Breaking the Cycle: From Ambition to Action
Health Bus Trust CEO acting Deputy CEO and Director of Communications Deano Pickering writes on how the Government can turn the laudable ambitions in the National Plan to End Homelessness into real actions that start building a country free from homelessness.
Introduction
The National Plan to End Homelessness sets out an important ambition: to make homelessness rare, brief and non-recurring. It also makes a clear commitment that no one should leave hospital, prison, care or another public institution into homelessness.
At HealthBus, we strongly welcome that direction. But from what we see every week on the ground, there is one vital connection that still needs to be made much more clearly. People need homes, but they also need the physical and mental health support that enables them to recover, settle, and stay safe in accommodation.
Without sustained health, housing can quickly become fragile. Poor health can make it harder to engage with services, manage daily life, keep appointments, build trust, and maintain a tenancy. If we are serious about ending homelessness, healthcare cannot sit at the edge of the strategy. It has to be part of the foundation.
What Health Bus Trust does
HealthBus provides nurse-led, trauma-informed healthcare for people experiencing homelessness across Bournemouth and the surrounding areas. We work using a mobile clinic, and provide drop-in sessions and outreach, taking care to people who often struggle to access mainstream services.
Many of the people we support are living with long-standing and untreated health needs. These include wounds, infections, respiratory illness, diabetes, poor mental health, trauma, substance dependency and the wider impact of years of exclusion. For some, their health has deteriorated because help has not reached them early enough. For others, previous experiences of stigma or rejection mean trust has to be rebuilt slowly.
Our work is practical, relational and consistent. We provide treatment, listen without judgement, help people reconnect with wider services, and support them to take the next step in their recovery.
How the Government can deliver on its commitments
The Government’s commitments on prevention, hospital discharge, rough sleeping and recovery are achievable. But they will only be delivered if health is built into the homelessness response at every stage.
This means investing in specialist homeless health services that can work alongside councils, NHS teams, housing providers and voluntary sector partners. Nurse-led outreach, mental health support, social prescribing and multidisciplinary care should not be seen as optional extras. They are part of what makes prevention possible.
For example, if someone leaves hospital without a safe place to recover, without follow-up care, and without someone they trust to help them manage their health, then the risk of returning to crisis is high. The same is true for people moving into temporary or supported accommodation. A roof matters deeply, but recovery often depends on the right health and wellbeing support being wrapped around it.
What needs to change
Too often, housing and health are treated as separate systems. Yet for people experiencing homelessness, they are inseparable. Poor physical and mental health can be both a cause and a consequence of homelessness. It can also be one of the main reasons why accommodation breaks down.
At HealthBus, we see people who are trying to move forward while managing pain, infection, anxiety, trauma, addiction or serious long-term conditions. We also see how difficult it is for people to keep engaging with mainstream services when they have no phone, no transport, no confidence, or no reason to believe they will be treated with dignity.
The National Plan recognises health inequalities and the need to improve access and reduce stigma. That recognition now needs to become a clear delivery commitment. Specialist healthcare for people experiencing homelessness must be sustained, accessible, trauma-informed and designed around the reality of people’s lives.
Our challenge to Government
To turn ambition into action, Government and local systems must recognise homeless healthcare as essential infrastructure in ending homelessness.
We urge Government, NHS partners, councils and commissioners to invest in specialist homeless outreach, mental health provision, social prescribing and multidisciplinary models that help people recover, stay well and sustain accommodation.
Success should not only be measured by how many people move into housing, but by how many are able to remain safe, supported and well within it. Ending homelessness requires homes. Keeping people safe, well and housed requires health.