Medics join with homelessness charities in open letter to the Home Secretary, urging reversal of asylum practice. They warn of homelessness and health risks amid pressures on the NHS.

  • Changes to Home Office practice are giving refugees as little as seven days to leave their temporary accommodation, pushing many onto the streets.
  • Refugees who become homeless as a result will face significant risks to health, especially in colder weather, when pressures on the NHS are already at their greatest.
  • Signatories, including leading medical Royal Colleges and homeless charities, call on Government to restore the previous standard of 28 days notice to quit accommodation, and to stop all evictions during very low temperatures to avoid loss of life.

A coalition of leading organisations in health and homelessness has issued an urgent open letter to the Home Secretary, expressing deep concerns over changes to Home Office practice affecting refugees granted asylum decisions. Signatories, including the Royal College of GPs, the Royal College of Emergency Medicine, the Royal College of Physicians, the Royal College of Nursing, and prominent homelessness charities including Crisis, Shelter and St. Mungo’s, are speaking out against a practice that compels individuals to leave National Asylum Support Service (NASS)-funded accommodation within seven days of receiving a decision on their asylum application.

The signatories underline that these changes will likely result in dire consequences for the health of those affected and will place additional, avoidable burdens on an already stretched NHS. The open letter highlights that such a practice means that many refugees will immediately become homeless, exposing them to serious health harms of homelessness, particularly during the coldest time of the year, leading to spirals of poor health and potential loss of life.

The letter says, “Practice that forces new refugees onto the street runs contrary to the founding principles of the NHS and are a waste of human life and potential. Reversing this would be an excellent start to your tenure as Home Secretary and we look forward to working with you to achieve this.”

People without an address struggle to access primary care so this new Home Office behaviour will also force refugees to rely on emergency health services, at the very time of year when those parts of the NHS are under the most pressure.

The signatory organisations and individuals urgently call on the Home Secretary to:

  • Restore the minimum 28-day period before refugees are required to leave their Home Office accommodation. This will allow for more time for homelessness prevention assistance and transition planning for primary care and housing.
  • Ensure that refugees receive all their new documentation at one time. People should receive their refugee grant letter, their Biometric Residence Permit, the letter containing the date when their asylum support will end, and the notice to quit their accommodation on the same day. The 28-day notice period should not begin before this point.
  • Stop all evictions during very low temperatures, at the very least when homelessness Severe Weather Emergency Protocol arrangements are activated.
  • Work urgently with NHS England, primary care providers and refugee support organisations to maintain access to primary care for evicted refugees.

The full letter can be read here.


Notes to editors

For more information contact: Dee O’Connell, Pathway Head of Policy and Programmes,

  • The acceleration of asylum decisions as the Government seeks to clear the backlog is a key driver of this issue. 5000 decisions are expected in London alone between now and Christmas, with 2500 decisions a month taking place nationwide.
  • This is against a backdrop of record levels of rough sleeping and the likely failure of Government to hit is rough sleeping target.
  • This letter underlines recent concerns expressed by The Refugee Council and others.
  • 4,068 people were counted sleeping rough in London between July and September 2023, according to the latest CHAIN figures. This represents a 12% increase on the same period in 2022 and is London’s highest quarterly rough sleeping count since records began.
  • Local authority leaders are extremely concerned by the impact on rough sleeping Boroughs warn of ‘spiralling’ homelessness crisis as London rough sleeping hits record high | London Councils
  • Pathway is the UK’s leading homeless and inclusion health 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.