ADD2734 Rough Sleeping, Migration and Drug and Alcohol Treatment 2024-25

1.1    A total of 11,993 people were seen sleeping rough in London during 2023-24. This is a 19 per cent increase compared to 2022-23. Of these, 66 per cent were new to the streets, an increase of 25 per cent on the previous year. UK nationals accounted for 45 per cent, compared to 49 per cent in 2022-23. People from the ‘rest of the world’ outnumbered people from Europe (excluding the UK) for the first time in 2023-24: they made up 30 per cent of the whole, compared to 25 per cent from Europe. 
1.2    In his 2018 London Housing Strategy, the Mayor set out his aim for a sustainable route off the streets for every rough sleeper in London. In June 2018 he published his Rough Sleeping Plan of Action, which outlines the steps that must be taken by City Hall, government and others to achieve this aim. In 2021, the Mayor refreshed his Rough Sleeping Commissioning Framework, which sets out the overarching and cross-cutting priorities underpinning the GLA’s commissioning activities from 2021 to 2024.  
1.3    Since taking office, the Mayor has been expanding the pan-London rough sleeping services that the GLA funds and commissions. These services – collectively forming the GLA Rough Sleeping programme – are for people with experience, or at risk, of sleeping rough. They are initiatives to tackle rough sleeping that cannot or would not be provided at a London borough level, as they either meet a very specific need or deliver at the pan-London/multi-borough level. Since 2016, the GLA Rough Sleeping programme has supported over 16,000 people to leave the streets for good. 
1.4    Since the Government launched its Rough Sleeping Drug and Alcohol Treatment Grant (running 2022-25), the GLA has been working with the Office for Health Improvement and Disparities (OHID) (London) and City of London to coordinate a pan-London programme of work to improve access to drug and alcohol services for people who are rough sleeping. The following decisions relate to this workstream: 
1.5    MD2993 (June 2022) approved receipt of £64,000 in 2022-23 from OHID and expenditure on a new 12-month fixed term Migrant health and Substance Misuse Lead post. 
1.6    MD3089 (March 2023) approved the receipt of an additional £64,000 in 2023-24 and expenditure on the extension of the Migrant health and Substance Misuse Lead post until March 2024. MD3089 also approved expenditure of £20,000 in 2022-23 of OHID funding to procure guidance materials on eligibility for drug and alcohol treatment services for homeless migrants which was delivered by Homeless Link and £7,361 in 2022-23 to vary a training contract with Homeless Link to deliver training on eligibility for drug and alcohol treatment.  
1.7    ADD2701 (February 2024) approved reallocation of revenue expenditure of £14,085 from OHID to vary a training contract with Homeless Link to deliver a programme of training in 2023-24 on eligibility for drug and alcohol treatment services for homeless migrants.  
1.8    This ADD seeks approval for receipt of £58,783 in 2024-25 from OHID and reallocation of £5,217 from OHID in 2023-24, receipt and expenditure of which was previously approved in MD3089. This totals £64,000 and approval is sought for expenditure of this in 2024-25 on: 
•    £54,000 to commission via contract research on drug and alcohol treatment needs of homeless migrants and barriers to accessing services, with a report to be delivered by 31 March 2025.  
•    £10,000 to grant fund the development of culturally informed foreign language resources for specific client groups, where language is a barrier to accessing drug and alcohol treatment, with materials to be delivered by 31 March 2025.
 

2.1    The aim of the research will be to improve our understanding of the number of migrants who are rough sleeping and also have a drug and alcohol need, the barriers and facilitators to accessing services and to collate good practice and examples of what tailored and culturally informed support looks like. The methodology will include focus groups and interviews with frontline staff and clients (both people engaged with treatment and people with a drug or alcohol need but not engaged with treatment). It will also include people who are identified as part of the Target 1000 (T1000) cohort, individuals who have been on the streets for a longer period and who have multiple complex needs. 
2.2    The findings of this research will be promoted amongst Drug and Alcohol Treatment Providers and Local Authority Public Health Directors and Managers, with the aim of influencing the design and delivery of local services. 
2.3    Feedback from the voluntary sector suggests that many migrant rough sleepers who have a drug or alcohol need are not engaged with treatment services and there are few resources specifically designed for rough sleeping migrants. Grant funding the development of materials aimed at migrants who are rough sleeping will support an organisation to test what materials could be useful in informing them of drug and alcohol treatment offers and providing basic public health signposting. The materials will be available as a resource for the sector to use and the effectiveness of these materials will be reviewed, with any learning and good practice shared with Local Authority Public Health Directors and Managers. 
 

3.1    Under section 149 of the Equality Act 2010, as public authorities, the Mayor and the GLA are subject to the Public Sector Equality Duty, and must have “due regard” of the need to:  
•    eliminate unlawful discrimination, harassment and victimisation  
•    advance equality of opportunity between people who share a relevant protected characteristic and those who do not  
•    foster good relations between people who share a relevant protected characteristic and those who do not. 
3.2    Protected characteristics under section 149 of the Equality Act are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation, and marriage or civil partnership status (all except the last being “relevant” protected characteristics).  
3.3    Objective 3 of the Mayor’s equality, diversity and inclusion strategy, Inclusive London, is “to address the specific barriers that prevent some rough sleepers exiting rough sleeping and rebuilding their lives”.  
3.4    The funding referenced in this decision will help to tackle the inequalities experienced by certain groups of Londoners most affected by homelessness and rough sleeping. Of those seen sleeping rough in 2023-24:  
•    55 per cent were non-UK nationals  
•    24 per cent were Black or Black British  
•    4 per cent were Roma 
•    48 per cent had a mental health need  
•    16 per cent were female  
•    59 per cent were aged 26-45  
•    9 per cent were under 26  
•    11 per cent were over 55.  
3.5    Migrant homelessness in London, and specifically rough sleeping, disproportionately affects people with certain protected characteristics. The allocation of funding in this decision is aimed at improving the understanding of the needs of migrant rough sleepers with drug and alcohol needs and improving the accessibility of information. 
 

Key risks and issues  
4.1    The key risks and issues are outlined in the table below: 

Links to Mayoral strategies and priorities  
4.2    The Mayor’s London Housing Strategy sets out the aim to provide a sustainable route off the streets for every rough sleeper in London. The Mayor’s Rough Sleeping Commissioning framework, published in August 2021, includes a priority to meet the health needs of people sleeping rough. 
4.3    There are no known conflicts of interest for those involved in the drafting or clearance of this report.  
 

5.1    Assistant Director of Housing’s approval is sought for receipt of £58,783 in 2024-25 from the Office of Health Improvement and Disparities (OHID) as part of the Rough Sleeping Drug and Alcohol Treatment Grant (RSDATG) programme. In addition to this approval is requested to spend £5,217 underspend of OHID funding received in 2023-24 (approved in MD3089).
5.2    Expenditure approval totalling £64,000 in 2024-25 is sought for items detailed in paragraph 1.8 above.
5.3    Specialist Housing and Services unit within Housing and Land Directorate will manage this funding and expenditure.