Ending homelessness, rebuilding lives

The impact of unmet care needs amongst people experiencing homelessness

Matt Bawden and James Lally, Service Directors and Leads for Health and Care at St Mungo’s recently contributed to an article published by the Clinical Medicine Journal, a Royal College of Physicians publication. Here they discuss their work on the survey, and how it ties into our critical work to support the health of people experiencing homelessness.  

People living in homeless hostels: a survey of health care needs, a project undertaken by St Mungo’s in collaboration with Transformation Partners in Health and Care and Marie Curie with the support of 8 other hostel providers. The work expands on the work in our Life Changing Care report and incorporates findings from 58 hostels across London bringing our findings around health and care needs in our service settings to an all-new audience. Being involved in this research has helped highlight the prevalence and impact of unmet care needs amongst people experiencing homelessness. 

Work initially began on the Life Changing Care report with Matt and Dr Caroline Shulman. At the time Caroline was Co-Clinical Lead for the Homeless Health programme, Transformation Partners in Health and Care. Caroline has long highlighted the unmet needs amongst hostel populations, so she helped us to design a questionnaire for use in our services at St Mungo’s which quantified the needs of our clients. This formed the basis of our Life Changing Care report which was published last year. The research highlighted the challenges that people experiencing homelessness face when accessing care. It also confirmed that many are forced to access accommodation that does not adequately meet their needs as a consequence. It also confirmed the need for more specialist care homes such as those already provided by St Mungo’s, Hilldrop Road and Chichester Road. As such, Matt has been leading a working group to develop policy, guidance and training for colleagues. This aims to better equip staff to understand Care Act legislation including powers and duties as well as to refer and escalate/challenge decisions when appropriate. We hope this will further support achieving better outcomes for clients with unmet care needs. 

Following the success of our Life Changing Care report, the questionnaire was then amended slightly and rolled out across a number of partner organisations. Both data collection exercises were then used for the basis of the People living in homeless hostels: a survey of health care needs article. The research within both the report and the article has been a powerful tool to evidence unmet care needs amongst people experiencing homelessness. We are using it to design a Complex Needs Care Service which we hope can meet the needs of this incredibly vulnerable group; working in partnership with a broad range of partners in doing so. The new service would be aimed at people who we believe have Care Act eligible needs but are currently without an agreed care package or placement.  

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