Agenda item

Following the recent publication of Healthwatch Dorset report looking at health inequality for people experiencing homelessness NHS Dorset and BCP Council welcome the opportunity to consider how current systems through existing services seeks to address inequality for people experiencing or at risk of homelessness. A number of areas of concern and enquiry have been raised.

The services available across the BCP area are varied to address this issue. In response to the recommendations within the research, the report describes how services, their interactions, together with how emerging plans and opportunities, are developing to address these themes.

The Principal Programme Lead, NHS Dorset presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'B' to these Minutes in the Minute Book. The Committee was advised that following the recent publication of Healthwatch Dorset report looking at health inequality for people experiencing homelessness NHS Dorset and BCP Council welcomed the opportunity to consider how current systems through existing services seeks to address inequality for people experiencing or at risk of homelessness. A number of areas of concern and enquiry had been raised. The Committee was informed that the services available across the BCP area were varied to address this issue. In response to the recommendations within the research, the report described how services, their interactions, together with how emerging plans and opportunities, were developing to address these themes. The Committee discussed a number of issues including:

·     The timeline for reconsideration of contracts – It was noted that most of the contracts were out of date in terms of the current situation. It was noted that there had been slow progress on this but discussion had been taking place and just before September the commissioning intentions for it went to Dorset Healthcare for consideration as part of a new contract.

·     Wound Care – At present there was no forward plan to address this other than improving the access to primary care and it was agreed that this should be something which was picked up in future.

·     Service delays - Services were overstretched in terms of housing and the Committee questioned whether this was the case in delivery of health services. It was noted that people who were homeless rarely considered health as a priority, and it was therefore important to build rapport with people and have a degree of flexibility in services. It was noted that sometimes the inability to access housing may be due to a person’s complex situation, but it could also be just a lack of available accommodation.

·     Housing Strategy – The Committee wanted to follow up on some of the issues raised and it was noted that a housing strategy was being developed which would be taken to Cabinet and would be considered by the Environment and Place Overview and Scrutiny Committee.

·     Mental Health – In response to a query it was explained that the Homeless Health Service had both physical and mental health practitioners and the whole partnership was important in providing a joined-up offer.

·     Integrated Care Board – The Committee enquired as to whether this issue had been previously considered by the Board and it was noted that it was going to its Prevention, Quality and Outcomes sub-committee and then it was thought to be coming to the Board in January.

The Committee expressed concerns about the current situation and suggested that there should be a more joined up offer in terms of service provision to homeless people. It was felt that there needed to be better ways to address the needs of people who did not have a local connection but who were homeless in the area and to address the significant housing shortage which currently existed within BCP. It was noted that the Integrated Care Partnership had membership from a range of areas which was working with housing health and social care.

The Committee gave further consideration to recommendations which it would like to make.

Resolved: That the Health Overview and Scrutiny Committee Recommend that Cabinet discuss the issues caused by a lack of funding for rough sleepers with no local connection and those without an identified priority need with a view to developing solutions in partnership with other local authorities and key stake holders such as the Integrated Care Board and relevant ministers to create a robust system that does not fail our most vulnerable or unfairly place the responsibility for caring for these people on local particular local authorities, with a view to getting something in place before the new strategy.

Voting: Nem. Con.