Local authority commissioners may be aware of Housing First. It is an approach that is evidenced to be highly successful in supporting people experiencing multiple disadvantage including long term homelessness, mental ill health, substance misuse and contact with the criminal justice system. It involves giving people an independent home and the intensive, open-ended support needed to help them to keep it.
Housing First is a cost effective intervention for this cohort of around 58,000 vulnerable people, who traditional services have usually struggled to support. It makes a real difference to their lives, giving them a stable home from which to recover, and a sense of belonging. It also benefits communities and the public purse, with evidence of cost savings compared to other services.
Despite these clear advantages however, currently only around 30 areas of the country deliver a Housing First service – meaning the majority of local authorities are without one.
At Homeless Link, we believe this needs to change. All local areas should consider establishing a Housing First service that is designed to fit the local context and address the specific needs of their community.
So why should you fund a Housing First project?
Firstly, there is a wealth of international research demonstrating that Housing First works. Our 2015 evaluation of nine services in England showed that 74% of residents across five services sustained their tenancy, indicating that it is possible to reduce entrenched and repeat homelessness, given the right approach. Furthermore, individuals recorded improvements in their physical and mental health, stabilisation or slight reduction in their substance misuse, and increased social integration.
While Housing First isn’t cheap, it is cost effective for the target client group while achieving better outcomes than most existing services. It reduces individuals’ repeated and sometimes inappropriate use of other services, including costly emergency medical services, as well as their rates of contact with the criminal justice system. It can also reduce their dependence on other services over time.
When compared to the high intensity supported housing that tenants might otherwise be accessing over the longer term, indicative research shows that Housing First also has the potential for direct annual cost savings of several thousand pounds per person.
Furthermore, there is certainly strategic relevance to establishing a Housing First service. As the holistic nature of the support improves outcomes across a range of areas, it will likely help meet the priorities which cut across a number of local strategies including homelessness prevention, health and wellbeing, and crime or neighbourhood renewal plans.
That there has been a steady increase in rough sleeping since 2010, alongside a reduction in funding for homelessness agencies, is certainly not news. On top of this, our research shows that 73% of services have turned people away because their needs were too high, acutely highlighting how those with the greatest needs are falling through the gaps of existing service provision.
Housing First can be part of the solution to this problem, working where other services don’t.
It will naturally be important to establish the need in your community and tailor a service to the local context in order to have a real impact. It may be that your focus is not on people known to homelessness services but on other groups experiencing complex needs, such as offenders, vulnerable women or care leavers.
For example, Oxford City Council have successfully used Housing First to support entrenched rough sleepers and are now looking at support a cohort with histories of repeat homelessness, whereas the Threshold service in Greater Manchester effectively supports women offenders.
Also exciting is that Housing First requires the creation of multi-agency partnerships at a strategic level, developing key local relationships that are likely to have benefits for service delivery more broadly, potentially increasing efficiency and effectiveness.
While most Housing First services are currently funded by councils through Housing Related Support, we believe opportunities exist to pool funding from various commissioners with a stake in the approach. Thurrock Housing First, for example, is jointly funded through housing, adult social care and public health.
While Housing First is not a panacea to end all homelessness, with such compelling benefits, we believe it should be made widely available as part of a suite of effective provision. Commissioners play a key role in this; many have told us they are considering Housing First as a more appropriate option for people in their community with the most complex needs, and we have published a range of practical guidance and resources to support teams to commission and deliver sustainable services.
In the context of continued funding cuts, we know that councils need to make difficult decisions. But recommissioning opens the door to innovation, and I hope that more funders will be inspired to bring about a culture change in service provision that works for individuals and communities alike.
Rick Henderson is chief executive of Homeless Link