Health for people who are homeless

At any one time, hundreds of people sleep rough in the capital. Over a quarter of people sleeping rough in the UK are now in London. The numbers are rising, including other types of homelessness that are difficult to measure.

For example, hostel dwellers, sofa surfers and people in chronically insecure housing. Life expectancy for the homeless population is almost half that for the general population.

Our vision

Every homeless person should receive care that is consistent in quality and experience with that of the general population and bespoke to meet their specific needs, and the systems which support homeless people will be linked up to reflect the transitory nature of the population and support improved communication and outcomes across the system.

Key London challenges

Hundreds of people sleep rough in the capital every night and their numbers are increasing. Current systems of healthcare struggle to meet their needs and it is common for them to have a number of complex health problems – almost a quarter have physical health, mental health and substance use requirements. We also know that often the homeless find it difficult to manage their own health conditions due to their chaotic lives, low literacy, poor access and, regrettably, hostility from health professionals. The impact of this is clear with the average member of the homeless population expected to live for 43-47 years, compared to 80-84 for the general population.

Homelessness is a growing and significantly greater problem in London than elsewhere in England and recent studies have identified the impact this population can have on the system:

Homeless individuals use eight times more hospital inpatient services than other people of similar  age, and are 40 time more likely than members of the general public not to be registered with a GP

Of a sample of the homeless population, half of total acute care costs were incurred by 10% of people

This demonstrates that quality of life could be improved for this population group by earlier intervention and pro-active services as well as financial savings by changing the model of care. Vulnerability is a key issue in homeless services: both for service users themselves, such as being victims of violence and/or the lack of engagement with, and understanding from, mainstream services; and the often short-term funding for service providers. Furthermore, homeless people and rough sleepers are transitory, and so the issue is necessarily London-wide and more needs to be done with our partners, such as local government, to link programmes across London and mainstream services.

Despite affecting a relatively small population, homelessness is growing and reaches right across health, public health, social care and into related areas such as housing and the justice system.

The London Homeless Health Programme was established to address recommendation 31 of the Better Health for London report (2014):

Commissioning guidance to support London CCGs to improve health services for people who are homeless

We have worked with Pathway to create a training package for GP receptionists and practice managers

The 'right to access healthcare' cards aim to help people who are homeless to register and receive treatment in GP practices in London

This report tells the stories and experiences of healthcare from the perspective of people who are currently homeless across London.

Why health services need to be improved for people who are experiencing homelessness.