Homelessness upon Discharge from Public Institutions

The Co-Chairs of the APPG for Ending Homelessness, Bob Blackman MP and Paula Barker MP, along with 46 other parliamentarians, have written to Government urging them to take action to prevent vulnerable people falling through the cracks and becoming homeless after being in the care of public services such as hospitals, prisons and asylum accommodation. 

This follows a meeting of the APPG in December 2023 to discuss this deeply concerning trend, where we heard from charity representatives across the homelessness sector, a clinician working in our healthcare system, and people who had direct experience of homelessness after being under the care of a public institution. 

Too often people who are without a safe and secure home, who are facing or experiencing homeless come into contact with or into the care of public institutions, such as the NHS, prison services and Home Office accommodation. This should be an opportunity for public services to address their risks of homelessness, but instead people are then are discharged into unsuitable forms of homelessness accommodation or onto the street.   

For example, people facing or experiencing homelessness access hospitals disproportionately, six times more often than the mainstream population, because of their difficulty in accessing primary care and other health support services. Hospitals therefore provide an important opportunity to engage people who are experiencing homelessness. A hospital admission is a key prevention opportunity to link people into wider services such as housing, drug/alcohol treatment, and social care. 

Homeless Link’s Health Needs Audit, which surveyed the experiences of people who are homeless, found that 24% of respondents who had had contact with acute care were discharged from hospital onto the streets and a further 21% were discharged into accommodation which was not suitable for their needs. This is all while presentations to hospital from people experiencing homelessness are increasing - 78,000 hospital visits were recorded in England in the past year from patients with no fixed abode, one every seven minutes and a 37% rise in four years.   

Similarly, statistics show that around 50,000 people are released from prison each year and that 1 in 3 are released into homelessness or unknown circumstances. In 2021, more than half of prison leavers were released without settled accommodation. This is deeply worrying, as people who are released from prison without somewhere safe to stay are around 50% more likely to reoffend, often as a means of avoiding homelessness, meaning they are not receiving the support needed to help them leave homelessness behind for good.   

And non-UK nationals are more vulnerable to homelessness than the general population.  The profile of people accommodated in emergency accommodation at the height of the pandemic showed that 32% were non-UK nationals, rising to 56% in London. People in asylum accommodation are particularly vulnerable to homelessness. Thankfully, since the APPG meeting, the Government has listened and has reversed the recent changes to the move-on period that were resulting in increased numbers of refugees with newly granted status ending up on the streets. Though we know that more can be done to reduce the risk of homelessness further. 

Hospitals and prisons have a statutory duty from the Homelessness Reduction Act to refer people they identify as at risk of homelessness to the local authority, in order to prevent incidences of homelessness, though a recent report by Crisis and Pathway found that this duty is not always working as effectively as it could be.  

The APPG has requested a cross-departmental Ministerial Roundtable to share this evidence with Ministers and explore Government commitments to: 

1. Preventing people from being discharged from hospital onto the streets, by ensuring that hospitals and housing services work together to support people to secure a housing outcome upon discharge and utilising multi-disciplinary health teams.  
2. Ensure no one is released from prison without safe and settled accommodation to go to, which requires Government to adopt a resettlement framework with minimum standards of support for each prison leaver and ensure that local authorities, probation services and charities are working effectively in a multi-agency capacity to implement housing solutions in a consistent way.    
3. Break the link between homelessness and the asylum system, including by allowing 56 days following an asylum decision before the cessation of support and accommodation and extending the Duty to Refer to Home Office asylum accommodation.