As the Homelessness Reduction Act marks its fifth anniversary, Pathway Policy Officer Emily Page looks at the ongoing benefits and challenges presented by the Duty to Refer. 

On the 3rd of April 2018, the Homelessness Reduction Act was implemented across all local authorities in England; a fundamental reform in homelessness legislation which put prevention at the heart of tackling homelessness.

The  Act  placed a duty on specified public authorities to refer service users who they think may be homeless or threatened with homelessness to a housing authority. The Duty to Refer was intended to encourage local authorities and other public bodies to build strong partnerships, enabling them to work together to intervene earlier to prevent homelessness through increasingly integrated services. It would ensure that people’s housing needs were considered when they came into contact with public authorities.

We know that health services such as emergency departments, urgent treatment centres, and inpatient care services treat people at risk of, or experiencing homelessness, everyday:

In 2022, 2388 patient referrals were accepted by 9 Pathway hospital teams across the country.

That’s why, five years on, Pathway is collaborating with Crisis to explore how the duty is working in hospital settings and the extent to which the legislation is working to prevent homelessness. Together, we convened conversations with local authority and healthcare staff across five localities in England to discuss how they feel the duty is operating in their area, provide a space to share best practice, and identify any difficulties and barriers in implementation.

Staff remained candid yet hopeful throughout the discussions, recognising that the Act and subsequent duty were a step in the right direction, with some staff reporting improvements in local discharge processes and integration between services.

Laudable though these aims may be, staff also highlighted that successful implementation of the Duty is mired in systemic challenges, including, most fundamentally, the lack of appropriate and accessible housing options on offer for patients with complex needs:

‘’It’s hard to do any real preventative work when you’re constantly firefighting’’.

‘’In a nutshell – there isn’t enough accommodation – the complexity of need just isn’t met’’.

To read more about the obstacles impeding the Duty to Refer in practice and recommendations for how we might mitigate them, look out for the report of our review, to be published in Spring 2023.