The pan-London Co-occurring Conditions Programme
Working collaboratively across London to ensure there is no ‘wrong door’ for people experiencing homelessness with co-occurring mental health and substance use issues.
Led by Transformation Partners in Health and Care and overseen by the Office for Health Improvement and Disparities (OHID) London, the programme focuses on improving integration and coordination between substance use and mental health services for people experiencing homelessness in London.
Why is this project important?
People experiencing homelessness with co-occurring mental health and substance use issues often face repeated and cumulative trauma and mental health challenges. A 2022 study found that 82% of people had experienced multiple traumas, two-thirds had experienced four or more, and half had experienced five or more traumatic events during their lifetime.
In England, 74% of people starting drug and alcohol treatment have a mental health treatment need.
These issues often create multiple barriers and increase stigma, making it harder for people to access the support they need.
What are we doing?
The Co-Occurring Conditions Programme is embedded within public health teams across London boroughs, driving local system change to improve support for people experiencing concurrent mental health, substance use and housing challenges. In 2026-27, we are working with Westminster, Waltham Forest, Ealing, Richmond and Wandsworth, with additional boroughs joining the programme each year.
Alongside our borough-based work, we collaborate across London and with national partners to influence policy, share learning and champion better outcomes for people with co-occurring conditions.
The programme is working in partnership with local stakeholders and people with lived experience across the following five areas:
- Leadership, Governance & Strategy: Building system leadership and clear plans so partners can work together to improve support for people experiencing co-occurring conditions.
- Integrated Service Design & Delivery (No Wrong Door): Designing coordinated pathways so people get help wherever they first ask for it, without being passed between mental health, substance use and homelessness services.
- Data, Screening and Information Sharing: Improving how partners collect, share and use information, including routine screening, so support is better coordinated.
- Workforce Development and Shared Learning: Helping staff across services build the knowledge and skills to support people experiencing homelessness, mental health difficulties and substance use.
- Co-Production, Equality, Diversity & Inclusion: Ensuring the voices and experiences of people who have used services shape decisions, while promoting fair, inclusive and accessible support.
Training and resources
Here you’ll find useful e-learnings and resources targeted at improving experience of and access to services for people with co-occurring mental health and substance use disorders.
Our partner’s work
Contact us
If you would like to know more about the London Co-Occurring Conditions programme, please feel free to contact Alison Bearn, Programme Manager at alison.bearn@nhs.net.
Page updated 27/08/2026