1. Restoring the Public Health Response to Homelessness HPM’s Meeting 18 th Aug 2015 Katy Hetherington – Programme Manager, Health Scotland Neil Hamlet – Consultant, Public Health Medicine, NHS Fife

2. The Task RestoringRestoring the …. ResponsePublic Heath Response to … Scotland.Homelessness in Scotland. –Prevention & Mitigation – Timely Opportunities: Housing Options approachesHousing Options approaches Health & Social Care IntegrationHealth & Social Care Integration ScotPHN is hosted by

3. Novel Approach ‘Do things differently – do different things’ Till – Sow – Nurture – Reap – (Repeat) Boundary Spanning & ‘Housing Speak’ ‘Started with the end in Mind’ –Stakeholder engagement –Literature review –Snowballing the passion –Presentations ScotPHN is hosted by

4. Results – intended & unexpected Insights into legislation, policy and practiceInsights into legislation, policy and practice Current on the ground experience from multiple perspectivesCurrent on the ground experience from multiple perspectives Heard ‘what needs to happen’Heard ‘what needs to happen’ Explored new opportunities with new partnersExplored new opportunities with new partners ScotPHN is hosted by

5. Early ‘wins’ Homelessness Prevention & Strategy Group – NHS presence and actionsHomelessness Prevention & Strategy Group – NHS presence and actions Awareness raising on back of NHS Fife’s HL1/SMR data linkage workAwareness raising on back of NHS Fife’s HL1/SMR data linkage work National roll out of data linkage approachNational roll out of data linkage approach Revision of HPHS CEL inequalities focus – homelessness action reporting requirementRevision of HPHS CEL inequalities focus – homelessness action reporting requirement Link to Commission on Housing & WellbeingLink to Commission on Housing & Wellbeing Housing Hubs Training Toolkit (health module)Housing Hubs Training Toolkit (health module) ScotPHN is hosted by

6. Further engagement.… Role of Police Scotland, VRU and Community Safety PartnershipsRole of Police Scotland, VRU and Community Safety Partnerships Criminal Justice, SPS and the ‘revolving door’Criminal Justice, SPS and the ‘revolving door’ Contribution of Social Work - IRISSContribution of Social Work - IRISS ADP angle on joint training / housing linksADP angle on joint training / housing links Housing Officer mindset – ‘statutory approach’Housing Officer mindset – ‘statutory approach’ Third Sector partnersThird Sector partners ScotPHN is hosted by

7. Key Learning Multiple Exclusion Homelessness – overlap with mental ill-health, substance misuse, offending and prison –Early childhood trauma –Visible homelessness happens late The contribution of housing to health and social care – importance of ‘home’ and environment (Place) High costs of ‘failure demand’ – to individuals, families, services and society ScotPHN is hosted by

8. So what next ? 1.NHS Board actions n=7 2.Scottish Government actions n=2 3.Health Scotland actions n=5 Discuss …..Decide …..Act ScotPHN is hosted by

9. In the Boards: Health Inequalities Strategies (include homelessness) LDP Returns (community planning, health inequalities, person-centred care and integration) HSCP – support housing & homelessness services within IJB remits (Housing Guidance Notes) HSCP Strategic Commissioning Process (include needs of multiply excluded including the homeless) By the DsPHs: DPH Champion for homeless and excluded groups Form a professional public health resource with housing and homelessness expertise Request Health Scotland to adopt workplan

10. Nationally: Reform a more strategic national lead group - to replace the current National Health and Homelessness Group HPHS 15/16 Reporting Requirements – to include section on homelessness work Data sharing between housing and heath – to roll out the pilot work in Fife linking HL1/Prevent1 data with NHS data Building the economic case for preventative MEH engagement By Health Scotland: Adopt a workstream for Homeless and Deep Exclusion community within HS Priorities and Workplan 2015/16 onwards Facilitate series of national and regional events Provide secretariat to National Heath & Homelessness Group

11. What Now....... Get the new Group up and running Launch a Scottish Faculty of Homelessness & Inclusion Health Rural event for Northern and Island Boards National event Peer-review pilots and voluntary roll out Work with SPS (and reducing re-offending agenda) Work with IRISS (form inroads into Social Work ) Work with JIT (support masterclasses for CPP events) Work with IAG (seeking for them to adopt Homeless as a ‘tangible’ community for policy and practice attention)

12. 'Houseless and Hungry' by Luke Fildes depicting homeless paupers queuing outside the casual ward of a London workhouse Meet needs of safety, nurture, belonging and purpose “We believe that health and homelessness services can work better together to ensure that an individual's health needs are identified and addressed as quickly as possible. NHS acute services currently bear the brunt of the health and other complex problems experienced by those who are homeless. A&E visits per homeless person are four times higher than that of the general public and over a quarter of those surveyed had been admitted to hospital in the previous six months” Rick Henderson, chief executive of Homeless LinkHomeless Link