Tools and guidance to help you understand, plan for and improve the health of people who are homeless in your area.
Do you understand the health needs of people who are homeless in your area?
Addressing health inequalities is a key priority for the NHS, Public Health teams and Clinical Commissioning Groups, but this is only possible with a robust evidence base. Despite having some of the highest and costliest health needs in our society, people experiencing homelessness are often overlooked when health and social care services are planned and delivered.
That’s why we launched the Homeless Health Needs Audit in 2010, to help commissioners and practitioners gather data on the health needs of people experiencing homelessness, and ensure the right services are in place to meet local demand.
New tools and a new way to explore the data
27 different local authorities have carried out audits over the past five years, analysing the health experiences and needs of more than 3,350 people.
Backed by Public Health England, we’ve updated the guidance to reflect changes to commissioning and health trends over the past few years. We’ve also published the combined findings from the audits carried out to date in these interactive charts.
What could the audit do for my area?
At a local level, the audit has been designed to enhance recognition of the health needs of homeless people in the commissioning process, filling in gaps left by local evidence gathering procedures such as Joint Strategic Needs Assessments.
The resources are free to use and open to anyone involved in planning, commissioning, or providing health services for people who are homeless.
It also offers and excellent opportunity to bring statutory and voluntary services together to develop responses to local priorities and address gaps in existing services.
For instance, data collected in the Leeds audit highlighted the need for improved access to TB screening. In response, the local authority and voluntary providers were able to introduce a new service specification for TB screening services at their no fixed abode practice.
Meanwhile in Wigan, the audit provided the evidence to show that people experiencing homelessness had poor access to GP services. Acting on this information, local partners introduced training for GPs to improve their awareness of homelessness and its causes. Part of this training involved creating clear lines of communication between GPs, the homeless health team and other local agencies.
The big picture
At a national level, the data collected from the audit has allowed us to gain a deeper understanding of the connection between homelessness and ill-health. For example, the latest Adult Psychiatric Morbidity Survey reports that 23% of the general population suffered from at least one psychiatric disorder during the previous year. By comparison, 44% of all respondents to the Homeless Health Needs Audit reported having being diagnosed with a mental health problem.
We have also been able to make some important distinctions between different groups within the homeless population. A particularly powerful finding reveals that although men report higher levels of drug use in general, women report higher levels of heroin, crack cocaine and benzodiazepine use. There is also a greater prevalence among homeless women of diagnosed mental health conditions like depression – 39% in women compared with 33% in men.
The new audit and guidance is now available to download from Homeless Link’s website. The resources are free to use and open to anyone involved in planning, commissioning, or providing health services for people who are homeless. The rest is up to you.