Any loss of specialist support services will save little but will result in delayed hospital discharges and extra cost to the NHS

“Joined up government” was a mantra of the 1997 Labour government. Unfortunately, it never really did take root, and inefficiencies and additional cost continue to result from a silo approach at both national and local levels.

The absence of accommodation for rough sleepers results in cost, not so much for housing and the Department for Communities and Local Government (DCLG), but for the Department of Health and the NHS. Rough sleepers are far more likely to require ambulance callouts, attendances at Accident and Emergency departments, and unplanned hospital admissions.

I have written a great deal in recent weeks about specialist supported housing services. The results of austerity, and cuts to and the decommissioning of services, should be of great concern to local mental health services. Any reduction in bed spaces will result in delayed discharges from psychiatric hospitals, rough sleeping, and worsening mental health.

And then there is, of course, the human cost which cannot be quantified in monetary terms.

There is a joint working group involving the DCLG and the Department for Work and Pensions is looking at the funding model for specialist supported housing. I think it is a critical error that the Department of Health is not involved because (other than clients) it has most to lose if rents in special supported housing is capped at Local Housing Allowance levels.

A & E admissions are already at record levels and, I understand, delayed discharge levels are now at 160,000 days lost per month. I think that the loss of specialist supported housing would mean that vulnerable people ready to be discharged from hospital would have nowhere else to go and there would be a further surge in delayed discharges and rough sleeping, the consequences would be catastrophic for local mental health services and for rough sleepers.


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