Rough sleeping guidance tells NHS and care services in England to act before Christmas
Mental health and drug and alcohol services should set up joint working protocols this winter, and GP practices should not turn people away for lack of an address or ID.
By Daily Oracles News Team2 min read
Health and care support should be part of any accommodation offered to people sleeping rough in England from the first day, under guidance published on Monday afternoon by the Department of Health and Social Care and the housing ministry. Its immediate priority is that everyone sleeping rough has a route off the streets before Christmas 2026.
The guidance backs the Rough Sleeping Programme, which councils lead. The programme was launched on 19 August with £442 million of new funding, and Downing Street confirmed before the Budget that a further £432 million for rough sleeping services would follow. The government says total spending on homelessness and rough sleeping services will be more than £4 billion over three years.
Who has to do what
Integrated care boards are told to commission joined-up pathways across GP services, mental health, drug and alcohol treatment, community health, adult social care and hospitals, matched to the housing on offer locally. Directors of public health are asked to make sure drug and alcohol treatment paid for from the public health grant links up with housing and mental health services. Health and wellbeing boards are to oversee the local winter response.
For this winter, mental health services and drug and alcohol services should agree joint working protocols covering assessment, care planning, risk, safeguarding and discharge. Mental health services should also make faster progress in using the Alcohol, Smoking and Substance Involvement Screening Tool - Lite (ASSIST-Lite), or another evidence-based assessment, as part of their checks.
Mental health teams should not refuse someone because they need drug or alcohol treatment, and addiction services should not refuse someone because of a mental health need. GP practices should not treat the lack of a fixed address, identification or digital access as a barrier to registering a patient or giving care.
Vaccines, A&E and discharge
GP contract directions have been changed to reflect advice from the Joint Committee on Vaccination and Immunisation that people experiencing homelessness are eligible for pneumococcal and seasonal flu vaccines. Practices are asked to find eligible patients and work with outreach teams and charities to reach them.
Local areas are asked to make sure chances to prevent homelessness are not missed in emergency departments, including among people who attend A&E but are not admitted, and may want to bring in specialist homelessness liaison staff. Discharge teams should work with housing services with the aim that nobody leaves hospital onto the street. Among the suggested actions is that no transfer between services is treated as complete until the receiving service has confirmed contact and ongoing support. The same principle applies to people leaving prison and residential treatment.
The first of seven principles for local partners, called no wrong door, means any service a person approaches should help them reach the others. The actions are not a fixed checklist, the guidance says, and should be adapted to local services.
