Collective Voice looks forward to supporting the Prime Minister’s ambition on ending rough sleeping

Our Chief Exec, Will Haydock, responds to the announcement of the Rough Sleeping Programme, designed to support the Prime Minister’s stated ambition to end rough sleeping and ensure no-one is sleeping rough this Christmas.

Yesterday, Andy Burnham gave a bit more practical detail about his ambition to end rough sleeping, announced in his first speech as Prime Minister.  The article in the Guardian was followed today by official guidance on what is being called the Rough Sleeping Programme, which aims to ensure no-one is sleeping rough this Christmas.

Collective Voice welcomes this ambition, and today’s guidance specifically.  Rough sleeping is a serious and growing issue, and our sector knows from experience that setting a bold and ambitious vision can help drive real change in practice that saves and improves people’s lives.    We look forward to working with the full range of relevant Government departments to make sure that this bold vision becomes reality.

If we are to end rough sleeping, specialist substance use support must be part of the solution

We know that substance use is often linked to rough sleeping, most sadly and shockingly as a cause of death.  Guidance from the National Institute for Health and Care Excellence (NICE) is very clear on the subject, noting that ‘the causes of most deaths of people experiencing homelessness in England and Wales were registered as drug-related poisonings, suicides and alcohol-specific deaths’.

That guidance is equally clear that specialist substance use treatment should therefore be part of the support offer for people who are homeless.  And we have good evidence that this works, including through recent schemes.

The evaluation of the Rough Sleeping Drug and Alcohol Treatment (RSDAT) grant suggested that the programme – which specifically supported substance use services in working with people rough sleeping – improved access and engagement in treatment, including to detox, improved partnership working and perhaps most importantly reduced drug-related deaths.

If we are to learn from the successes of this programme, then, we must ensure that future plans to end rough sleeping involve and enable specialist organisations that have the specific expertise to support people with all relevant aspects of their lives.  For some people that may not include substance use issues, but for many it will – and the evidence shows that our members are best placed to do this work.

Local areas should lead on service design, but this must go alongside accountability

Exactly what that support looks like needs to sensitive to the person being supported and the wider context they find themselves in.  The programme will need to encourage collaboration and avoid duplication, and so we welcome the Prime Minister’s clear statement that the scheme shouldn’t be too centralised: “I don’t want Whitehall trying to dictate how every penny of that is spent.  The people who know what will work in Newcastle, Liverpool or Plymouth are the people who live there and see the problem first-hand every day.”

At the same time, local autonomy must come with local responsibility and accountability.  Exactly how specialist substance use providers are involved may vary, but there can be no doubt that there will need to be drug and alcohol support available and resourced in all areas.

So it’s encouraging to see the way that the guidance for the scheme emphasises the importance of specialist substance use support.  But there would need to be a check and reassurance that attention and resource is genuinely flowing to all elements of support that are necessary to make a difference.  This isn’t just about working with existing or generic services; as the Rough Sleeping Drug and Alcohol Treatment grant showed, there’s a strength in dedicated outreach and support.

Monitoring must be proportionate and useful

As someone coming from a research background, whose first job in a Drug and Alcohol Action Team was as a research and information officer, it’s no surprise that I’m interested in the monitoring processes that might be introduced as part of this project.  I’m hoping Collective Voice will be publishing something on data collection and monitoring across our sector in the next few months, but that’s a story for another day.

In the meantime, it’s crucial that any monitoring and reporting is proportionate and genuinely useful.  Too often, reporting processes become a burden that distracts from service delivery and doesn’t end up providing genuinely valuable information about how we can improve support and outcomes for the people that the services being measured are actually meant to serve.

We should also be making better use of technology to make sure the whole process of creating data is straightforward both for people engaging with support and the staff involved in providing this – and then the reporting process to government should be simple.

The guidance gives an initial steer on some elements of accountability in a section on “Monitoring outputs and outcomes”, and it’s encouraging to read that, in the first year at least, they will focus on ‘existing management information already provided’ to government – and they promise that as this develops it will remain proportionate.

We look forward to working directly with government on how we can have the necessary oversight and accountability, while ensuring the information collected is both genuinely useful and actually used.

We must look beyond rough sleeping

In thinking about homelessness and rough sleeping, we should be aware that it affects different people in different situations, and the programme guidance is encouragingly clear that service design and monitoring must consider how ‘women, young people, LGBT+ people and others may face barriers to accessing rough sleeping services’.

But we should also be aware that the prevalence and visibility of rough sleeping itself is shaped by these differences and inequalities.  As the Women’s Rough Sleeping Census – supported by one of our members, Change Grow Live – makes clear: “Women’s homelessness is hidden because the system isn’t built for them.”

So must ensure that work on rough sleeping acknowledges and addresses the full range of ways in which this might manifest itself.

The Collective Voice Women’s Treatment Working Group is very clear on the importance of making sure that treatment and other support is sensitive to people’s needs and situations, as expressed in this recent comment by members of the group on the government’s Women’s Health Strategy – which barely mentions substance use issues.

But more than this, we must look beyond rough sleeping itself.  If we are to address issues around substance use and homelessness, this will involve a much wider range of people and require a much wider commitment.

This isn’t just asking for government to focus on our specific field; it’s relevant to the Government’s broader work to, as the Prime Minister put it, ‘feel that this country is finally moving forward again’.

As we have noted previously, if any government is to achieve ambitions on housing and homelessness and beyond – on criminal justice, health, education, employment and beyond – it must think about how to support people facing issues related to substance use.

We look forward to seeing the government publish ambitions and priorities for in relation to alcohol and other drugs.  As Dame Carol Black explained back in 2021, “Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences.”  This will always remain true, so we need the current Government to make the right choice and tackle the problems related to alcohol and other drugs head on.