who are homeless is covered by NHS contracts and we depend on your help to secure the remainder to maintain our staffing, services and facilities.
Mildmay is a charity providing specialist services to the NHS, not an NHS or private hospital. We don't make a profit and all donations are invested in our patients, staff, services and facilities.
Help us secure the future of our UK hospital by developing our services for people who are homeless, so we can ensure equal and fair access to healthcare for all.
Less? is an informative film created by NHS England, Pathway UK, and Groundswell. It is about personal stories and journeys to health by people who have experienced and overcome homelessness.
Film-maker CJ Barton interviewed people with lived experiences of homelessness, sharing their stories with us, through the medium of film.
The film's website contains a discussion guide to help foster reflective discussions with friends, peers, or colleagues about homelessness, and we encourage you to share it with them.
There are also additional links and resources, and a feedback form to contact the film's makers.
While the tone of the film is optimistic, it does contain references to depression and suicide.
If you need help please contact 111, or speak to Samaritans on 116 123.
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