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Experts at the national Housing First Conference agreed that the approach goes far beyond simply addressing rough sleeping. They called for Housing First to be rolled out nationwide with a cross-departmental approach, sustainable funding and the backing of multiple sectors.

Homeless Link, Greater Manchester Combined Authority and Greater Manchester Housing First welcomed over 400 people to our conference on 10 November, as professionals from across homelessness, housing, health, criminal justice and beyond met to recognise the achievements and discuss the future of Housing First.

This is much more than about homelessness. It is a disruptive, whole system approach. Everybody had a part to play in this.

Rick Henderson, Homeless Link CEO

In a pre-recorded message, Housing and Homelessness Minister, Felicity Buchan, praised the work of local Housing First services and hailed the three regional pilots for “real dedication... finding innovative ways to continue supporting and housing some of our most vulnerable people during increasingly challenging times.”

Speaking in the opening plenary, Greater Manchester Mayor, Andy Burnham, announced that the government-funded regional Housing First pilot had been a “game-changer” for the city-region.

Greater Manchester Housing First is a partnership between 12 local organisations, led by the Great Places Housing Group. Since its launch, nearly 375 people with entrenched experiences of rough sleeping and multiple needs have been supported into safe and secure accommodation, with more than three quarters of those people sustaining their tenancies. “If you set people up to succeed, they will succeed. Housing First works” stated The Mayor.

Burnham added that the next Government should make Housing First not a project but a philosophy, with the right to decent housing enshrined in law – a sentiment that was well received by the delegates. He advocated for “extending funding for the very successful Housing First pilot or better still, making it permanent and rolling it out across the country.”

Things are working out for me on a personal basis quite well at the moment... there's more people getting involved with my mental health support. And, you know, all the financial stuff as well… I'm in the right frame of mind, and the support helps me stay in that positive frame of mind.

Housing First beneficiary

Homeless Link panel members, Jo Prestige and Alex Smith, who have led the growth of the Housing First movement in England, highlighted the hard work of services across the country to successfully deliver this unique approach. Jo Prestige stated that, “to make it work properly you’ve got to change the system and that is what Housing First has done, it is a catalyst for change.” 

But, referring to the political backdrop, Alex Smith added that “homelessness is a symptom, not a cause, and if we keep treating the symptom we will never get to the cause, and we will continue to see short-term funding and questions over long-term support – conditions which do not allow Housing First to thrive.

The conference also acted as a platform to launch the topline findings from Homeless Link’s research into the holistic long-term impacts of Housing First, which helps us to understand the approach as more than just a homelessness intervention.

Presented by Homeless Link’s Head of Policy and Research, Sophie Boobis, Chris Brill of Expert Link and peer researcher Shannon Johnstone, the research contributes a vital piece of evidence around the efficacy of the model across a range of support needs and will play an important role in our national policy influencing work – a call for a cross-departmental national Housing First programme.

The premise was that, in the words of Housing First founder, Sam Tsemberis: “Homelessness is a category that lets other systems off the hook.” While it benefits sectors including criminal justice, health, mental health, substance use and social care – and some fantastic partnership working already exists locally – we don’t have that sustained commitment to Housing First as a truly cross-sector intervention, particularly at a national level.

The help just wasn’t there back then, they put you in a hostel, then move you to another hostel, because my lifestyle was manic then, I was addicted to drugs, I haven’t taken them for 5 years now… now with Housing First, that’s when I first started to stop and change my life.

Housing First beneficiary

Key findings show that beyond the positive outcomes of residents’ high tenancy sustainment and their ability to manage everyday tasks over time, they experience:

  • A reduction in their overall physical health issues, with 31% improving by the end of their first year of Housing First and 39% improving by the end of their third year.
  • A significant increase in the engagement with GP services from the point of entry where only half of people (50%) were registered with a GP, to 81% engaging with a GP by the end of their first year, and 89% by the end of their third year
  • A decrease in use of A&E, falling from 59% of Housing First tenants on entry to 38% by year three, and a reduction in hospital admissions from 38% to 18%,
  • A substantial increase in engagement with mental health services between the point of entry until the end of the first year (23% - 39%). A reduction of safeguarding concerns around self-harm and suicide risk is also shown, from 50% of people supported in Housing First projects on entry to 32% at the end of the third year.
  • Sharp decreases in offending behaviour from 84% at point of entry to 45% at the end of the third year and similar decreases in contact with the criminal justice system over time.
  • A decrease in substance misuse of 22% between the point of entry into Housing First and the end of the third year and a corresponding increase in engagement with drug and alcohol services.

We will be publishing the full results, learning and recommendations from the research shortly, with a lot more breadth and depth.

However, a key reflection is the need to call for greater joint working including across commissioning, and the setting up of multi-disciplinary groups representing professionals and workers from diverse sectors. Only when we find collaborative ways of working together as standard, can we provide holistic and high-intensity support for people with histories of repeated homelessness and experiences of multiple disadvantage.

Emphasising this, experts in the closing panel discussion, who represented a range of sectors from probation to health, noted the opportunity to use this new data to influence, and the importance of joint commissioning and decision making, and collaborating to unlock barriers. Housing First, it was agreed, is “everybody’s business.”

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Alex Smith

Senior National Practice Development Project Manager (Housing First Lead)

Alex is a Senior National Practice Development Project Manager leading Housing First England.