Good news as BHT-led partnership is given the go-ahead to bid for £9.2 million Big Lottery funding

We have had some very good news this week which is attracting some media interest.  A consortium, being led by BHT, is in the running for funding from the Big Lottery of up to £10 million over 8 years.  The initiative is designed to improve services for men and women with complex needs (a combination of mental ill health, homelessness, offending behaviour and substance misuse problems) in Brighton, Eastbourne and Hastings. Between now and September, a full bid and business plan needs to be prepared.  A decision will then be made by the Big Lottery and the new services will begin from April 2014.

The purpose of this funding is to bring about lasting change in how services work with people with multiple and complex needs; this funding is a vehicle to help bring about that change. The legacy of the 8 year programme will be that systems and services in all 3 geographical areas will better meet the needs of this group.

At this stage we have been awarded funding to develop the bid on behalf of our partnership which includes partners in local government and in the third / charity sectors.  Should the partnership be successful, it won’t just be BHT staff (contrary to what the Argus reported this morning) who will provide services.

My colleagues, Nikki Homewood and Jo Berry, are leading on this initiative for BHT. Nikki said: “As the lead partner for the Brighton and Hove, Eastbourne and Hastings area, BHT is thrilled to receive funding to develop our partnership bid to ensure better service provision for people with the most complex needs.

“Using the wealth of knowledge and expertise within our local Core Group, comprising seven voluntary sector organisations and five statutory partners including commissioners, along with the 60+ organisations in our Partnership Group, we will develop a programme that will truly bring about change for the clients the programme work with, and local communities.

“Our vision is to bring about long-term systemic change by putting service users at the heart of services, fully understanding what they need in order to move forward with their lives: thorough monitoring and evaluation will result in well-evidenced findings, which will then be used to influence future commissioning.”

BHT’s partners in this initiative, and who are represented on the local Core Group, include: Brighton and Hove City Council, Brighton Women’s Centre, CRI, East Sussex County Council, Eastbourne Borough Council, Hastings Borough Council, Homeless Link, Sanctuary Supported Living, Southdown Housing Association, Sussex Oakleaf, Sussex Probation Service

The absence of a national approach to combat homelessness could have tragic consequences

Today I met with colleagues from some of the country’s larger homelessness charities, at a gathering organised by Homeless Link, one of our trade bodies. Amongst the themes discussed were those that come up at many meetings I attend these days, including severe funding restrictions, the “race to the bottom” as far as pricing tenders (“the race is over”, said one colleague from an area that has had cuts of over 80% in its Supporting People budget), and the risk to the quality of services.

One issue that struck me was a comment by someone I admire a great deal who said that any discussion around a minimum standard for homelessness services would rapidly become the default position. He spoke of the danger of a provider then going beyond ‘poor’, such as happened with the Winterbourne homes for men and women with learning difficulties.

All providers have their own ‘bottom line’ beyond which they won’t go, but there was a recognition that there are other agencies (not all exclusively in the private sector) who might bid at domiciliary care rates, where ‘support’ is reduced to a mere attendance as workers (inexperienced and untrained), and even volunteers, dash from one appointment to another.

The inevitable consequence will be an erosion of quality, increased turmoil for those with mental health problems, exploitation of those who are vulnerable, anti-social behaviour by some, and (in extreme cases) death through neglect.

The scenario was presented that in these circumstances, workers and volunteers are particularly at risk (a la Jonathan Newby), and clients might be overlooked, possibly with tragic consequences.

What is shocking about the current state of affairs is that, for the first time since 1968 (the year of Cathy Come Home and the setting up of homelessness charities including Shelter and BHT itself), there is no national funding framework. The ring fence for support services was removed by the previous government, and the devolution of funding to local commissioning bodies, is resulting in huge differences in provision across the country.

Notwithstanding the principles of Localism, there are groups of vulnerable people whose well being cannot rely on the vagaries of local funding decisions and where a national safety net is required, not least homeless men and women.

When we have a spate of deaths on the streets, there will be a mad panic to put something in place. Why not do this in a planned and co-ordinated way that will prevent man of these deaths in the first place?

What is clear is that the situation in Brighton and Hove and in East Sussex is so much better than in many places across the country, not least because of the all-party support there has been over the past few years for protecting services for homeless and vulnerable men and women. Long may that continue, particularly in these difficult times.

Bullingdon Club Bullies dehumanise homeless man by burning £50 in front of him

This afternoon I was writing a no doubt worthy item for this blog on BHT’s preparation for the digital inclusion challenges relating to the introduction of Universal Credit when I saw the tweets by Aideen Jones, the Chief Executive of Southdown Housing Association, regarding members of the Bullingdon Club who allegedly burnt a £50 note in front of someone begging on the streets of Oxford. (26/02/13: Please note I have removed a link to the original article on another blog which has itself been removed).

Aideen is right to point out that £50 could have bought 40 pairs of thermal socks for homeless people.

Of course people will make a connection between this obscene flaunting of wealth by a group of rich boys. The Prime Minister, the Chancellor of the Exchequer, and the Mayor of London, all were members of the Bullingdon Club during their misspent youth, but I imagine Messrs Cameron, Osborne and Johnson will today share the outrage felt by most reasonably minded individuals over this incident.

The thing that upsets me most about this incident is what it says about how homeless men and women are dehumanised by society. If the allegation is true, these Bullingdon Bullies are merely an extreme example, and are the rightful targets for the contempt of decent people. But this dehumanisation goes much wider, from the groups of lads who think it is funny to give someone sleeping rough a kicking on a Saturday night, or a drunken reveller relieving himself on someone sleeping in a doorway, or the security guard who pours a bucket of cold water over someone sleeping in a car park.

More extreme examples lead to the violent death of homeless people through assault or setting fire to a sleeping bag when the individual is asleep in it. Dropping a paving slab on the head of someone asleep on the beach or in a park is likely to do serious damage.

Yet this happens. What we need to do is to put an end to homelessness. A grand objective, but one that should be seen as historically important as the abolition of slavery or the ending of apartheid. This week, Homeless Link will be launching a manifesto aimed at seeing the end of homelessness in the UK by 2023. My colleague, Nikki Homewood, will be at the launch of this manifesto in the House of Commons on Tuesday.

But individually we can do something. In response to Aideen’s tweet, I will buy £50 of thermal underwear for homeless men and women who use First Base Day Centre. You, too, can help, either by buying something from Amazon using the First Base wish list on this link or for those of you who don’t wish to use Amazon, donations can be made direct to First Base through our Just Giving page.

But there is one other thing we can do. We can stop using the term ‘the homeless’, a phrase that dehumanises people. They are men and women, they are someone’s son or daughter, husband or wide, brother or sister, father or mother. They have names. They have hopes and aspirations, feelings and fears. I always try to refer to “homeless men and women”.

In South Africa, where I grew up under apartheid, the white rulers referred to “the blacks” who had second class status, and whose lives were valued less than those of white people. The murder of a black man and woman rarely attracted media attention, more rarely warranted a police enquiry. In the white community, black people had become dehumanised. Hopefully in Britain in 2013 we won’t allow the same to happen to homeless men and women.

Should hospitals be doing more to help homeless men and women before discharge?

I recently quoted some research from Leicester that homeless men and women are six times more likely to attend at A&E than the ‘housed’ population, four times more likely that they will be admitted, and are likely to stay twice as long.

Today on the radio I heard that the cost to the NHS of treating a homeless person is five times that of the housed population.

In a previous post I reflected on the medical interventions at First Base Day Centre, and how they prevented the need for A&E presentations and hospital admissions.  The savings to the NHS must be far greater than the cost of running the whole of the service at First Base which has a deficit each year of between £50,000 and £100,000.

Today Homeless Link published an excellent guide for hospital staff and managers “From Hospital to Home: Steps for hospital staff – identify need and take action”.

Homeless Link says “When someone who is homeless is admitted to hospital, their stay will often last longer, and become more complex and costly for the NHS, than your other patients.

“When they leave, more than 70% will be discharged straight back onto the streets, further damaging their health and all but guaranteeing their readmission.

“Housing is key to a ‘safe discharge’ from hospital, as well as to reducing the ongoing burden on your service. There are steps you can take to help.”

Here is the Homeless Link guidance:

On admission, identify homeless patients and those living in homelessness services:

• Ask if people have accommodation, whether they can return and if they risk losing it
• Contact the patient’s support services – this can prevent them losing their accommodation

If a housing need is identified, know how to respond and who to refer them to

• Find out who to notify within the hospital and externally – is there a named contact?
• Know how to make a referral to the local Housing Options team
• Ask for training on the assessment and referral of homeless people
• Keep an up-to-date contact list of local agencies such as hostels, outreach and drug and alcohol services on each ward.

If homeless people discharge themselves:

• Alert local services
• Record the self-discharge and the reason

Ensure patients can access ongoing care

• Complete a social needs assessment
• Notify the GP and relevant agencies about follow up treatment
• Provide a copy of the discharge plan and medication

Help people return to their accommodation

• Let the housing agency know when the patient is returning to ensure they can get in
• Avoid out of hours discharge
• Help the patient get home – they may need travel expenses

I wonder if there is a champion in local hospitals ensuring that these good practice guidelines are being implemented?