Health access and homelessness

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Summary of report content

Healthwatch Salford undertook a follow up to their May 2018 report on health care access and homelessness.  This research focuses on rough sleepers and their access to mental health and drug and alcohol services. A survey was designed, and 25 rough sleepers were engaged over a 3-month period, starting at the very end of October 2018. The survey was designed to capture experiences across specific services and allowed for more expansive answers for some of the questions.

Key findings

  • Family was important to homeless people where they had kept in contact with or had young children. Location of temporary accommodation would have an impact on wider family life if too far away and the ability to parent for those with children.
  • Some would contribute to the cost of accommodation if they were working and could afford it.
  • There were some reservations and concerns about sharing living spaces
  • Clear and professional boundaries were seen as important but with a fair approach if mistakes are made
  • Those that could cook preferred to prepare their own meals if there was a kitchen
  • People talked freely about good and bad staff attitudes, having experienced both when accessing services
  • Most people were negative about their experience of using night shelters
  • People were positive about drug and alcohol services but more negative about mental health services
  • Many people walked to services but if they had money or a pass would use public transport
  • 14 out of 25 people spoken to were accessing mental health, drug or alcohol services
  • 24 out of 25 were male
  • 10 out of 25 said they had a long-term medical condition or disability
  • The participants were aged between 18 and 60+.

Rough sleepers are often high users of services and so it is not surprising that they have had both good and bad experiences. It is however concerning that night shelters and mental health services had the most negative comments. This is especially concerning because rough sleepers often access these services when they are at their most destitute and vulnerable. It was noted that two people with an urgent mental health need that turned up at Salford Royal A&E left feeling unsupported, with one of them swearing to never go back there again. Whilst this was a small sample of rough sleepers there was significant reporting of negative experiences and comments about staff and service approaches. There is clearly both a need for more staff training and support and service user involvement in the review and design of services.


  • Commissioners of these services should consider reviewing the services with the most negative comments. They should also recommend they look at the good practices demonstrated by other services, as commented on in this report.
  • Commissioners should consider reviewing the quality of night shelter services. It is important to engage staff and services users in this process and in any proposed changes to improve the service and ensure staff and service users are getting the support they need

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General details

Report title 
Health access and homelessness
Local Healthwatch 
Healthwatch Salford
Date of publication 
Monday, 9 December, 2019
Date evidence capture began 
Wednesday, 31 October, 2018
Date evidence capture finished 
Thursday, 31 January, 2019
Type of report 
Key themes 
Health inequalities
Lifestyle and wellbeing
Service delivery organisation and staffing
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
How was the information collected? 
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Mental health services 
Community mental health team (CMHT)
Mental health recovery service
Community services 
Community based services for people who misuse substances
Community based services for people with mental health needs

Details about conditions and diseases

Types of long term conditions 
Mental health condition
What type of pregnancy or maternity themes are included in the report 

Details of people who shared their views

Number of people who shared their views 
Age group 
All people 18 and over
Mixed / multiple ethnic groups
Sexual orientation 
Not known
Other population characteristics 
Homeless people
People who misuse drugs
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
Not known

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.