Learnings from ‘Everyone In’ initiative in England for improving health of people facing homelessness

Abstract Issue The COVID-19 pandemic presented an unprecedented health risk to people experiencing homelessness including risk of infection due to inability to self-isolate, and pandemic restrictions adding barriers to accessing health support. The English Government implemented the ‘Everyone In’ policy at the start of the COVID-19 pandemic, which offered accommodation to those who were (or at risk of) sleeping rough. This led to integration of support for health, care and housing. Description of the problem Between January-October 2023, a qualitative study was undertaken to understand what worked well and less well in implementing the ‘Everyone In’ initiative for improving physical and mental health outcomes for people experiencing homelessness. People who were provided accommodation and those involved in the planning or delivery of the initiative were interviewed. Results Flexibility in provision of funding and support, lack of red tape and joined-up working between partners across sectors were key positives of implementing the policy. ‘Everyone In’ also led to new ways of supporting and overcoming barriers to support, for example, provision for people with no recourse to public funds. Access to health services for people experiencing homelessness was improved by strengthened relationships with service providers, and outreach within the accommodation for wrap-around support. Challenges were faced in support for substance use. Data sharing practices, mental health support, and recognition of trauma were areas that could have worked better. Lessons Availability of flexible and earmarked funding is crucial in implementing strategies for improving outcomes in homelessness. Many short and long-term initiatives have been launched as a result of ‘Everyone In’. This study highlights the importance of partnership working, supported housing and maintaining flexible, responsive approaches to interventions to meet the health and social care needs of people experiencing homelessness. Key messages • Multi-sectoral partnerships and integrating housing with health and care support can improve access to services. • Availability of flexible funding for homelessness strategies supports adaptable and responsive service provision.