How the Health and Care Bill can ensure the NHS plays its part in ending homelessness

Chris Hicks, Senior Policy Officer

Today, amendments to the Health and Care Bill will be discussed in the House of Lords that Crisis, along with Pathway, St. Mungo’s, Groundswell, Changing Lives, Basis Yorkshire, Praxis, Refugee Council, Friends, Families and Travellers, and Doctors of the World, are supporting.

The amendments will help ensure that people who are homeless, or experiencing other forms of social exclusion, have the health services in place that meet their needs. Over the last twenty-two months we’ve all become acutely aware of our health and that to stay well having a home has never been more important.

We’ve also looked to the NHS and the wider healthcare system to keep us safe more than ever before – but for people without a roof over their head, staying healthy and being able to access the services they need to do this is near impossible.

For decades, people who are homeless have experienced some of the most damaging and completely avoidable differences in their physical and mental health compared to the rest of society.

The average age of death for people experiencing homelessness is desperately low - just 46 and 42 for men and women respectively, and challenges with accessing the health and social care services they need to stay well remain pervasive.

As a result, the number of people attending A&E without a home is six times higher than the general population; they are admitted to hospital four times as often, and end up staying three times as long.

On top of this, people are frequently unable to register with a GP because they don’t have proof of address or photo ID (despite NHS rules stating that GP services do not need to ask for these documents), leaving them unable to access help before their condition becomes more serious.

The challenges with having no home don’t stop there. Shame and stigma can prevent people from reaching out and the attitudes they experience when they do can be incredibly detrimental.

When people have to move constantly, it can be incredibly difficult to achieve consistency in their care and often healthcare professionals lack awareness of their specific needs. Simply put, the people who need healthcare the most face the most barriers to accessing it.

This must change and we have an opportunity to make this happen.

The Health and Care Bill

The NHS is currently going through a significant transformation. The Health and Care Bill is a new piece of legislation that reforms the delivery and organisation of the NHS, creating Integrated Care Systems that will oversee the bringing together of local organisations such as councils, the NHS and other partners like charities and community groups, to collectively plan healthcare services that will best meet the needs of their residents.

This joined-up tailored approach presents an opportunity to stop some of the most marginalised people in our society from experiencing harmful health inequalities and significantly poorer health outcomes.

But as it stands there is nothing in the legislation that will require our healthcare system to take steps to tackle and improve the health of people who need it the most, such as people who are homeless or facing other forms of social exclusion.

That’s why Crisis and partner organisations are urging the Westminster Government to amend the Health and Care Bill so that people experiencing homelessness and others excluded from society can access the services they need to stay well and are helped to do so.

The Bill provides a timely opportunity to finally cement that homelessness is a health issue. By paving the way for proper support, we can enable people to leave homelessness behind for good.

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