Addressing health inequalities in homeless children, young people and families learning resource and toolkit.
Reducing inequalities of homeless families
Caroline Bernard, Homeless Link and Emma Rigby, Young People’s Health Partnership
Our brief was to co-produce a toolkit and a learning resource for public health nurses i.e. health visitors and school nurses, to improve knowledge and understanding of this vulnerable group, and support more positive outcomes by spotting children, young people and families at risk of homelessness.
We wanted to ensure that we worked in an inclusive way, by taking a wide definition of “family” when putting together a group of partners for this project. We considered the needs of same-sex couples and single parents, migrant and refugee families, young homeless people, and people, be they parents or children, with both learning and physical disabilities. Health and Wellbeing Alliance partners that joined us to provide specialist knowledge and advice were Maternity Action, Win Win Alliance, the Race Equality Foundation, the Mental Health Consortium through the Mental Health Foundation, the LGB&T Partnership, and Citizens’ Advice. Our specialist non-Alliance partner was the Queen’s Nursing Institute (QNI), who has done extensive work in this arena.
Background to the issue
Public Health England highlighted the scale of the problem in its presentation to the QNI’s Healthcare for Homeless Families conference, There’s No Place like Home, which sets out that the number of homeless families with dependent children is increasing. There is a growing use of temporary accommodation, the form of homelessness most prevalent for families, and more families are being placed “out of area” i.e. in a different local authority area. Since 2010, there has been a 255% increase in the number of homeless households placed out of area.
Developing the toolkit and the learning resource through co-production
We began our work by issuing a Call for Evidence to identify emerging good practice in supporting homeless families and homeless young people to reduce their health inequalities and improve wellbeing, using public health interventions. Alongside this, we ran two focus groups, two with young people, led by MAP in Norwich, and one with homeless families, led by the Doorstep Homeless Families project in London. This combination worked well as many of the young people had experienced street homelessness, and the families were mostly living in temporary accommodation.
A commonality between both groups was the challenge of mental health. Both groups saw their homelessness as directly impacting on their mental health, and whilst many of the families enjoyed good access to primary care services, young people experienced problems registering with a GP.
“It’s hard to register with a GP when you’re homeless and don’t have ID. Health workers should use their NHS databases to help us get new ID” (Young person)
To include the professionals’ point of view, we ran a survey with public health nurses and attended Public Health England events for public health nurses where we presented the project and sought early input as to what would work well as we developed the toolkit and learning resource. We also worked closely with Public Health England throughout.
An opportunity arose to talk to a local audience, through the Level Trust, a charity that works to address child poverty in Luton. At their annual Child Poverty conference, we presented a workshop where we asked delegates to think about health inequalities and homelessness and how they would address it locally. Luton is a beacon of good practice with strong relationships across the voluntary and statutory sectors, and whilst this was not an audience of nurses, delegates’ input was invaluable to the section of the toolkit that identified what professionals can do to support homeless people, and illustrates what the HWA is all about, providing an avenue for the health sector to learn from the voluntary and community sector and better understand how they support positive outcomes for people.
The QNI’s Health at the Margins event in July provided a further opportunity to speak to nurses about the forthcoming products and to share the themes with them. The overall feedback from delegates was encouraging, and we will be sharing the final products with them as a follow up to the conference.
Launch – and next steps
This World Homelessness Day provides a perfect opportunity for us to launch the toolkit and the learning resource, to remind us that homelessness comes in many forms, and needs to be thought about in the context of families of all types, shapes and sizes. We plan to work with Public Health England and the Health and Wellbeing Alliance to ensure the products are widely available and make a real difference in the learning and development of public health nurses at all stages of their careers.
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Head of policy and communications
Caroline currently job shares her role with Helen Mathie, jointly overseeing Homeless Link’s policy, research, information and communications team.
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