DD2193 Homeless Health Peer Advocacy Project

1.1 The Mayor has committed to tackling homelessness and, in particular, noted that the rise in rough sleeping over recent years is a growing source of shame that we have a “moral imperative” to stop. In his draft London Housing Strategy, he pledges to support rough sleepers off the streets as quickly and sustainably as possible, with the key aim of ensuring a route off the streets for every single rough sleeper in London.

1.2 The Mayor funds and commissions a range of pan-London rough sleeping services and other initiatives. These are services for rough sleepers, or initiatives to tackle rough sleeping, that cannot or would not be provided at a London borough level, as they are pan-London or multi-borough in their remit. A budget of £33.8 million for these services was approved (through MD1532) for the period 1 April 2016 to 31 March 2020.

1.3 The shape and nature of these services and initiatives are underpinned by the pan-London Rough Sleeping Commissioning Framework. This includes a priority ‘to work with boroughs and partners to meet the physical and mental health needs of rough sleepers’. The Homeless Health Peer Advocacy (HHPA) project assists in meeting this priority by using peer mentors to ensure that rough sleepers attend medical appointments and sustain health treatment and by providing health promotion activities to rough sleepers. In addition, the Healthy London Partnership Homelessness Programme’s commissioning guidance for Clinical Commissioning Groups (CCGs) , published at the end of last year, recommends that London CCGs should commission peer support to help homeless people access healthcare and identifies HHPA as a model of good practice.

1.4 The GLA has grant-funded Groundswell to provide this unique project since 2012, in which time it has won the Andy Ludlow Homelessness Award in 2014 and the GSK Impact Award in 2016 . The HHPA has enabled rough sleepers to attend 1,662 health appointments and 4,500 people have attended the health promotion in-reach sessions in this time. This funding has enabled the service to be rolled out across London. During this time Groundswell has levered in a total of £1.7 million of match funding as result of GLA investment. By the end of 2016/17, the project was funded by and operational in three London boroughs (Hackney, Wandsworth and Hounslow) and five CCGs (covering Westminster, Hammersmith and Fulham, Kensington and Chelsea, Tower Hamlets and Camden). During 2016/17, the GLA contributed £50,000 of grant funding and the boroughs/CCGs £461,000. The GLA’s share of funding towards the project fell from ten per cent to 8.5 per cent during the year, as Groundswell levered in funding from additional organisations.

1.5 With the support needs of those on the streets remaining at a high level (with 77 per cent of those on streets having an alcohol, drug and/or mental health need), there is a strong case for ongoing GLA investment to enable roll out of the project across the capital to continue. A further three years’ of GLA grant-funding would enable Groundswell to expand into another six London boroughs, resulting in the project working in a total of 14 boroughs across London. In 2017/18, it is envisaged that the London Boroughs of Greenwich and Southwark would join the project, as would Lambeth CCG and Guys and St Thomas’s Charity.

1.6 It had, until recently, been expected that seed funding from 2017/18 onwards for this expansion would be available from the London Homeless Health Partnership (LHHP), but contrary to expectations the LHHP does not have any budget for this purpose.

2.1 Last year, Groundswell exceeded the targets set out in their grant funding agreement with the GLA. It is therefore proposed that even more stretching targets are set for the next three years. These higher targets mean that the cost to the GLA per engagement would reduce from £70 to £14, resulting in improved value for money.

3.1 Under section 149 of the Equality Act 2010, as public authorities, the Mayor and GLA are subject to a public sector equality duty and must have ‘due regard’ to the need to (i) eliminate unlawful discrimination, harassment and victimisation; (ii) advance equality of opportunity between people who share a relevant protected characteristic and those who do not; and (iii) foster good relations between people who share a relevant protected characteristic and those who do not. Protected characteristics under section 149 of the Equality Act are age, disability, gender re-assignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation, and marriage or civil partnership status (all except the last being “relevant” protected characteristics).

3.2 Of those seen rough sleeping in 2016/17:

• 53 per cent were non-UK nationals

• 47 per cent had a mental health need

• 15 per cent were women

• most of those seen rough sleeping (56 per cent) were in the 26-45 age group

• nine per cent were under 26 years old

• 11 per cent were over 55

• four people were under 18.

3.3 As rough sleepers are over-represented among those with the protected characteristics of race and disability, the proposals in this paper are likely to have positive impacts on these groups.

a) Key risks and issues

b) Links to Mayoral strategies and priorities

The objectives of the proposals are in line with the pan-London Rough Sleeping Commissioning Framework priority 8, as well as the Mayor’s draft London Housing Strategy which includes a commitment to ‘fund and commission a range of pan-London services and other initiatives. These will focus on identifying rough sleepers and intervening rapidly to support them off the streets, providing specialist support for particular groups, and helping rough sleepers stay off the streets.’.

c) Impact assessments and consultations

The pan-Rough Sleeping Commissioning Framework was made available for consultation with key stakeholders and partners and was subject to a full equalities impact assessment. The draft London Housing Strategy has been subject to a full-integrated impact assessment and statutory consultation with the public was recently undertaken.

5.1 This decisions requests approval to expend £135,000 towards the provision of Homeless Health Peer Advocacy (HHPA) project. The project will be delivered by Groundswell and will run for a period of three financial years (2017/18 to 2019/20).

5.2 The expenditure will be funded from the Rough Sleeping budget (MD1532), which has been allocated a four-year indicative budget of up-to £33.8m (£8.450m per/year) and have been profiled to be spent as follows:

3. The confirmation of the future years funding is subject to the finalization and sign-off by the Mayor.

4. This project has been funded by the GLA since 2012 (see table below), in which time its share of funding towards the project fell from ten per cent to 8.5 per cent (in 2016), with Groundswell securing the additional funds from the boroughs/CCGs.

6.1 The foregoing sections of this report indicate that the decisions requested of the Director fall within the statutory powers of the Authority to promote and/or to do anything which is facilitative of or conducive or incidental to the promotion of social development within Greater London and in formulating the proposals in respect of which a decision is sought officers have complied with the Authority’s related statutory duties to:

(a) pay due regard to the principle that there should be equality of opportunity for all people;

(b) consider how the proposals will promote the improvement of health of persons, health inequalities between persons and to contribute towards the achievement of sustainable development in the United Kingdom; and

(c) consult with appropriate bodies.

6.2 In taking the decisions requested of him, the Director must have due regard to the Public Sector Equality Duty; namely the need to eliminate discrimination, harassment, victimisation and any other conduct prohibited by the Equality Act 2010, and to advance equality of opportunity between persons who share a relevant protected characteristic (race, disability, gender, age, sexual orientation, religion or belief, pregnancy and maternity and gender reassignment) and persons who do not share it and foster good relations between persons who share a relevant protected characteristic and persons who do not share it (section 149 of the Equality Act 2010). To this end, the director should have particular regard to section 3 (above) of this report.

6.3 The officers are reminded of the requirements of section 12 of the GLA’s Contracts and Funding Code as regards the distribution of the funding the subject of this decision. Furthermore, the officers should ensure that the GLA enter into a funding agreement with Groundswell, before the GLA makes payment of any part of the funding.

7.1 The GLA will continue to monitor the service on a quarterly basis to assess performance against targets. The performance of the service will be reported to the quarterly internal Rough Sleeping Internal Governance Group convened by the Deputy Mayor for Housing and Residential Development.