MD2083 New rough sleeper services and projects

1.1 Rough sleeping is a growing and persistent issue in the capital. 8,096 people were seen sleeping rough in London in 2015/16 (seven per cent more than in 2014/15). 61 per cent were new to the street, almost a quarter (23 per cent) were long term rough sleepers (ie were seen rough sleeping in both 2014/15 and 2015/16), 59 per cent were non-UK nationals and 47 per cent were from EU countries. Around three quarters had a support need (46 per cent mental health, 43 per cent alcohol and 31 per cent drugs).

1.2 The Mayor has committed to tackling the ‘scourge of homelessness’ and in particular has noted that the rise in rough sleeping over recent years is a growing source of shame that we have a ‘moral imperative’ to stop. He has begun to develop a ‘No Nights Sleeping Rough’ initiative - a London-wide taskforce to oversee the implementation of the Mayor’s rough sleeping work and funding priorities. The taskforce has now been set up. Chaired by the Deputy Mayor for Housing and Residential Development, it brings together partners key to tackling rough sleeping in London (including boroughs, voluntary organisations and central government).

1.3 The Mayor has responsibility for funding and commissioning a range of pan-London rough sleeping services. 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 £33.8m for these services was approved for the period 1 April 2016 to 31 March 2020 granted through MD1532. This Mayoral decision also approved the reprocurement of a number of key services, which have now been commissioned and mobilised. A further MD (MD2031) approved the procurement of a successor to the flagship No Second Night Out service, to run from 1 April 2017 to 31 March 2019. Procurement has now concluded and the new No Nights Sleeping Rough service will commence on 1 April 2017. There are currently seven core services under contract with annual values ranging from £200,000 to £3.68m, as well as a number of grant-funded initiatives. In A City for all Londoners the Mayor commits to maintaining City Hall investment in services and making the case to Government for additional funding for London’s rough sleepers to get the support they need.

1.4 On the back of work carried out by the No Nights Sleeping Rough taskforce, the GLA has recently successfully bid for over £4.2m of Government funding for a number of additional rough sleeping services and initiatives, which will be launched during 2017:

• a Social Impact Bond (SIB) for entrenched rough sleepers (£2m from DCLG plus £1m from the GLA)

• a Safe Connections service (£1.875m from DCLG)

• a Hostels Clearing House (£340,000 from DCLG).

Rationale for and details of these new services and projects

The Social Impact Bond

Rationale

1.5 The number of long term rough sleepers is increasing. This group typically have highly chaotic and disrupted lifestyles, and make unplanned use of a range of health and substance abuse services. Recent estimates indicate that the homeless population utilises around four times more acute hospital services than the general population, costing at least £85m per year. Rough sleepers are also far more likely to present to health services with co-morbidity – one in five who have contact with hospitals had three or more diseases. For a subset of rough sleepers, these issues are particularly acute. The average cost to the health service for the five per cent of rough sleepers with the highest health cost is £27,000 per person each year. These people are likely to be those with the most acute needs and entrenched patterns of rough sleeping. Research by the Ministry of Justice also suggests a strong link between rough sleeping and offending behaviour, which incurs significant costs to the public sector.

1.6 Rough sleeping also results in significant costs to local authorities. Many rough sleepers intersperse nights on the street with spells in hostel accommodation and other forms of short-term locally-funded accommodation, and local authorities also fund outreach and floating support services for rough sleepers.

1.7 There is therefore a clear financial and social case for additional support to break the cycle of rough sleeping for London’s most entrenched rough sleepers.

The service

1.8 Building on the rough sleeping SIB administered by the GLA between 2012 and 2016, the new SIB will work with 330-350 of the most entrenched rough sleepers across all 33 London boroughs, providing tailored and personalised support to help them rebuild their lives.

1.9 Given the proposed size and geographical spread of the cohort, it is envisaged that the service will be delivered by two different providers. Commissioning will be outcome-based, rather than involve a detailed service specification, to promote innovation, creativity and flexibility in how the services are designed and delivered. It will be 100 per cent payment by results, to incentivise providers to deliver and to drive performance.

The Safe Connections service

Rationale

1.10 The No Second Night Out service (NSNO), which focuses on those that have been seen rough sleeping only once, has been successful in ensuring that those who attend the service do not sleep rough again. Since it started, only 24 per cent of those seen each year are seen sleeping rough again. However, not all new rough sleepers are seen by No Second Night Out (only around a quarter in 2015/16), primarily because some refuse to attend the service. Largely as a result of a lack of early engagement, 36 per cent of rough sleepers (1,904 people) who arrived on the streets during 2015/16 spent at least a second night out.

1.11 Most UK national rough sleepers do not have a local connection to where they are bedded down. The No First Night Out (NFNO) service, for example, has found that around four out of five relatively new UK national rough sleepers they see have a known local connection to another local authority. For many UK nationals, reconnection to their home local authority, where they have support networks and access to services, is the best route off the street.

1.12 Currently, GLA and borough-commissioned outreach teams provide a service for new rough sleepers who spend more than one night sleeping rough. This includes working to reconnect UK rough sleepers with the local authority with which they have a local connection. This is, however, an inefficient use of outreach resources, which could be better used to find and assist new rough sleepers and seek solutions for more entrenched rough sleepers.

1.13 There is therefore a case for a new service targeted on resolving this group’s rough sleeping, with more rapid crisis interventions and support to access and sustain move-on accommodation

The service

1.14 A specialist UK reconnections team will work with new rough sleepers to reconnect them to their home area. It will cover rough sleepers in London who:

• have a local connection with a London borough other than the one in which they are rough sleeping or another local authority in the rest of the UK

• have been on the streets for less than three months

• have between two and ten bedded down contacts, and

• are willing to engage with the team and an initial single service offer, or local connection assessment.

1.15 Flexibility will be built into the service to allow it to respond to changes in the target group, should the landscape of rough sleeping in the capital change significantly.

1.16 It is proposed that this service will be commissioned, and that ten to 15 per cent of the contract value will be based on payment by results, linked to the numbers not returning to the streets.

The Hostels Clearing House project

Rationale

1.17 There are 11,890 hostel bedspaces for rough sleepers across London. While the hostel system works well in many areas, there is a lack of consistency across London, in both the provision of specialist hostel beds and the quality of service offered.

1.18 An average of around eight per cent of beds (951) in London’s hostels are void at any one time (over 11 per cent for one major hostels provider). For some of the large providers, even relatively low percentages can equate to large numbers of bedspaces. For example, Evolve, the fourth largest provider, has an average void rate of 4.4 per cent, generating 8,744 void days a year. Some are short term, and others can be justified by maintenance issues. However, some are due to a lack of suitable referrals. This is because most hostel spaces are earmarked for the borough in which the hostel is situated, so limiting the pool of potential beneficiaries. The major London hostel providers estimate that around half of all hostel voids due to maintenance and a further quarter are extremely short term. Therefore, a quarter of hostel voids, 238 a year (a quarter of the 951 beds) could be contributed to the central pot – because there are no locally available referrals.

The project

1.19 The proposed project would enable more effective use of this provision in London. It would do so by hostel spaces for which there is no suitable person locally being contributed to a central pot that can be accessed by other boroughs for their rough sleepers. Supported housing bedspaces (of which there are 4,854 across London) could also be contributed to the ‘pot’. This would not only provide a wider range of options for rough sleepers, it would also enable boroughs without hostel provision to both contribute to and benefit from the scheme. These vacancies would then be matched to the referrals that are received to the service from participating boroughs.

1.20 This web-based project would be reciprocal, so that no borough gains or loses bedspaces. Participation by boroughs would be voluntary, although to be successful it will require a critical mass to take part. Of the 12 boroughs so far consulted about this project, 11 have given informal support, as have four of the top five providers of hostel beds in London (St Mungo’s, Look Ahead, Evolve and Thames Reach).

The Social Impact Bond

2.1 The key objective for the SIB is to achieve transformative and sustainable change for some of London’s most vulnerable individuals. It is also expected to deliver cost savings to Government and local authorities, drive improvements to the commissioning of contracts in London (with further use of PBR targets in wider contracts) and change providers’ approaches to tackling rough sleeping for the most vulnerable clients, through increased use of personalisation.

2.2 The specific outcomes for the new SIB relate to accommodation, health, substance misuse and employment. Providers will be financially incentivised to achieve these outcomes, through PBR, with payments linked specifically to those set out below:

The Safe Connections service

2.3 The key objective of the proposed service is to increase the number of rough sleepers leaving the streets, and the speed in which they do so, by:

• increasing the number of reconnections within the UK, through the service itself

• increasing the number of new rough sleepers found and engaged with in a short timescale, because of freed up capacity within outreach teams.

2.4 It is envisaged that the service will work with an estimated c800 people over two years, referred by outreach teams, with resources split 70:30 between London and non-London reconnections. Over this period, this service has potential to result in:

• up to 800 safe connections (400 more than it is estimated would be made without this service )

• up to 3,000 additional outreach shifts in the capital

• up to 2,000 people finding a route off the streets.

The Hostels Clearing House

2.5 By enabling more effective use of the hostel system across London, this project will give more London rough sleepers a quicker route off the streets. Based on the level of provision and voids for the boroughs and providers that have informally agreed to participated, it is envisaged that an additional 150 spaces each year would be made available (300 over the course of the two and a quarter year funding period).

3.1 Of those seen rough sleeping in 2015/16:

• 59 per cent were non-UK nationals

• 46 per cent had a mental health need

• 15 per cent were women

• most of those seen rough sleeping (58 per cent) were in the 26-45 age group

• ten per cent were under 26 years old

• 11 per cent were over 55

• four people were under 18.

a) Key risks and issues

b) Links to Mayoral strategies and priorities

See paragraphs 1.2 and 1.3 above.

c) Impact assessments and consultations

The bids for the proposed new services and project were developed in partnership with the Mayor’s No Nights Sleeping Rough Taskforce, and were informed by in depth consultation with stakeholders from London boroughs, voluntary sector providers and the wider homelessness sector.

5.1 This decision requests an approval for the receipt of grant funding of £4.215m from the Department for Communities and Local Government (DCLG), as well as an expenditure of £5.215m to develop and deliver a pan-London Rough Sleeping Services and projects. The programme is set to continue until March 2021.

5.3 Funding gap of £1m is proposed to be assigned from GLA’s Rough Sleeping Commissioning budget (MD1532), which has been allocated a four year indicative budget of up-to £33.8m (£8.45m a year).

5.4 The following table sets out the profile of spend over the period of the programme:

6.1 The foregoing sections of this report indicate that the decisions requested of the Mayor 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 in 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 mayor 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 mayor should have particular regard to section 3 (above) of this report.

6.3 Officers must ensure that the services required be procured in accordance with the GLA’s Contracts and Funding Code (the “Code”) and with the assistance of Transport for London’s procurement team. Furthermore, officers must ensure that appropriate contractual documentation be executed by both the GLA and the relevant contractor prior to the commencement of the required services.

6.4 Any grant funding to be awarded as part of any of the projects, the subject of this report, must be distributed in accordance with the requirements of section 6 of the Code.

7.1 The SIB and Safe Connections service will be commissioned, to be delivered by external providers. The development work for the Hostels Clearing House project will be delivered by the GLA, with IT commissioned and delivered by an external provider.

Appendix 2 Homelessness Prevention Programme – successful bids [1]