POLICY UPDATE SNAP 2010 (SURVEY OF NEEDS AND PROVISION) HEALTH NEEDS OF HOMELESS PEOPLE OLDER...

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WWW.HOMELESS.ORG.UK POLICY UPDATE SNAP 2010 (SURVEY OF NEEDS AND PROVISION) HEALTH NEEDS OF HOMELESS PEOPLE OLDER HOMELESSNESS

Transcript of POLICY UPDATE SNAP 2010 (SURVEY OF NEEDS AND PROVISION) HEALTH NEEDS OF HOMELESS PEOPLE OLDER...

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POLICY UPDATESNAP 2010 (SURVEY OF NEEDS AND PROVISION)

HEALTH NEEDS OF HOMELESS PEOPLE

OLDER HOMELESSNESS

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1. SNAP 2010

• What is it? • What can it be used for?• Key headlines from 2010

– Dramatic improvement in service availability – 43,655 bedspaces nationally– The sector's diversity is increasing but clients’ support

needs seem to be remaining stable – Funding a key concern for agencies– Mental health and move on also key issues

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SNAP 2010: Substance misuseHEADLINES

– Overall availability of substance misuse services increased

Type of service Overall service availability SNAP 2008

Overall service availability SNAP 2009

Overall service availability SNAP 2010

% increase 2008-2010

Drug services 87% 91% 95% 8%

Alcohol services 88% 94% 96% 8%

Mental health services 78% 93% 96% 18%

Physical health services 71% 90% 97% 26%

Meaningful activity 61% 90% 94% 33%

Education, training and employment (ETE)

66% 89% 98% 32%

Advice 92% 97% 99% 7%

Resettlement 59% 86% 92% 33%

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•Provision of substance misuse services via external agency most common

•Roughly 1 in 10 agencies provide substances misuse services in house or in partnership

•However, problems with access remain. Inadequacy of external service and client motivation most commonly reported problems.Type of service Of projects

where service available… Problems with access[2]

%

Of projects where there are problems with access…

Some clients ineligible%

Some clients unsuitable%

Sometimes due to client motivation %

External service inadequate%

Internal service lacks financial/staff resources%

Internal service lacks suitable premises /equipment%

Drug services 47% 5% 3% 66% 32% 11% 3%

Alcohol services 53% 4% 2% 62% 41% 12% 2%

Mental health services 57% 8% 6% 33% 62% 10% 2%

Physical health services 23% 2% 1% 55% 26% 16% 5%

Education, training and employment (ETE)

45% 11% 6% 67% 18% 16% 5%

Meaningful activity 46% 1% 2% 60% 18% 34% 6%

Advice 20% 0% 3% 55% 32% 18% 2%

Resettlement 29% 16% 12% 15% 56% 19% 3%

HEADLINES, continued

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OTHER FINDINGS• Proportion of clients experiencing drug or alcohol problems remained fairly

consistent over 3 years

• 10% respondents cited alcohol and drug services as biggest gap in provision (3rd most commonly identified gap)

‘Alcohol services for adults. It seems to be very distant for waiting times and referrals. It is because of the different agencies that provide it.’

‘Having somewhere for chronically excluded people, the rough sleepers who are in and out of hostels, somewhere for the chronic drinkers/drug users, to try and keep them off the streets and support them.’

• 6% agencies cite alcohol and drug use as the top issue facing them. This refers to issues around behaviour as well as accessing appropriate services.

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2. HOMELESSNESS and HEALTH

HEALTH NEEDS AUDIT• Project to evidence health needs and feed into commissioning • Looks at picture of local health needs. Client, not staff, perspective

POLICY CONTEXTLOCAL DRIVERS: needs assessment and delivery at a local level (LAA, JSNA)

HEALTH INEQUALITIES: delivering to most excluded - .eg Marmot Review, Inclusion Health, No One left Out

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What can it tell us about substance misuse?• Levels and type of consumption• Health needs relating to substance misuse• A&E and hospital admissions relating to drugs and alcohol• How clients are currently engaged, if atall, with drug and alcohol

services and how effective clients think they are• Unmet need/demand for different D&A services (eg reduction, harm

minimisation)• Access to relevant screening• Dual Diagnosis

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How will the data be used?

•Improve dialogue with clients about health

•Feed clients’ experiences directly to commissioners and JSNA (joint work with JSNA and alcohol teams)

•Encourage agencies to take action at local level – from across LA, NHS and voluntary sector

•Inform agenda around health of socially excluded. ‘Inclusion Health’, DH commissioning guidance

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3. Older homelessness? SNAP suggests more agencies are working with clients who are over 50.

Recent research is showing an increase in hidden heavy drinking among general older population.

37 % of newly homeless older people reported drinking heavily before becoming homeless. Some said this had contributed to the breakdown of a relationship which had then led to homelessness.

Estimated 50% older homeless population have alcohol needs. This is often in combination with mental health problems, chronic physical ill health and lack of engagement in support planning

Particular challenge of move-on for this group. Sheltered housing reluctant to take alcohol dependent older people and difficult to get funding for a care package for people who continue to drink.

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Services and solutions

Specialist accommodation projects and floating support

Feed issues into JSNA locally – “PCT to take a leading role in JSNA and commission alcohol interventions for the needs of the local population”. E.g make case of high costs of small section of homeless heavy drinking population.

New guidance for commissioners and providers on how to assess and meet specific needs of older people and importance of this agenda:

http://www.homeless.org.uk/guidance-older-homelessness

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SNAP: http://www.homeless.org.uk/snap

Health needs project:

http://www.homeless.org.uk/health-needs-audit

More info: [email protected]