The programme is being delivered by Public Health England and the City of London, in partnership with the Greater London Authority and London boroughs

The programme

There is strong evidence that people who sleep rough experience some of the starkest health inequalities in London. Indeed, the average age of death of a person who sleeps rough in England is under 50 years old. People who sleep rough also experience higher levels of multiple, complex co-morbidities than other groups including substance misuse and physical and mental health problems. Their lack of stable accommodation is a further barrier to engagement with treatment and healthcare which in turn creates a revolving door of homelessness, addiction, ill health and early death.

Beginning in 2020, the Ministry of Housing, Communities and Local Government (MHCLG) provided funding as part of the ‘Everybody In’ programme, aiming to end rough sleeping in the longer term, but also supporting accelerated local collaboration and effort to house everyone who sleeps rough due to their vulnerability to COVID 19. In recognition of the high level of drug and alcohol misuse amongst this group, funding was also announced for drug and alcohol treatment services. Given the particular complexities of London’s commissioning landscape, and the transient nature of the population in scope, a regional approach was agreed to complement and enhance the local efforts to engage people who sleep rough in treatment.

In consultation with London stakeholders, this approach allowed PHE London and the GLA to submit a number of pan-London bids to fund provision where unmet needs were identified. A pan London programme of specialist and bespoke services is being developed and funding continues to be confirmed. The elements of the programme have been designed to be interdependent, creating synergy between the proposed provision so that systems in London can meet the multiple needs and comorbidities of people who sleep rough/risk of return to the street/risk of homelessness. The programme is designed to complement and enhance Local Authority substance misuse provision rather than to duplicate it, whilst also developing regional expertise and capacity and bringing cost savings.

The programme of services is being commissioned by the City of London on behalf of the partnership.

This is a unique chance to engage with the most marginalised cohort of Londoners facing some of the most extreme health inequalities, and a key opportunity for London’s public health systems to act collaboratively to transform service delivery for this group.

This page will be updated as and when funding is confirmed for different elements of the programme, and as services are mobilised. Key information about the services and any eligibility and referral information, as well as details of any contribution to the cost by the Local Authority, can be accessed via the links on the right.

If you would like to be updated about the work programme please subscribe to the newsletter by contacting: Nadia.Adigbli@cityoflondon.gov.uk

The services

• The Addiction Clinical Care Suite 1 (ACCS 1) is provided by Guy’s and St Thomas’ NHS Foundation Trust at St Thomas’ Hospital and is the first of the pan-London services to open its doors. The ACCS offers five elective in-patient detoxification and stabilisation beds for people who sleep rough, are at risk of return to the street, or at risk of homelessness and are dependent on drugs and/or alcohol who also have high levels of co-occurring complex physical/mental health medical need.
• The Addiction Clinical Care Suite (ACCS 2) Universal Unit is open to all people who are dependent on drugs and/or alcohol and is not specific to people who are at risk of, or experiencing, street homelessness. This service is intended to address the gap in complex inpatient detoxification provision in London for those with co-occurring physical and mental health needs.

Further ahead, the programme will also commission:

• new recovery-focused intermediate residential care units (following in-patient substance misuse detoxification and stabilisation)
• new ‘Pan-London Homeless Substance Misuse Engagement Team’ to work across London and alongside local community substance misuse teams to provide an expert network and support more people who sleep rough/risk of return to the street/risk of homelessness to engage with treatment as part of the homeless health pathway

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