COVER STORY
Opening the do
The efforts to get homeless people
into emergency accommodation
must not be wasted, as DDN reports
Homelessness
has been long
been regarded as
complex, difficult,
inevitable – and
easy to ignore.
The substance misuse sector has
struggled to maintain outreach
services in the face of disappearing
funding and has tried to create care
pathways with varying levels of
success.
A conference on homelessness
and addiction last year (DDN
February 2019, page 16), raised many
questions – why don’t we take notice
of the evidence to stop ‘thoroughly
preventable’ drug poisoning deaths
with simple and cost-effective
harm reduction measures such
as naloxone? Why are we still
discharging from hospital onto the
street? Why are care pathways so
fragmented? Why aren’t we creating
routes out of dependent drinking?
Why is there no help for smokers?
While COVID-19 has thrown
everyone’s life into disarray, there
is one group of people who might
actually benefit as a result. Things
couldn’t have seemed much worse
for the street homeless population
when housing minister Robert
Jenrick announced £105m to
provide interim housing to take
thousands of rough sleepers off
the street during the pandemic,
including £16m for people in
emergency accommodation to
access specialist help for substance
misuse. The money is also aimed
at helping rough sleepers to secure
their own tenancies, as part of the
government’s commitment to ‘end
rough sleeping for good’.
Dame Louise Casey, chair of the
COVID-19 Rough Sleeping Taskforce
called the ‘Everyone in’ initiative
an ‘extraordinary effort’ and an
‘extraordinary opportunity’ to turn
lives around if we get the next steps
right. ‘I am clear that there can now
be no going back to the streets as
people begin to move on from the
emergency accommodation that
has been put in place,’ she said.
In London the initiative has
taken shape through the Homeless
Drug and Alcohol Service (HDAS),
commissioned by Public Health
England and the Greater London
Authority. The ’pan-London system’
involves the South London and
Maudsley (SLAM) and Central North
West London (CNWL) NHS Trusts,
working with Change Grow Live
and Turning Point (who coordinate
logistics), We Are With You and
Phoenix Futures. A 24-hour phone
line is manned by recovery workers
from the pool of organisations
involved.
Dr Emmert Roberts is clinical
lead for HDAS and told DDN how
the service was commissioned for
three months in March, extended
for another three, and is looking
likely to carry on for longer. A
‘hodge podge of a system’ at the
beginning, it has had to come a
long way in a short time, he says. ‘It
was chaos – getting people off the
streets as quickly as you can. Once
they were off the street, we could
do more stuff.’
The first challenge was to secure
rooms in hotels, and this involved
splitting the intake into three distinct
cohorts. People with symptoms or
who tested positive for COVID-19
needed to be isolated in ‘COVID
‘I am clear that
there can now
be no going back
to the streets as
people begin to
move on from
the emergency
accommodation...’
DAME LOUISE CASEY
care’ rooms. The next category was
‘COVID protect’ for those who tested
negative but who had medical
vulnerabilities. Everybody else was
assigned a ‘COVID prevent’ room.
Once this was achieved – which
Roberts admits involved ‘abject
6 • DRINK AND DRUGS NEWS • SEPTEMBER 2020
WWW.DRINKANDDRUGSNEWS.COM