City and Hackney: Rough Sleeper's Drug and Alcohol Peer Support

The numbers of people sleeping out on the streets across England hit record levels in 2018, amongst those who sleep out there is a high prevalence rate of problematic and dependent drug and alcohol use. Due to 8 years of central Government underfunding, community drug and alcohol treatment services have been unable to offer the type of enhanced treatment options which achieve better, sustained recovery outcomes for people experiencing homelessness with substance use disorders.

Following the success of Everyone In during the first year of the pandemic in 2020, the Office of Health Improvement and Disparities (OHID), alongside the Department for Levelling Up, Housing and Communities (DLUCH), launched a number of grant funded schemes targeting support for people rough sleeping. The Rough Sleeping Drug and Alcohol Grant is one of these grant funded programmes of work. Most recently this programme has been extended and will run up to the end of March 2025.

The City and Hackney were 2 of the authorities out of 60 in total awarded grant funding. The successful City and Hackney bid focuses on providing greater outreach through two dedicated rough sleeper community treatment teams, taking treatment to people sleeping rough. The second phase bid further includes a greater mosaic of clinical and service expertise most relevant to the needs of rough sleepers, such as more GP time, an alcohol specific nurse, a Speech and Language Therapist and Peer Health Advocates.

Overall, the project aims to engage more rough sleepers into all forms of treatment, from harm reduction, structured treatment, to detox and rehab. It requires local systems to provide an enhanced offer to rough sleepers which supports sustained longer term, improved health outcomes.