College supports proposals for healthcare to play its part in tackling homelessness

College supports proposals for healthcare to play its part in tackling homelessness

Ahead of what may be a difficult winter for many, the College has backed proposals by the Scottish Government and COSLA for legal duties on local authorities and wider public bodies, including health and social care services, to prevent homelessness in Scotland.

It is widely acknowledged that there is often increased contact with health services before homelessness occurs and that struggles with mental health and addictions, experience of the criminal justice system and other factors are common ‘routes in’ to homelessness for those facing severe and multiple disadvantage.

People experiencing homelessness may have experienced poverty and trauma, including higher prevalence of adverse childhood experiences, including harm to their physical and mental health.

The Scottish Government and COSLA have proposed that a statutory duty be placed on the Health and Social Care Partnerships (HSCPs) to identify the housing circumstances of service users, and where necessary work with partners to ensure that service users are assisted into suitable housing or that a risk of homelessness is prevented.

In England, all NHS trusts have a duty to refer someone who is homeless or may be threatened with homelessness to a local housing authority of their choice. The person making the referral must make sure the person being referred consents to it, understands the purpose of the referral, and consents to information and contact details being passed on. Services must also ensure that their organisation has processes in place, and that those processes are understood by staff.

Commenting, Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said:

As the cost of energy, food, rents and mortgages continues to rise, the College is concerned that a significant number of people may find themselves homeless for the first time this winter in Scotland – and across the UK.

Yet in Scotland, there is no legal duty on wider public services – including healthcare services - to refer someone who is homeless or who may be threatened with homelessness to a local housing authority of their choice.

Healthcare workers regularly come into contact with people who are at risk of becoming homeless, or who are already homeless. Indeed, studies show that peoples’ use of health services peaks just before they make their first homelessness application. This includes A&E, where many of our Fellows and Members work.

As healthcare workers are deemed responsible enough to provide people with treatment, it is appropriate to expect that they are responsible enough to refer individuals and families to housing services within local authorities, should it become apparent that they require this. This must, of course, be done with the individual’s consent.

The College believes that, as is already the case in England, a legal duty for healthcare services to refer is a positive step that could help save lives and improve peoples’ quality of life – particularly ahead of what may be a difficult winter for many. Scotland is, in global terms, a wealthy country – nobody should be left homeless.