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Blog posted by: Rick Henderson, Tuesday, 14 April 2020.

More than two weeks ago, the government charged all Local Authorities to bring all those living on the streets into self contained accommodation as a response to the Covid-19 crisis. Rick Henderson writes about the need to shift focus from a humanitarian response to a homeless health approach, to ensure that people at high risk are supported in an appropriate and effective way in partnership with clinical services.

It is over two weeks ago now that Local Authorities were instructed to urgently acquire accommodation for people on the streets. What followed was a series of unprecedented measures: setting up local co-ordination cells, block booking hotels, and the closure of day centres. Things have happened at a speed which was hard to imagine.

Until now, much of the focus has been on this process of getting ‘everyone in’. Services and their partners in some parts of the country are still very much in the midst of this incredibly challenging process. The sector is having to tread new territory and we are rapidly grappling with the reality of delivering this task. I don’t imagine many of our members have had the chance to even look up from the job they are doing in the past few weeks, but for those who have, I hope they have recognised the incredible resilience, resourcefulness and commitment that the sector has shown as it has come together with local partners to deal with this crisis.

But what started as an emergency humanitarian response now needs to shift its focus. The sector faces an equally challenging period of providing support to people who we know will be at increased risk of covid-19 because of their poor underlying health, and are likely to struggle with the reality of social distancing. We’ve been receiving more and more queries from members about what input they should be expecting from clinical services, given the obvious pressures the NHS is under.

The original MHCLG ‘everyone in’ letter, as its now known, outlined the ‘triage’ model which should structure each area’s response to accommodating people who are homeless, setting out how we can group different individuals to best manage their risk of covid-19. The reality of putting this into practice has so far raised many questions from our sector – what can we expect from the NHS? Is this the job of our frontline services? How can we put this model into practice when for some people it is their first time away from the streets in years?

Last week I chaired our weekly webinar with colleagues from the health world, and the message was clear: this is about clinical and homelessness leadership coming together. It is about ensuring clinical input is sought and provided, and it’s about forging new alliances with the NHS if these were not there before. The triage model seems to be working well where hotels and other covid-19 sites have this clinical expertise, where advice and support is being offered to homelessness staff, and where local treatment providers are putting in place alternative arrangements around drug and alcohol support.

The sector will continue to face tough decisions and be stretched in new ways over the coming weeks. Already questions are being asked about how services can best help clients adjust to their new environment, cope with heightened anxiety, disruption to their support networks, and vital access to treatment. Staff are worried about their role in ‘compliance’ with Government guidelines, how to ‘keep people in’ when people’s patterns of everyday life are based on being out on the street.

This is a critical time to return to the core strengths of our sector: the value we place on relationships, of strength-based practice, and having a trauma informed approach at the heart of what we do. None of this should change just because the accommodation is a hotel rather than a hostel. A priority for Homeless Link is how we can support our members to adopt emerging practice during this emergency and share it across the frontline.

Over the coming days we will also continue to challenge Government to take urgent action on areas we feel are missing from their response to the covid-19 crisis. We will continue to lobby for the funding and resources you need, and push for the guidance we feel is still missing. We will be looking to what comes next, to ensure when the transition comes, it results not in a return to homelessness but a step change in action to end it. These are all things which will be needed for the sector to keep both clients and staff as safe as possible, and give people the support they will continue to need as we collectively navigate this strange new world.

Catch up on last week's webinar with health experts here. 

Read about the importance of trauma-informed approaches when providing accommodation for those experiencing multiple disadvantage from the Making Every Adult Matter (MEAM) coalition  here.