The new NHS plan for mental health services has a clear offer for people sleeping rough

    For organisations who have campaigned for many years on homeless health, the NHS Mental Health Implementation Plan is a cause for celebration. Beatrice Orchard, St Mungo’s Head of Policy, Campaigns and Research, explains why the plan must deliver on its ambition to make sure everyone sleeping rough can access the mental health support they need.

    When the Government’s Rough Sleeping Strategy was published exactly one year ago by MHCLG, there were some positive signs that other government departments would also be doing their bit to reverse the dramatic rise in the number of people sleeping rough in England.

    One of the most solid commitments was in relation to improving mental health support for people who are sleeping on the streets. Last month, the details of this commitment became clearer when the NHS Mental Health Implementation Plan was published.

    The plan is clear that by 2023-24, 20 areas with high levels of rough sleeping will have established new specialist mental health provision for people sleeping rough, which will be made possible with £30m of central NHS funding invested for this specific purpose.

    This is a fantastic result for St Mungo’s Stop the Scandal campaign and our continued efforts to press the Government for investment in specialist mental health services to ensure people sleeping rough can access the support they need.

    Sleeping rough and mental health – the links

    It is fairly easy to understand that sleeping rough has a negative impact on a person’s mental health and wellbeing, as well as their physical health.

    Evidence shows people sleeping rough are 17 times more likely to be victims of violence compared to the general population. News reports describe horrifying attacks and abuse on people sleeping rough and our clients tell us about their experiences of feeling lonely, frightened and even suicidal.

    Furthermore, we mustn’t overlook the fact that some people sleeping rough have already been through many traumatic experiences in their lives, including violence and abuse from a young age.

    All of these experiences can cause mental health problems to develop or worsen, but also impact on the type of mental health support people need and how easy they find services to access.

    New avenues into support

    The new, NHS-funded, specialist services will make sure that people sleeping rough can access to clinical mental health support by integrating with existing homeless outreach, accommodation and physical healthcare services.

    They will be required to adopt a trauma-informed approach, known to help improve the psychological and emotional wellbeing of people with complex needs. We also expect the new services to help people who have drug and alcohol problems and are currently excluded from some mainstream mental health services as a result.

    This specialist support breaks down all of the barriers people sleeping rough often face when trying to get help to improve their mental health. Really effective specialist teams can also influence mainstream health services in their local area, encouraging them to become more knowledgeable and understanding of the needs of people who are sleeping rough.

    So far, so good. But what about people sleeping rough in other areas not in receipt of this new funding?

    A welcome step forward

    Research shows 4 in 10 people sleeping rough in England have an identified mental health problem. The latest data from the CHAIN reports on rough sleeping in London shows 50% of people sleeping rough in the capital in 2018-19 had a mental health support need.

    It is welcome, therefore, that the new plan for mental health requires all areas of the country to complete a mental health needs assessment for people sleeping rough and take action to increase access to mental health services for this group.

    This new approach to mental health for people sleeping rough is a real step forward.

    Specialist mental health services have been tried in the past. We know they can make a dramatic difference to individuals’ lives, and help to reduce rough sleeping by supporting people to move on from homelessness for good.

    Better still, it doesn’t stop with specialist services this time. Instead all NHS services will need to think about how people sleeping rough can access the healthcare they need in order to rebuild their lives.

    St Mungo’s will be watching closely and encouraging all areas to ensure the plan delivers.

    Run to the Moon Challenge

    To mark St Mungo’s 50th anniversary year we are challenging our supporters to do 50 things to help us end homelessness. We have seen everything from dog hiking to art exhibitions as part of our 50@50 campaign

    Now it is time for us to join together for our biggest 50@50 challenge yet. We need the help of our staff, supporters, volunteers and clients more than ever as St Mungo’s challenges you to Run To The Moon.

    One Small Step

    One small step for man 50 years ago on 20 July 1969 marked one giant leap for mankind. In that same year a group of volunteers decided to do something to help homeless people, forming St Mungo’s and marking one small step towards ending homelessness in the UK. Fifty years on and the technology revolution is accelerating at a rapid rate whilst the gravity of issues surrounding homelessness shows little sign of relenting.

     

     

    The Challenge

    The distance to the moon is 238,855 miles. Over the course of 164 days (July 20 to Dec 31) we need to run a combined average of 1,455 miles per day. To do this you will need to link up with Strava or RunKeeper and get as many comrades running as possible.

    There is no fundraising obligation or minimum distance for this challenge. We want to unite staff, clients, volunteers and supporters to remember those who have been involved with St Mungo’s in the past and to consider those who need our help now.

    You are welcome to clock up the miles by walking, running, handcycling, via wheelchair, or any other way that the required fitness tracker will allow you. Every person who joins the challenge will appear on the shared event page with a combined total counter for miles travelled and a leader board for those who have contributed the most.

    Virtual Events

    It might sound like a new series of Black Mirror but virtual events are no longer something of the future – they are taking over the world of fundraising.

    We understand that you might want to support a cause, but getting to a specific place at a specific time and raising a set amount before a deadline just doesn’t always work out. That’s why more and more people are getting on board with virtual events – they fit around your lifestyle.

    We have teamed up with the fundraising platform GivePenny to develop a challenge that uses their ability to integrate with the fitness tracking apps you might already use, like Strava and Runkeeper, so you can challenge yourself and raise money as and when it suits you.

    How To Sign Up

    Follow the small steps below and sign up to St Mungo’s Race To The Moon challenge:

    1. Sign up by following the ‘Join Campaign’ link on our GivePenny event page
    2. Download the fitness tracking apps Strava or RunKeeper. If you already use a different fitness tracking device you should be able to sync it with Strava.
    3. Get running.
    4. Share your page and encourage others to join the challenge.

    Have some fun and challenge your friends, family or colleagues to join us as we launch St Mungo’s into outer space. If you have been inspired to get involved or set-up your own 50@50 challenge, get in touch with our dedicated events team at events@mungos.org.

     

    Meet our youngest fundraisers

    The annual London Marathon is the UK’s biggest fundraising event of the year. Ahead of the 2019 race, we caught up with two of the smallest fundraisers of the year, Alex (6) and Nicholas (8), who are taking on the London Marathon course by walking it with their dad the day before the official race.

    Why have you decided to walk the London Marathon? Whose idea was it?

    Nicholas wanted to fundraise for St Mungo’s so Dad suggested we walk the London Marathon course.

    Have you managed to go on many training walks?

    Lots. We started back in November.

    What are you looking forward to most about the walk?

    Seeing all the sights in London: the Cutty Sark, London Eye, Tower Bridge, Canary Wharf, Tower of London, Big Ben and Buckingham Palace.

    Where is your favourite place to walk?

    N: By a river as it is peaceful.
    A: Near flowers so I can smell them.

    Image: Nicholas and Alex walk the London Marathon

    We have heard Alex and Nicholas like to collect objects whilst walking. What is your favourite thing you have collected so far?N: Sticks and golf balls.

    N: Sticks and golf balls.
    A: A coconut shell.

    Why did you choose to fundraise for St Mungo’s?

    We have chosen to fundraise for St Mungo’s because we have seen homeless people struggling on the streets and want to help them.

    Do you think homelessness is a big problem in the area that you live?

    There are a few homeless people where we live and we see a lot more in bigger towns like High Wycombe.

    What do you hope St Mungo’s will be able to do with the money you raise?

    Pay for shelters and food, as well as for training people so they are better able to get jobs.

    Have you got a message to our London Marathon runners who will be running the day after?

    A: Keep going especially when it is hard.
    N: Even if you are small, you can achieve great things.

    Alex and Nicholas will start the course with their dad, Tom, at 7am on Saturday 27 April and aim to complete it by 7pm the same day. They have their own Twitter page and have already exceeded their £1,000 fundraising target on their JustGiving page.

    The 2019 London Marathon is set to exceed £1 billion in donations raised for good causes during Race Week. Every year we are blown away by the commitment of our supporters to raise money whilst training for the race of a lifetime, and we wish everyone (big or small) the best of luck for this weekend!

    Get inspired, get involved

    Check out our current challenge events or get in touch with Will at events@mungos.org to receive a free fundraising pack and find out more about how you can plan your own fundraising event.

    On a typical day…

    “For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed.” St Mungo’s Mental Health Practitioner, Fatima, shares her experience of working in Outreach, helping people sleeping rough in the Tower Hamlets area.

    I’ve been a mental health nurse for 18 years. In 2011, I became and an approved mental health professional, which incorporates social work. I will work typical outreach shift in terms of going out early in the mornings and staying out late in the evening, as late as two or three in the morning, speaking to clients who are sleeping rough to try to form therapeutic relationships with them to help them move away from a life on the streets.

    ‘Blinded to homelessness’

    I was one of those people who was blinded to homelessness. I could walk past a homeless person or rough sleeper and not really see them to understand what they’re going through. It’s been an eye opener for me and I’ve fortunately been able to influence others to see homelessness through what I do at St Mungo’s.

    It can take a week or months to be build a relationship with a person. Sometimes they are in denial – they have no insight about what is happening to them so I try and to slowly educate them. I take decisions out of people’s hands when they’re experiencing mental distress.

    I enjoy my work. I can get people registered with a GP surgery, then get them to start medication, stabilise their mental health illness and then help into accommodation whilst we support them. Many people may have been de-registered and have been turned away from Accident and Emergency (A&E) wards. They can go through those revolving doors three or four times a month, back and forth from A&E.

    I also work with the clients to ensure they engage with the process of recovering from homelessness. You cannot take someone off the streets and expect them to turn up for every appointment. I have to build that relationship, that rapport and that routine of them coming to see me to talk about their mental health, the medication and the side effects.

    ‘Long days full of drama’

    My days can be very long and full of drama. Sometimes I get abused, which can be quite stressful. But my job is also fun and flexible. For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed.

    It’s brilliant to see someone who has been sleeping on the streets for five or six years leave that life behind. The kerb becomes their family so getting them into accommodation is not easy. When you put them in a room in a hostel it can be very lonely. The silence can be deafening for them because people out on the streets give them money and say hello – some people get to know them as they walk past them on their commutes. So they run back onto the street and people wonder why because they have accommodation.

    ‘Everybody is unique, everybody has a journey.’

    A lot of clients can lose their accommodation in hostels because of poor mental health – some people cannot understand their journey. Everybody is unique, everybody has a journey. How you hold their hands to support that journey is what makes a difference. People might think, ‘go to housing and get a property, get off the road and get your benefits’, it’s a much longer journey, however.

    Different clients talk about their living conditions. Finances are a problem. People have not been used to managing money and paying bills. Universal Credit has also caused a lot of problems for our clients.

    I have one client, for example, who believes he has all his money invested in stocks and shares. He says when his investments mature, he’ll pay his rent. He has a diagnosis of schizophrenia with delusional disorder. I ask for my colleagues to work with him in terms of hand-holding to ensure he does not get evicted from his hostel.

    I’m working with this lady that I’ve known since I was a student nurse. Up to now she will not allow anyone else to work with her. She was sleeping in a bin shed. She became mentally unwell, and started using drugs to self-medicate the voices she was hearing. Her children were taken into foster care when they were young. I worked with her and got her a place in a hostel. He son got in touch after 15 years and they’re building a relationship again.

    ‘You cannot be judgemental’

    Because of the nature of the people we work with, many with chaotic life styles, who are extremely marginalised, it’s very difficult to get through to the NHS. Even though I am that link between the NHS and homelessness services. Sometimes the nurses have no understanding or knowledge of homelessness. They’ll say, ‘he needs to go, he might bring drugs in here’. It’s a big challenge to get my clients treatment because of the way they look, or dress and their circumstances.

    Working in outreach, you cannot be lazy. I have gotten used walking everywhere. You must be able to multitask as you’re dealing with more than one client, sometimes up to seven a day, who are in crisis. I’ve jumped over six feet walls and walked along canals to help people – it’s part of what we do. You must have people skills, respect humanity, and you cannot be judgemental at all. It takes a lot of character to try and support people who are not ready to receive help.

    It’s a nice feeling to know you’ve helped someone from being a hermit to re-engage back into society and to be part of a community. I think that’s what has been missing in [conversations about] homelessness. Our country has forgotten how to be a community. To me, it feels like in London everyone is in a rush, so in that mad rush, we are blinded to homelessness.

    Here’s to 2018 and Thank You

    St Mungo’s Chief Executive, Howard Sinclair, reflects on the achievements by clients, staff and volunteers this year and looks ahead to 2018.

    This time of year – however you mark the holidays – can be a time of reflection, gratitude and goodwill.

    Reflecting on 2017, I’ve been thinking about our clients’ achievements this year.

    Mandy (pictured centre), for example. Her story has included mental health issues, family relationship breakdown and sleeping rough.

    Mandy now lives in a St Mungo’s project in Islington which is for people who need some support. She’s also connected in with our client representative group Outside In and our innovative Recovery College. In Mandy’s blog she wrote: “I am at a turning point in my life, where my life is more positive. I can honestly say I am doing things I never thought I would do. If it wasn’t for St Mungo’s I would most likely be dead, they saved my life.”

    On 21 June 2017 she and her friend Claire, who is also a client at St Mungo’s, led a team of St Mungo’s clients and staff up Snowdon. Between them they raised over £40,000 for St Mungo’s.

    It was a tremendous thing to do and a privilege to hear her talk about it at our Carol Concert this year. My very best wishes to her and all of the Snowdon Challenge team. Please do read more about what they accomplished and why.

    And Paul (pictured right). He’s an apprentice in our Housing First scheme in Brighton. This year he told us: “I have peace of mind, a safe home, a pound in my pocket, food in the cupboard and good friends – that’s a world beyond my wildest dreams.”

    My congratulations to him and all those involved in our award-winning apprenticeship scheme for people with lived experience of homelessness. Apprentices like Garry (pictured left), who works in one of our projects for people with mental health needs.

    He told us about his new role: “It feels really good that I’m helping people to recover – it’s that old cliché ‘giving something back’. I’m being a resource rather than using the resource.”

    I agree with his sentiment that: “There’s outside stuff beyond St Mungo’s where frustrations lie, for example, things that should be different with the government, but you have to work with what you’ve got. There are only some things you can impact.”

    We live in a complicated world, where homelessness is rising and, without more joined up national and local strategies, the concern is that welfare changes, lack of affordable accommodation and other social factors may see even more of a rise in rough sleeping and homelessness.

    But homelessness is not inevitable. In 2018 I will be sitting on the Rough Sleeping Advisory Panel, made up of people from charities and local government. Our role is to support a new Ministerial Taskforce, which brings together ministers from key departments to provide a cross-government approach to preventing rough sleeping and homelessness. I will be making sure our client voices are heard as we feedback  on ways we can work together to end homelessness and rebuild people’s lives.

    Thank you to our clients, staff and amazing volunteers and supporters for their dedication and commitment this year. May I wish you all a happy and peaceful holiday. Here’s to 2018.

    Out of London; Down to Paris

    “It is fatal to look hungry. It makes people want to kick you” is a quote from George Orwell’s Down and Out in Paris and London. You may not have wanted to kick someone for sleeping out but how many times have you walked by, getting on with your busy life, not caring to think about what the needs are of someone sleeping rough?

    I have never been in the position of not having a roof over my head or wanting to know when I will get my next meal. It is not something I want to experience and do not think others should have to experience it either. But they do. There is a housing crisis; people are not able to afford to buy or rent and there are increasing numbers of people sleeping rough as well as hidden homeless.

    ‘Supporting people through times to rebuild their lives’

    As someone who works for a company providing housing, Network Homes, I and 19 of my colleagues signed up to ride London to Paris to raise money for St Mungo’s. We believe in the value of services they provide to end homelessness and supporting people through some tough times to rebuild their lives.

    The Network Homes’ team is of mixed ability. When we decided to sign up for this in February 2017, some had not had the wind (or rain) in their faces since childhood! The thing that bonds us is the desire to get to Paris and raise as much as we can for St Mungo’s.

    Over £63,000 raised

    We have raised over £63,000 through donations and sponsorship. Our L2P jersey and bib shorts are adorned with logos from our sponsors, topped and tailed with our company branding.

    For me, as a regular cyclist, it has given me more of an excuse to get out during the long spring and summer days to get my training in. After riding Ride London 100 at the end of July, in the St Mungo’s colours, my training continued with an increase in the number long rides on consecutive days and now I am excited about setting off from Crystal Palace.

    On the 13 September it will be ‘au revoir London’ and 300 miles and four days later it will be ‘hello Paris’.

    James Dean
    Network Homes

    Why we fundraise for St Mungo’s

    I will put my hands up and say, I am not cycling to Paris. But what I am doing is supporting the fantastic team of 20 get from Crystal Palace to the Eiffel Tower and encouraging them every step of the way for the fantastic work and effort they have been putting into this momentous challenge.

    I have been championing fundraising at Network Homes since 2015, and since 2016 St Mungo’s has been our charitable cause. Chosen by staff, St Mungo’s and Network Homes share common values and passions for challenging the housing crisis and helping those in need. This cycle is the culmination of efforts from every single member of our staff. While only 20 will be cycling, our staff have attended tea parties, baked cakes and donated household items – and even played in football tournaments, all to help the St Mungo’s cause.

    I am immensely proud of our cyclists and of all the staff at Network Homes who have contributed to our fantastic achievement. It is a true story of how one good idea can become a tremendous force for change, and we hope that every single penny raised will help the homeless and generate real change in their lives.

    On to Paris!

    Rebecca Bicocchi
    Network Homes

     

    A festival for clients by clients

    Last month St Mungo’s held its annual Client Festival organised by Outside In, our client involvement group. Liam, a member of Outside In, tells us about his role helping to organise the Festival.

    St Mungo’s Client Festival is a festival for clients by clients. The theme this year was ‘Elements’ and aimed to bring together the different elements that will empower clients to learn thrive, and contribute to their communities.

    I got involved with the Client Festival accidentally. I had intended to enrol at the St Mungo’s Train and Trade Centre, in South London, which offers training in various trades like bricklaying and painting and decorating. Whilst there, I was introduced to Nathan Rosier, the manager of Outside In, a group which is made up of clients who work in partnership with St Mungo’s to improve its services.

    ‘Like a flower blooming’

    Outside In do a lot of different things so I was able to dip my toes in a lot of different things. It was like a flower blooming. I’ve gone from knowing one person to knowing many people in different departments of St Mungo’s. I’m getting to know the different things that interest me.

    Organising the Client Festival was intense but fun. I think I brought a fresh perspective when I was helping organise it. I wanted people to engage with the stall holders at the festival. So I came up with an emoji style quiz, which got people walking around.

    ‘ I had something to bring to the table’

    I took the lead on our raffle quiz, which required people interact with the stall holders. I would probably change how I engaged with the donors of the raffle prizes. I don’t have that much confidence so ringing the donors and the face to face conversations were a bit challenging.

    It’s the first point in ten years where I felt that I had something to bring to the table. It was stressful long days. Hectic! Really hectic! It gave me a routine because I had to manage my personal stuff as well. It made me feel like a professional. I miss it. When I was packing away the stuff at the end of the day, I was thinking, ‘this is all done now’.

    ‘It was a big hit!’

    The Festival went really well. I think it was a big hit! What I hoped for was that clients got more aware of what happens in St Mungo’s and what the different departments do. It was the high level of client involvement from members of Outside In, and volunteers who helped out on the day that made it special.

    Clients took control of the Festival, we decided on the small things, the decorations to the trees on the stage – that’s what made it a success. It wasn’t St Mungo’s coming up and telling us what to do. It was our ideas. It was the engagement from the clients that made it a success.

    ‘The clients’ perspective’

    Client involvement to me is those who live in St Mungo’s properties or use their services getting involved from the smallest things to the biggest. It’s their perspective. It’s their views recognised and listened to by St Mungo’s. It’s the clients acting proactively in everyday things from meetings to events.

    Involving clients is enormously important. I don’t think St Mungo’s would grow or learn without a client perspective and understanding what works. It gives clients motivation, a sense of being, achievement and something to grasp onto. They learn. They grow. They’re inspired. It’s fundamental to what St Mungo’s is.

    ‘The year ahead’

    I’m looking forward to next year. I have applied for a volunteer role at St Mungo’s. I’ve also been speaking to St Mungo’s head of diversity and inclusion about the new Client Involvement Strategy, which is something I am really into. I am keen to find out where I can get most involved next.

    We came. We saw. We conquered.

    St Mungo’s client and volunteer, Mandy, has shown incredible strength in her journey to conquer homelessness. Having now also conquered Mount Snowdon, Mandy shares with us her inspirational challenge and her ongoing determination to help others on their road to recovery from homelessness.

    From the streets to the mountain top

    In June I took on one of the biggest challenges of my life. Along with my friend Claire, also a client at St Mungo’s, we successfully led a team of other clients and staff to the top of Mount Snowdon. Snowdon is the tallest mountain in Wales at 1,085m above sea level, and the highest point in the British Isles outside of Scotland. We were keen to do this for a couple of reasons; to celebrate how we had conquered homelessness and to raise funds and awareness to help give others the same chance.

    Your support helped us to the summit, thank you.

    Having spent months meticulously planning, we arrived at Snowdon the day before full of excitement and couldn’t wait for challenge day!

    The team set out first thing in the morning in great spirits. We could all feel exactly how much the challenge meant to us, and we were so determined to complete it.

    We were totally overwhelmed by the number of people who supported us with generous donations and lovely good luck messages in the lead up to the big day. This kept us motivated all the way to the top, we really wanted to do everyone proud.

    We came. We saw. We conquered.

    We made some truly special memories along the walk which we’ll never forget. Touching the summit of Snowdon was a dream come true. It was a proud and emotional moment for all of us, who had never imagined we could do something like this.

    In memory of those who have died while sleeping rough

    At the top of Snowdon we dedicated our challenge to those who have died while homeless or sleeping rough. We all knew that could easily have been us.

    It was a particularly emotional moment for me as I took the chance to reflect on how far I had come along my journey to recovery. Just two years ago, I was sleeping rough. Today I have a place to call home and have had the chance to rebuild my life. I’ve seen myself grow so much, and I know this wouldn’t have been possible without St Mungo’s and their supporters.

    Let’s help everyone conquer homelessness

    At the heart of our challenge was our determination to help others who are homeless. Along with the rest of St Mungo’s, we believe that everybody should have a place to call home and can fulfil their hopes and ambitions.

    I’ve experienced first-hand how dangerous rough sleeping is and how it can affect mental health.  At St Mungo’s having a place to stay, therapy and learning new skills all helped me to recover. We desperately want to give other homeless people the same chance. It would mean the world to so many people if you could give a gift to help us save and change the lives of others.

    We cannot thank people enough for supporting us

    Thank you so much for your support. Without it, this walk would have been literally that; only a walk. Your support has made it a life changing experience not only for us, but for the homeless people we’re now able to help.

    I hope that our challenge will inspire others to think that if Mandy and Claire can climb a mountain, then they can do anything they put their mind to. We’d love to think that someone sleeping rough today could hear about our achievement, feel inspired to conquer their own challenge and make a positive difference to their life or the lives of others.

    Thank you all so much for making this possible and supporting us every step of the way.

    People who are homeless and facing the end of their life

    As Dying Matters Week comes to a close, Niamh Brophy, St Mungo’s Palliative Care service – the only one of its kind in the homelessness sector in the UK – explains more about how the service helps people the end of their lives.

    Last week I met John. He is 65 and has been intermittently homeless since his marriage broke down in 2009. The trauma of losing his family meant John lost control of his life. He ended up on the streets before coming to live in one of our hostels.

    When John was diagnosed with cancer a few weeks ago it came as a shock not only to him, but to the staff and residents of the place that had been his home for the past eight years.

    I also met Stephen, his support worker, who helps him in many ways, and who is doing his best to help John do what he wants to do with the rest of the time he has.

    The link between homelessness and health is widely recognised. Our wider understanding of the experiences of homeless people dying on the streets, in hostels or in hospital remains patchy.

    People experiencing homelessness have a much higher likelihood of having a long term health condition. Illnesses can often go undetected and untreated over time if people are reluctant to engage, because of other priorities they may have around being homeless. Care can then often become crisis led, particularly if further compounded with alcohol or drug use and worsening mental health.

    A consequence of this ‘non-engagement’ is demonstrated most shockingly in the statistic for the average age of death for someone who’s been homeless: 47 for men, 43 for women.

    St Mungo’s Palliative Care service

    It should not come as a surprise to hear that most homeless people do not gain access to palliative care until very late in their illness, if at all. Often their choices for care are limited, and their death is more likely to be perceived as sudden, untimely and undignified.

    In 2007, St Mungo’s started working to address these issues and improve care services for residents with advanced ill health.

    Our service aims to give our residents with serious health concerns the opportunity to choose their treatment, the chance to reconnect with loved ones, and the possibility to die in a dignified, comfortable way in a place of their choosing.

    We do this in five different ways:

    • Support residents to make informed choices about future needs and wishes and ensure access to supportive services, including specialist palliative care;
    • Support residents and staff in dealing with the psychological and emotional aspects of approaching the end of life;
    • Provide appropriate training to frontline staff in dealing with end of life issues, including bereavement support and spotting when clients may be at risk of dying;
    • Provide bereavement support to frontline staff and residents through a volunteer-led bereavement befriending service;
    • Work in partnership to raise awareness of the end of life care needs of people who are homeless.

    Since the service started a decade ago, we have:

    • Provided more than 190 residents with end of life care support including bereavement support. This created opportunities for residents to stay longer at home, feel supported emotionally, as well as allowing them the opportunity to make their wishes and preferences known.
    • Delivered training about homelessness and end of life care to more than 300 staff, including training sessions tailored to the specific needs of our individual projects. This has enabled staff to feel more confident in identifying those who may benefit from support.
    • Developed an online resource pack aimed at supporting staff working with people who are homeless.
    • Forged greater links and partnership working with services such as a multidisciplinary working group set up to identify earlier on those residents whose health may be deteriorating. This involves the local alcohol service, GP, hostel and hospice staff and is chaired by the Palliative Care Coordinator.
    • Partnered on collaborative research and training development with UCL, Marie Curie and Pathway that explores the challenges of palliative care for homeless people and how best to overcome them.

    In the UK, according to the Economist Intelligence Unit, we provide the best end of life care in the world. Providing end of life care for people, like John, who are homeless brings unique challenges. (Here’s a link to more information)

    We must work to ensure best practice is extended to all members of our society, particularly those vulnerably housed who all too often fall through the cracks.

    How you can help

    If you’re interested in the work we do to help our clients and want to do more, here’s how you can get involved:

    Ref: Economic Intelligence Unit. The quality of death: Ranking end-of-life care across the world. 2010

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