September2 2020 - Page 6

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