No-one left behind: Supporting people with complex needs on universal credit

Immediate release
5th April 2022


Pathway supports today’s report from IPPR on the cost of living crisis, by urging the DWP to end the ‘punitive sanctions regime’ that’s pushing people into hardship.

IPPR’s analysis of DWP data shows sanctions on benefit claimants have almost returned to pre-pandemic levels. As the cost of living hits people relying on social security hardest, we agree that benefits need a rethink to ensure a more ‘humane’ system.

Social security payments are now lagging far behind inflation, which will push many vulnerable benefit claimants into hardship and destitution. The IPPR’s analysis of the latest DWP figures show that sanctions on benefit claimants are almost back to pre-pandemic levels, despite the cost of living crisis now increasing the risk of people falling into destitution. In November 2021, when the latest data is available, 46,000 claimants were sanctioned, but the number of people being sanctioned has likely risen since then.

Today’s report warns that people on Universal Credit are not being treated as individuals, with their own circumstances and needs – leading to impossible conditions being imposed on claimants to receive their benefits. These inappropriate conditions set claimants up to fail and lead to sanctions, according to researchers.

This means many people mistakenly find themselves ‘at the sharp end of an often-punitive system’ and that for those vulnerable people with complex needs, this can be potentially lethal.

IPPR says that ‘punitive sanctions’ remain a core part of the Job Centre regime, despite limited evidence on their effectiveness and extensive evidence of the hardship they can cause – particularly for those with complex needs.

Interviews with those adversely affected revealed that many claimants felt pressured by the power-dynamic to agree to unsuitable conditions without raising concerns, and that open-plan Job Centres made them reluctant to raise important personal information. Others reported being put ‘on edge’ by the presence of security guards.

One Universal Credit claimant told researchers:

“I feel like I was in that situation where I haven’t got a penny to my name, I would have agreed to anything. If I challenge it they are gonna question it and it could delay everything.”

IPPR argues that the entire Universal Credit system needs to be reformed to increase levels of support and to achieve a higher basic minimum standard of living. In response to the Chancellor’s ‘shockingly inadequate’ Spring Statement, IPPR called for a policy combining an increase in Universal Credit and legacy benefits of 8.1 per cent and a rise in child benefit by £10 per child per week.

To ensure the benefits system works better overall and to ensure claimants, particularly those with complex needs, do not face inappropriate conditions or punitive sanctions, IPPR’s report calls for:

·    A humane approach – Claimants should be given a ‘second chance’ and not sanctioned immediately if they don’t appear meet the conditions of their benefits. They should get an opportunity to explain the situation, clear up any confusion and discuss potential changes to conditions.

·    Improved information – Claimants should have all the information they need about their claim and the conditions relating to it. They should automatically be informed of and offered the opportunity to change how and when their benefits are paid and given the chance to ask for an advance to avoid the five-week wait before receiving benefit payments.

·    Greater sensitivity – Claimants should be given the option to discuss their personal circumstances in a private room or over the phone or video call.

·    Better conversations – Job Centre work coaches should be better trained to spot warning signs of someone with complex needs. For example, researchers found that claimants who said they had ‘no housing costs’ on their applications were not being systematically asked why this was – meaning many who required homelessness support were not being offered it and were being expected to do entirely inappropriate job searches.

·    Preventing serious harm – Decision-makers should have the power to cancel a sanction if there is a risk of harm for the claimant. A range of public servants, from doctors to social workers, should also have the ability to raise ‘complex-needs flags’ with DWP so they are fully aware of the challenges people face and ensure they are not set up to fail.

Henry Parkes, IPPR senior economist, said:

“As the cost of living crisis deepens, the UK government must do more to support people living on low incomes – whatever their circumstances. It absolutely shouldn’t be making people’s lives any harder by imposing inappropriate conditions and punitive sanctions on them in a time of need.

“Alongside desperately needed action to increase the value of Universal Credit to keep up with the rising cost of living, we also need urgent action to ensure our social security system offers genuine security where people fall back on it. This should include urgent reform of the punitive sanctions regime, and a wholesale review of how the system can treat every claimant with dignity and respect.”

Julian Dalley, a support worker with lived experience of homelessness and rough sleeping, said:  

“Too often universal credit treats you like you must be lying and like what you have said isn’t true. The staff have no idea what it’s like to be on the street or moving from one friend’s sofa to the next. People who hit rock bottom need time and support to get themselves sorted out, but instead of support, DWP staff often feel like they are judging you, that you have failed and need to be taught a lesson.”

Alex Bax, CEO of Pathway, a homeless healthcare charity, said:

“Our specialist teams working in hospitals with homeless patients hear too many stories of sanctions, exclusions or inappropriate barriers being enforced by the benefits system. It often seems that the system withdraws support from people precisely when they need it most, when someone’s circumstances suddenly fall apart, when a relationship has broken down or when bad luck strikes.

“The benefits system defaults to assume wrong-doing and deceit. For people who’ve been made homeless, perhaps in the context of a mental illness or battling an addiction, Universal Credit is too often another source of stress and difficulty, rather than a basic building block of their recovery.”




Government responds to call for continued Covid-19 tests for homeless services



Pathway and the Faculty for Homeless and Inclusion Health, welcomes the Government’s decision to continue offering free Covid-19 tests for high-risk settings, including homelessness settings.

The news comes after Pathway and the Faculty, in partnership with other homelessness organisations, wrote to the Secretaries of State for DHSC and DLUHC calling on the Government to continue supporting patients and staff in homelessness settings after the end of community testing.

Following that letter, this week the Health and Social Care Secretary Sajid Javid confirmed that after the universal testing offer ends on the 1st April, tests will continue to be available to protect those most vulnerable to the virus at no cost.

These include:

  • Free symptomatic testing for people living or working in some high-risk settings, including supported living services, and;
  • Free asymptomatic testing for high-risk settings where infection can spread rapidly, including domestic abuse refuges and homelessness settings.


Pathway is pleased the Government responded to the recommendations of the homelessness sector, who have been working together to advocate for continued free testing across homelessness services. Covid-19 remains a serious health threat, particularly for those who are clinically vulnerable.




New joint statement on Covid-19 and free community testing


A new joint position statement has been released by UCL Collaborative Centre for Inclusion Health and the Faculty for Homeless and Inclusion Health on Covid-19 and free community testing.


As it stands, free community testing is due to an end on 1 April. The homelessness sector is deeply concerned as to the effects the removal of community testing will have on people experiencing homelessness and the ability to provide Covid-19 safe homelessness accommodation. 


Professors Andrew Hayward and Al Story have updated homeless sector advice in relation to Covid-19. As a minimum, they are recommending continued free availability for vulnerable people and health care workers to testing, and continued outreaching to provide Covid-19 vaccination.


View the statement here.


Pathway welcomes ‘game-changing’ NICE guideline on care for people experiencing homelessness

Immediate release

16th March 2022 

Pathway welcomes the National Institute for Health and Care Excellence’s (NICE) first ever guideline on integrated health and social care for people experiencing homelessness. Pathway has long advocated for multi-disciplinary responses to the complex health needs of people experiencing homelessness, who are at the sharp end of our nation’s health inequalities 


Pathway has a significant track record in implementing expert multi-disciplinary support in hospital settings for patients experiencing homelessness, and we are pleased to see NICE’s support for this approach.  

This new guideline comes at a crucial time in health and social care reform. The Government’s emphasis on health inequalities shows the importance of improving the health of those who have been least well served. This guideline will support the implementation of the Core20PLUS5 principles in Integrated Care Systems, giving clinicians and commissioners a clear, practical guide to meeting the needs of people experiencing homelessness.  

The new NICE guideline recognises the value in addressing the social determinants of health and multi-morbidity through poverty/trauma informed care, multi-disciplinary working, building cultural competences, and the requirement of services to always consider safeguarding risks and individuals’ mental capacity. Also, significant, and in alignment with Pathway’s view, is the acknowledgment that much more needs to be done to meet the palliative care needs of those experiencing homelessness who are reaching the end of their lives. The proposal of wraparound health and social care support that sensitively responds to patients’ palliative care and wider long-term support needs is vital. 


Pathway Chief Executive Alex Bax said: 

This new guidance should be a game-changer in the lives of homeless patients. We are delighted that NICE recognises that more effort and targeted health and care provision is needed for those experiencing homeless and social exclusion, across primary and secondary care; over the short and long term; taking into account addictions, mental health and palliative care support; and working within NHS structures as well as through outreach teams. This acknowledges the multiple and complex needs of people experiencing homelessness and the range of integrated services needed to support the most vulnerable in our society. 


Pathway’s model of creating specialist multi-disciplinary teams to support people experiencing homelessness in hospital is fully aligned with the new guidance (i)We were pleased that the NICE Committee accepted the evidence we submitted (ii) and the fact that our model is highlighted in the NHS Long Term Plan (iii)Through our national Partnership Programme, we will continue to work with NHS partners, doing all that we can to support them to comply with the new guidance issued today and improve health and care outcomes for those who need us most.” 

Dr Nigel Hewett, Secretary to the Faculty for Homeless and Inclusion Health said: 

We first published our set of inclusion health standards in 2011 with the primary aim of reaffirming the fundamental rights of all people to be treated with dignity, compassion and respect. At the sharp end of health inequalities, homelessness and other expressions of social exclusion are associated with extremely high healthcare costs coupled with appalling outcomes – we must and can to do better than this. These NICE guidelines have the potential to bring the whole NHS into alignment with the values and standards of the Faculty for Homeless and Inclusion Health and deliver better health outcomes for those in most need. 


NICE’s guideline is published as clinicians and practitioners from across the inclusion health community meet this week at Pathway’s 10th annual symposium. The conference includes keynote addresses from the Mayor of Greater Manchester Andy Burnhamhealth and government advisor Professor Dame Carol Black, and social policy advocate Dame Julia Unwin. 




Notes to editors 

For more information contact: Eva Morrison, Pathway Communications Lead, on 


Pathway’s 10th annual symposium on inclusion health PATHWAYS FROM HOMELESSNESS 2022 takes place in Manchester, on Wednesday 16 March, at King’s House Conference Centre, 49-51 Sidney St, Manchester M1 7HB; and in London, on Thursday 17 March, at the Royal National Hotel, Bedford Row, 38-51 Bedford Way, London WC1H 0DG. 


Pathway is the UK’s leading homeless healthcare charity. We work with the NHS and other partners to create improved models of care for people experiencing homelessness. 


The Faculty for Homeless and Inclusion Health is an inclusive membership organisation for people involved in healthcare for excluded groups. Membership is open to nurses, doctors, allied medical professionals, social workers, public health experts, health advocates and support workers, commissioners, researchers and people with a lived experience of exclusion. Our aim is to improve the quality of healthcare for people experiencing homelessness and other excluded groups. The Faculty is hosted by Pathway. 


Pathway Partnership Programme offers a defined, not-for-profit method to replicate and scale proven interventions, partnering with NHS organisations to deliver health care to quality standards. Pathway’s Partnership approach aims to increase the adoption of the Pathway hospital team model nationally by making it as easy as possible for local NHS service providers to adopt the model. It also ensures Pathway’s growing body of knowledge and expertise can be made available across the NHS. 


NICE is the National Institute for Health and Care Excellence. NICE’s role is to improve outcomes for people using the NHS and other public health and social care services by: Producing evidence-based guidance and advice for health, public health and social care practitioners; Developing quality standards and performance metrics for those providing and commissioning health, public health and social care services; Providing a range of information services for commissioners, practitioners and managers across health and social care. 

Further reading 

  1. Hewett 2016 

  2. Khan 2020 

  3. p42 NHS Long Term Plan 2019 



Pathway model case study 

Inclusion Health: outreach, in-reach, and community support 

The Pathway charity works with the NHS to help spread and develop its successful model of enhanced care coordination for people who are homeless and other excluded groups. 

Pathway developed the Pathway Partnership Programme to systematically partner with more providers to deliver high quality care to the people who need it most. 

Pathway’s work in Bradford, Brighton and at the Royal London, illustrate the ideal package of support across primary and secondary care for the most vulnerable patients. In these locations the Pathway team in the hospital consists of a GP, Nurse, OT/Social Worker, Housing Worker and Peer support. 

The Pathway team is based in the hospital, and can accept referrals directly via outreach and community services as well as hospital departments. Patients are then assessed in hospital for their healthcare needs by the Pathway team. Whilst in hospital, the patient is then registered with local a GP, and any addiction or mental health challenges are also addressed and their housing needs supported. The Pathway team hold weekly multi-disciplinary team meetings to discuss each patient with all partner organisations. On discharge from hospital, the Pathway team continue patient follow-up with community liaison – be that respite care if needed or straight into housing/GP support. 

Pathway is commissioned and works in partnership with the NHS, other health and social care organisations, and local authorities to help deliver quality care to marginalised patients. In Bradford Pathway also works with Bevan Healthcare and Horton Housing; in Brighton Pathway works with Arch Healthcare and Juslife; and, at the Royal London, Pathway works with Health E1, Providence Row, Thames Reach and the Peabody Trust. 



Pathway patient case study 

Adam is in his 30s. He has been known to the local Housing and mental health team over the last five years and had experienced homelessness due to his excessive alcohol use in an attempt to numb child and adulthood traumas.  

When the Inclusion Pathways team met Adam, he had presented in A&E after spending some time out of area. He had disengaged from services, stopped his medications and was involved in a relationship which he described as toxic.  

Adam presented tearful, unkempt and covered in bruises, he stated he was “desperate for help” and that his drinking was “ruining his life.” “I had to leave the flat I was living in and was told I could not be housed as I had no local connection, I used the last of my money to get a train to visit my sister. I knew I could not stay with her for long because of her children, it would not be fair – I needed to stop drinking but I was scared.”  

Adam told the team he had children who he had lost contact with and had increased his drinking to roughly 1L of spirits a day since leaving the army, 4 years ago. He wanted to detox but had had a seizure the last time he tried. He agreed to accept support from the Pathway team upon discharge but did not have a phone; he consented to the team making contact with his sister and providing her with a phone for him.  

The team advocated for Adam with hospital staff and encouraged him to stay in A&E to be assessed. After spending some time on the hospital Medical Emergency Unit, he was transferred to a Rapid Access Detox Acute Referral bed at a local detox unit. The aim of the Service is to provide quick access for patients from acute hospitals presenting with alcohol dependence or acute alcohol withdrawals who would otherwise require admission to an acute hospital bed.  

In the meantime, the team contacted the local Housing team to make an application for accommodation. Adam was able to return to his property that he occupied before leaving the area and was linked back up with his supported tenancies worker who specialises in supporting veterans.  

From the Detox unit, Adam made contact with the team to check in and organise support upon discharge, he was registered with the Inclusion GP service to promote wrap around care, and during the weekly MDT he was discussed with the local Drugs and Alcohol Community team who agreed to provide Outreach support upon discharge. Weekly reviews allowed the team to monitor Adam’s progress and support as and when needed.  

Adam finds working with the Community Drugs and Alcohol team difficult and he is also finding it hard to budget to meet his basic day-to day needs but the team are on call to provide regular support to help him maintain the progress made. He has abstained from alcohol since his detox. During the team’s last call, he shared that he had accepted a full-time job which he is looking forward to starting to keep him busy. His long-term plan is to reconnect with his children once he is more settled; he said he feels like to he is on the road to a good place. 

A new Pathway Inclusion Health Team at the Homerton


A new local health service officially launched in Hackney last week [24th February 2022] to treat its most vulnerable patients.


The new Inclusion Health team at Homerton Hospital has been created to treat the health and social care needs of people experiencing homelessness and others excluded from mainstream health services. The team was brought together by Pathway, the UK’s leading homeless healthcare charity, in partnership with the NHS and other community organisations, to improve care for people experiencing homelessness.


The launch event heard from Councillor Sade Etti, Hackney Cabinet Member for Homelessness, Housing Needs & Rough Sleeping; Cindy Fischer, Commissioning Programme Manager, NHS North East London CCG; Breeda McManus, Chief Nurse, Homerton University Hospital Foundation Trust; Irfaan Ibne, Head of Operations at East London Foundation Trust; Dr Theresa Murphy De Souza (GP) and Hannah Green (Senior Nurse), from the Inclusion Health team; Alan Ferguson, Head of Service from Peabody (housing and community programme provider); and Pathway CEO, Alex Bax.


The Inclusion Health team aims to stop the revolving door of hospital attendance, and treat patients’ health, social care and housing needs. The new team want to bridge the gap in treatment so that all patients are able to access high quality health care, and whilst also establishing a safe and secure home, so that once the patient leaves hospitalthey will be aided in their recovery and on-going health.


At the launch Dr Theresa Murphy De Souza, Clinical Lead of the Inclusion Health team, said:

“Homelessness is a healthcare issue. You can’t be well if you don’t have a safe, clean, stable place to stay.”


Cllr Etti said the new team will: “improve quality and improve partnership working.”


Irfaan Ibne, East London Foundation Trust, said: “This is collaborative working at its best.”


Alex Bax , Pathway CEO said: “We are pleased to have been a part of setting up this service at the Homerton, and it has been inspiring to work with a team who are so clearly committed to caring for some of London’s most vulnerable people. There is a real need locally to treat people who may be missing out on care. This new team will treat all patients with respect and dignity, and help as many people as possible move on from homelessness.” 


The Inclusion Health team will support and advocate for homeless patients, improve patient care, enable safe discharge and follow up in the community. They will also help to train hospital staff to identify homelessness, and host regular team meetings to ensure ongoing progression of complex cases.

Referrals to the service are accepted from within the hospital, GPs, supported housing providers, local authorities or from people experiencing homelessness themselves.



St Martin in the Fields Charity selects Pathway for funding

Pathway is delighted to have been selected by the St Martin in the Fields Charity, for funding over the next three years.

The Frontline Fund has made £1.5 million available to Pathway and five other organisations to support our shared vision of everyone having a safe palace to call home and the support they need.

Thanks to St Martin’s Charity support, Pathway will be able to provide the legal advice needed in securing more stable outcomes for our patients and help improve even more lives across the UK.


Alex Bax, Pathway CEO commented: “Being homeless or the threat of homelessness is extremely bad for your health. Disease rates for people who experience homelessness can be ten times higher than those found in the housed population. Getting ill can also be a trigger for homelessness, through losing your job, or struggling to manage life with a mental health or addiction problem.

Homelessness is a healthcare problem but getting access to it can prove challenging for our most vulnerable patients. We are delighted to partner with St Martin-in-the-Fields Charity to help provide the legal advice needed in securing more stable outcomes for our patients and help improve even more lives across the UK.”


Tim Bissett, Director of St-Martin-in-the-Fields Charity, said: “We are delighted to be able to use the funds raised by the BBC Radio 4 Christmas Appeal to provide people experiencing homelessness with a safe place to call home and the support they need.

“We are excited to be partnering with all of these outstanding organisations and are looking forward to seeing what our relationship can achieve over the coming years!”


Following 81 applications from organisations across the UK, Pathway is a recipient for funding alongside Caring in Bristol, TGP Cymru, Legal Services Agency, akt, and Extern. We have entered a multi-year working partnership with St Martin’s Charity over three years and will receive a share of the Fund, which will enable us to deliver our existing services more effectively, and/or develop new and innovative ways of providing meaningful support for people at risk of or experiencing homelessness.

St Martin’s Charity is able to award this Fund, due to the annual BBC Radio 4 Christmas Appeal – which each year raises millions of pounds to transform the lives of people facing homelessness across the UK.


About the Frontline Fund recipients

Caring in Bristol deliver projects around homelessness that engage a community of volunteers, bringing people together to make change. Like St Martin’s Charity, Caring in Bristol are striving to create a society where everyone has a home and works hard to prevent people becoming homeless in the first place.

TGP Cymru is a leading independent Welsh children’s charity working with some of the most vulnerable and marginalised children, young people, and families in Wales. Helping individuals access appropriate services in health, education, and social care – TGP Cymru works tirelessly to ensure everyone has a voice to have a say in their future.

Legal Services Agency (LSA) is a Scottish law centre and charity committed to defending legal rights and using the law to effect social change. Believing that everyone is entitled to specialist legal advice when they need it, LSA works to prevent homelessness alongside other valuable services.

Akt supports LGBTQ+ young people aged 16-25 in the UK who are facing or experiencing homelessness or are living in a hostile environment. Not only do they support individuals into safe homes, but the charity also ensures young people have access to employment, education or training in a welcoming and open environment that celebrates LGBTQ+ identities.

Extern is a leading social justice charity across the island of Ireland who speaks up for and supports more than 21,000 children, young people, individuals, and families each year to overcome challenges, empower positive change and support family unity.


Read the Frontline Fund announcement press release here.

Pathway appoints new Head of Programmes and Policy

Pathway’s CEO Alex Bax said:  “I’m so pleased that Dee has decided to join our core team. I know that Dee’s extensive senior level knowledge, skills and experience, and the personal commitment she brings, will substantially increase Pathway’s ability to influence the wider health and social care system.”

Dee O’Connell said:  “I am delighted to be joining Pathway’s core team. Their mission to improve the health and wellbeing for people experiencing homelessness is one that speaks deeply to my passion for improving services for people facing multiple exclusion.

It is a privilege to have the opportunity to work with so many committed colleagues, as well as those in the NHS, housing and beyond, doing such excellent and important work on inclusion health. As the external environment gets ever more challenging for people experiencing exclusion, Pathway’s drive to change how health services respond is needed now more than ever. ”


Editor’s notes:

Pathway is the UK’s leading homeless healthcare charity. It works with the NHS and other partners to create improved models of care for people experiencing homelessness. Pathway’s model of a multi-disciplinary team in a hospital uses the opportunity of a hospital admission to enable people experiencing multiple exclusion to move onto a more positive life path.

Founded in 2009, Pathway has worked to improve the quality of healthcare homeless and excluded groups receive by:

  • developing and sharing best models of care like its hospital teams;
  • increasing specialist skills of workers in healthcare;
  • influencing policy; and
  • reducing stigma in healthcare against people experiencing multiple exclusion.


For more information, contact:


The Ministry of Housing, Communities & Local Government is now called the Department for Levelling Up, Housing and Communities (DLUHC).

The DLUHC  supports communities across the UK, and is a ministerial department supported by 13 agencies and public bodies. Its work includes investing in local areas to drive growth and create jobs, delivering homes, supporting community and faith groups, and overseeing local government, planning and building safety.


Pathway joins call for the Health and Care Bill to tackle extreme health inequalities

Today, a coalition of organisations working directly with people experiencing homelessness or other forms of social exclusion are calling on the Westminster Government to accept amendments to the Health and Care Bill as it passes through the Lords. The amendments would ensure the NHS plays its full role in tackling health inequalities amongst these groups.

The full letter reads:

Ms. Gillian Keegan MP
Minister for Care and Mental Health
Department of Health and Social Care
39 Victoria St

11th January 2022

Dear Minister,

As organisations supporting or representing people from marginalised communities, we are writing to urge you to amend the Health and Care Bill so that it addresses the needs of people who experience severe health inequalities  as a result of social exclusion.

As you will know, there is a well-established link between disadvantage and poor health that demonstrates the devastating impact that social exclusion can have on someone’s physical and mental health. For example, the average age of death for people experiencing homelessness in England and Wales is 46 for a man and 42 for a woman. This is compared to life expectancy in the general population of 79 for men and 83 for women. We also know the life expectancy of Gypsy, Roma and Traveller communities is around 10-12 years less than the general population.

People who experience the most extreme of health inequalities, such as those who are homeless; sex workers; Gypsy, Roma and Travellers communities; vulnerable non-UK nationals; and people with substance misuse issues, also encounter significant barriers to accessing and receiving healthcare that meets their needs. These barriers can include stigma, discrimination, no fixed address or photo ID, fragmented services, a disruption to continuity of care because of unstable accommodation, immigration status, and a lack of awareness by healthcare professionals of their specific needs. Too often this results in people continually moving through support systems without getting the help they need.

We work directly with people in this situation on a daily basis and witness how they can fall through the gaps of basic health services. For example, one patient experiencing rough sleeping, supported by the HealthNow partnership, had run out of his medication but could not afford to travel to his GP or pharmacy. He also struggled to read and write so he couldn’t understand written information. With the support and help of a Health Advocate this individual was able to access the help of his GP and local Drug and Alcohol Service.

However, such services that connect these communities to mainstream healthcare and support their holistic needs, are not currently widely commissioned and remain a postcode lottery. This was highlighted in the Kerslake Commission on Homelessness and Rough Sleeping, which found that during the pandemic there was a significant degree of local variation in response to meeting the health needs of people experiencing homelessness. King’s College London found that 56.5% of homelessness projects in England do not have specialist primary healthcare services in their area.

We strongly welcome the Government’s commitment to tackle inequalities and to integrate health and care services. However, we are concerned that the current Health and Care Bill does not go far enough to address the needs of people who have historically faced severe health inequality and continue to do so. As the Bill passes through the House of Lords, we urge you to accept the amendments laid by Lord Young of Cookham which will be considered today, on the first day of Committee Stage (amendments 152, 156 and 157 to Clause 21). The amendments are also co-sponsored by Baroness Armstrong of Hill Top; Lord Shipley; and Baroness Neuberger. We have attached these cross-party amendments in full to the accompanying email for your ease.

The amendments will ensure that all newly created Integrated Care Partnerships have ‘due regard’ in their strategies to improving the health outcomes of people who experience the worst forms of health inequalities due to social exclusion. Although the Bill already places a duty on Integrated Care Boards to have regard to the need to reduce health inequalities, we do not consider this to be at the scale nor the level of integration required across the health and care system to tackle health inequalities faced by the people we support and represent.

These amendments would ensure specific and dedicated attention from Integrated Care Partnerships to people who experience severe health inequalities. It will help strengthen and complement the Government’s welcome ambition in this area to tackle the ‘disease of disparity,’ as the Secretary of State for Health and Social Care said recently. Building on the progress made in the pandemic, it will also make clear the importance of having a stable home on health outcomes, by ensuring Integrated Care Partnerships consider housing in addition to health and social care in their local strategies. It is clear from our expertise working with these groups that inadequate housing can have a devastating impact on an individual’s mental and physical health.

Beyond the damaging effect of health inequalities on individuals, these unmet health needs also come with a huge and avoidable cost to the healthcare service and wider society. These amendments will help alleviate pressure on emergency care and save money, at a time when NHS services are under unprecedented pressure – research by the Lankelly Chase Foundation estimated conservatively that the cost of severe and multiple disadvantage to society is £10.1 billion per year.

These amendments will help the most marginalised in our society to access and benefit from critical health services, and we call on the Government to use the opportunity of the Health and Care Bill to strengthen its commitment to tackling health  inequalities. We would welcome the opportunity to discuss these amendments with you as the  Bill passes through the House
of Lords.

Yours sincerely,

Matt Downie MBE, Chief Executive, Crisis
Alex Bax, Chief Executive, Pathway
Steven Platts, Chief Executive, Groundswell
Sarah Mann, Director, Friends, Families and Travellers
Steve Douglas CBE, Chief Executive St. Mungo’s
Sally Daghlian OBE, Chief Executive, Praxis
Anna Miller, Head of Policy & Advocacy, Doctors of the World UK
Enver Solomon, Chief Executive, Refugee Council
Stephen Bell OBE, Chief Executive, Changing Lives
Moya Woolven, Chief Executive, Basis Yorkshire

Croydon launches new Pathway team

Croydon Pathway Team

Media Release

For Immediate Release: 8 December 2021


Croydon Health Services NHS Trust bolsters support for people experiencing homelessness this winter


As well as providing emergency medical care, Croydon’s doctors and nurses will be offering additional support to people experiencing homelessness who live in the borough, to help them off the streets this winter.


The specialist team, which includes nurses, mental health professionals, GPs and supporting teams from Croydon Council, will work together with those at risk of homelessness to find somewhere safe to live and to support ongoing health needs. Care navigators will also be able to provide clean clothes and essential items and offer signposting to additional advice services.


Juliette Penney, Head of Public Health Nursing at Croydon Health Services NHS Trust said:


“The NHS is here to provide medical treatment to those who need it. However, often those who need emergency care also need other support, which extends outside of the hospital walls.


“We really want to do more for the hundreds of people experiencing homelessness in Croydon who seek help, and so we’re bringing together all of the right people in one dedicated team we can make a real difference to those living on the streets.


“It’s another important step forward in addressing the avoidable differences in health that we see across the borough. We want to thank our excellent partners including the Pathway charity and our SW London Health and Care Partnership.”


The service was launched at an event for local health and care professionals on Tuesday (7 December), introducing the Croydon Health Services Homeless Pathway Team and discussing the key areas that the team will tackle in their quest to end homelessness in the borough.


According to the Office for National Statistics (ONS), people experiencing homelessness often suffer from multiple health issues, and the average death for women experiencing homelessness is 43 years, and 46 years for men.


Dr Subhro Banerjee, Medical Director and Emergency Department added:


“As an ED doctor, I often see homeless people coming through the Department for medical care, but they also need much more than that. Throughout the year, but especially during the winter period, sleeping on the streets can be a real health risk, with conditions such as hypothermia commonplace in colder months.


“We know that the cycle of readmission to hospital is more common for our homeless population and there’s real passion within the Pathways team and across the Trust to end this and improve the health of those experiencing or at risk of homelessness.


“I’m incredibly proud of the teams working tirelessly to provide joined up health and care for those who really need it and can’t wait to see the difference this service will make to our patients.”


South West London Clinical Commissioning Group successfully secured funding from the Department of Health and Social Care for this project which will initially be for a 12-month period costing around £360,000.


Dr Agnelo Fernandes, GP Borough Lead for Croydon and Croydon Local Committee Chair said:


“This scheme brings together all of the vital teams working across the NHS, Croydon Council and our community organisations to offer a rounded package of support for the borough’s homeless population.


“The health inequalities facing people in Croydon can be stark and we need to do everything we can to care for our most vulnerable residents. Alongside supporting people into housing, it’s hoped that this service will allow us to improve the overall health of local people and improve access to essential primary care and mental health services as well as financial and educational support.”




Editor’s notes:

·         Croydon Health Services NHS Trust runs two hospitals in Croydon as well as providing community health services at home, in schools and in 15 health centres across the borough.

·        How to contact the Croydon Pathway team

Ask a nurse of doctor if you want to talk to the Homeless Pathway Team. You can also call the team yourself.

Telephone number: 07766 939 141


Opening hours: Monday – Friday 9:00-17:00

There is also an outside hour’s housing support officer as part of the Pathway Team.

Telephone number: 07766 939 141


Omicron homeless sector Statement

New joint position statement released today by UCL Collaborative Centre for Inclusion Health and the Faculty for Homeless and Inclusion Health on the Omicron variant and vulnerable patients.


It follows the Government announcement on 8 December 2021 to enact Plan B due to the high probability of widespread community transmission of SARSCoV-2 Omicron variant putting the NHS under unsustainable pressure.


Plan B commits to communicating clearly and urgently to the public that the level of risk has increased and steps should be taken to manage the increased risks of the virus.


Professor Andrew Hayward and Professor Al Story have now updated homeless sector advice in relation to Omicron, proposing regular structured use of testing, and isolation of positives and confirmatory PCR testing.


View the statement here.