Homeless people in London die 40 years too soon

If you are homeless you can expect to live until you are 47.

This is the life expectancy for the average person who lives on the streets.

It’s almost half that of the average person in the UK — who has a life expectancy of 81 years.

You are also 35 times more likely to commit suicide if you are a homeless rough sleeper.

These two facts alone highlight that we urgently need to improve the health of homeless people in London.

If the average homeless person is dying in their forties then something is clearly very wrong.

Change is also urgent because London has more homeless people than anywhere else in the UK — and the numbers are rising.

More than 7,500 people slept rough on London’s streets during 2015/16 — hundreds of people every night.

That number has more than doubled over the last five years and nearly tripled over the last 10 years.

The numbers of people who are homeless in other ways are also growing.

These include hostel dwellers, sofa surfers and people in chronically insecure housing.

We know that current systems of healthcare struggle to meet the needs of homeless people.

There are national and many local services, but at times they are fragmented, poorly coordinated and often aren’t suited to the way homeless people live.

It is common for homeless people to have a number of complex health problems.

Up to 80% have mental health problems, including complex personality disorders.

The number of rough sleepers with a mental health support need has more than tripled over the last five years from 711 in 2009/10 to 2,342 in 2014/15.

Rates of drug and alcohol dependence are very high and almost all other areas of their health, such as dental, foot and respiratory health, are significantly worse than the general population.

Homeless people often find it difficult to manage their own health conditions due to their chaotic lives, low literacy levels, poor access to services and, regrettably, hostility from health professionals.

Figures from the charity Streets of London showed 55 per cent of homeless people had not had contact with a GP in a year.

Recent studies have identified that homeless people:

· use eight times more hospital inpatient services than other people of a similar age

· are 40 times more likely not to be registered with a GP.

Of a sample of the homeless population using acute care, half of the costs were incurred by 10 per cent of people.

This demonstrates that the quality of life for homeless people could be improved by more pro-active services and earlier intervention.

Our vision is that every homeless person will receive health care that is consistent in quality and experience with that of the general population.

This care will be bespoke to meet their specific needs and linked up across London to reflect the transitory nature of homeless people.

At Healthy London Partnership, we are working to support London clinical commissioning group (CCGs) to commission better services for homeless people.

We are working with Homeless Link to produce a toolkit for London CCGs which will include borough-level homeless statistics, details on local specialist services, prevention and relief statistics and data on homeless people’s needs.

We are working with homeless charity Groundswell to reach out to homeless people in London and gain their experiences of health care.

Their views on what barriers they face to accessing services and how they feel services can be more accessible will fed into a final report for CCGs.

This final report will also include a ‘best practice guide’ for commissioning health services for homeless people.

We have engaged with over 100 organisations, including all CCGs, to develop this suite of resources.

We are now holding 11 London-wide workshops with a sample of these organisations to seek their feedback and input into the draft best practice guide.

This includes CCGs, local authorities, Public Health England, NHS providers, the third sector, and those who have experienced homelessness.

We have also just hosted the first quarterly ‘Partnership Board’ with the third sector.

The resources for CCGs will be published in the autumn.

We hope London CCGs find them useful tools to commission health services that support the needs of homeless people.

Homeless people are some of the most vulnerable and socially excluded people in our society.

We all have a duty, in the NHS and beyond, to ensure they have access to the same quality of health services as all Londoners.

Written by:

Garry Money, Head of the London Homeless Health Programme at Healthy London Partnership