OUTREACH SERVICES
BREAKING BARRIERS
L ast November, City & Hackney Recovery Service became the largest drug and alcohol service in London to achieve microelimination of hepatitis C. This milestone reflects not only clinical success, but the impact of a sustained, on-the-ground effort to reach some of the city’ s most vulnerable residents.
At the heart of this work is the rough sleepers team( RST), whose outreach approach is helping to break down the barriers that often prevent people experiencing homelessness from accessing treatment. In the year to April 2025, the RST carried out 67 hepatitis C tests by meeting people where they are, through satellite hubs, partner services and a community wellbeing van.
The team works across a network of locations where homelessness and substance use intersect: hostels, soup kitchens, community organisations and homelessness assessment centres. Rather than expecting people to come to them, recovery
A proactive outreach approach is transforming care for rough sleepers in East London, says Jara Senar Villadeamigo
workers bring support directly into these spaces. Alongside the clinical team, they offer a range of interventions on outreach, from prescribing and BBV testing to harm reduction and wellbeing support.
FILLING THE GAP The rough sleepers team was established in 2021 through the rough sleeping drug and alcohol treatment grant – before this, no dedicated substance use outreach service existed across City and Hackney for this group. As a result, many people referred into treatment disengaged before even completing an assessment or dropped out shortly afterwards. Despite significant effort from partner agencies to encourage attendance, services struggled to meet people in ways that addressed the realities of homelessness.
Today, the RST is made up of five recovery workers, each supporting 25 to 30 individuals experiencing rough sleeping or other forms of homelessness. The team operates flexibly, delivering assessments, welfare checks, keywork and clinical interventions in a wide range of settings, from the street and community centres to hostels and Turning Point service sites.
Central to the team’ s success is its ethos: meeting people where they are, both physically and emotionally. At Turning Point City and Hackney, individuals can walk in Monday to Saturday without referral and receive a sameday assessment. Drop-in clinics are also delivered through the outreach van in partnership with City and Hackney public health community wellbeing team, and where clinically appropriate opioid substitution therapy can begin on the same day.
Staff work alongside individuals and their wider support networks to understand their experiences, including why previous attempts at treatment may not have worked. For many people who are rough sleeping, services can feel inaccessible or unwelcoming due to past experiences of exclusion and stigma. The RST’ s flexible, persistent approach helps to rebuild trust and create sustainable routes into care.
STRENGTH IN PARTNERSHIP The team’ s impact is strengthened by close collaboration with a wide network of partners, including hospitals, GPs, mental health services, community organisations such as North London Action for the Homeless, sex worker support services, hostels and homelessness assessment centres. They also deliver naloxone training and overdose prevention support, equipping partner organisations with the tools to help reduce overdose risk in the community.
A key part of the model is the community wellbeing van, which enables weekly early morning outreach alongside the Hackney street outreach team( SORT), City of London Thames Reach and the Greenhouse homeless GP service. The team also plays a role in multi-agency outreach coordinated with police, enforcement teams and other services, targeting areas of high drug-related activity. For people who may never walk through the doors of a traditional service, the van provides a vital lifeline, offering assessments, prescribing and health interventions in familiar and accessible environments.
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22 • DRINK AND DRUGS NEWS • JUNE 2026 WWW. DRINKANDDRUGSNEWS. COM