Last month, the Government published the final evaluation report for its three regional Housing First Pilots. These reports aim to build the evidence base for what works in delivering positive outcomes for people with experience of homelessness and complex needs and provide highly positive findings on the success of Housing First. Homeless Link will use this evidence to support our own asks around the sustainable roll-out of the approach.
In 2017, the Government invested £28 million in Housing First Pilots across Greater Manchester, Liverpool City Regional Combined Authority and West Midlands Combined Authority. The Pilots were designed to test the model over multiple local authority areas, support over 1,000 people experiencing multiple disadvantage and explore how regional devolution could support Housing First development.
From 2022 the Pilot areas received additional funding of £13.9 million and in 2024 they were rolled into the Ministry of Housing Communities and Local Government’s (MHCLG) Rough Sleeping Initiative (RSI) funding programme. Almost all current funding for Housing First under RSI and other programmes such as the Rough Sleeper Accommodation Programme (RSAP) and Single Homelessness Accommodation Programme (SHAP) are due to end in March 2025.
From 2017 to 2022 the Pilots were evaluated by a consortium of research organisations, producing three Interim Evaluation Reports and a 12-month client outcome report. The final synthesis report and a cost benefit analysis, published in October 2024, highlight the key findings and successes of the programmes.
Over the evaluation period, a total of 1,061 people experiencing homelessness, health and social care needs were supported into independent settled tenancies. Of the individuals supported, 61% had longstanding health conditions, and there were high levels of depression and anxiety (79% and 80%), trauma and PTSD (42% and 40%), personality disorder (31%) and psychosis and schizophrenia (31%). Three quarters of people supported had spent time in prison, with 71% having used substances.
The cost benefit analysis shows that the Pilots averaged a spend of £7,700 per person per year, with long-term savings estimated at £15,880 per person per year. It concludes that "The Pilots have delivered good value for money."
In line with international evidence, tenancy sustainment is confirmed at 84% after three years across the Pilot programmes.
Since I’ve been indoors my health seems to be just getting better. Everything is getting better. I’m a lot happier… I’m fitting into the community here. I’ve made loads of friends around the area... Normally people are too quick to judge you, all they see is an addict. I’m not getting that so much around here. My neighbours are great, they do a lot for me. (Housing First resident)
Housing First works in ending homelessness for the majority of the people it supports. But we know, based on the profile of those individuals, that housing is only one part of the solution. The success of Housing First lies in the combination of providing people with a home alongside the support they need to keep it. Beyond tenancy sustainment, the 12-month client outcomes data show improvements in social connectedness, safety, wellbeing and health.
“They've had some absolutely miraculous outcomes… for example one [customer]… within the first 10 weeks of being supported on Housing First he had zero hospital admissions as opposed to 54 in the 10 months prior to that." (Stakeholder, Housing)
The data also indicates reduced contact with the criminal justice system.
“To stay in my flat, I need the support I have at the moment to continue. I didn’t think it would be so soon getting my own flat and seeing my own son…In the future I want to be more settled, see my son more, and get my flat how I want it. Reduce crack use…the main aim is to not go back to prison." (Housing First resident)
The report does highlight a lack of progress when it comes to individuals’ drug use and problematic alcohol intake at the 12-month point. However, this is unsurprising given what is known about the need for long-term support. As Homeless Link research shows, by the end of the third year there is a 22% reduction in drug/alcohol use with a 12% increase in engagement with drug/alcohol services.
The Pilot data also shows, in line with broader evidence across England, that graduation rates of people moving on from the services are relatively low. This indicates that adhering to the Housing First principle of offering flexible support for as long as is needed is essential.
Interestingly, there were no differences on outcomes between men and women, but those aged 40 or over were significantly more likely than younger people to be in long-term accommodation at the end of the evaluation period. This does perhaps speak to the need for a different approach for younger people, following the specific Housing First for Youth Principles, which is still in its infancy in England.
Unfortunately, while the report does not go as far as to make recommendations on the future roll-out of Housing First provision in England, there was a consensus among interviewees that a national strategy regarding the funding of long-term (and cross-sectoral) support for Housing First users is needed.
This conclusion supports Homeless Link’s call for the Government to secure the future of Housing First for 2025 and beyond as an essential part of the solution to ending homelessness and we will continue to make the case for an ongoing national programme.
