This project, as part of the Test and Learn Program, aims to integrate qualified health specialists within homeless outreach teams across England to address the unique and complex health needs of individuals experiencing rough sleeping. Over an 18-month period, these specialists, managed by Change Grow Live (CGL), will collaborate with outreach teams to deliver focused healthcare interventions, support pathways out of homelessness, and improve access to primary health services. Through a comprehensive evaluation, this project seeks to provide strong evidence on the impact of healthcare integration within homeless outreach, supporting future funding and policy decisions.
Funded by the Centre for Homelessness Impact and the Department for Levelling Up, Housing and Communities, this initiative targets areas across England with the greatest needs. By embedding healthcare expertise directly into outreach efforts, the project aims to show that a comprehensive, health-centered approach can reduce rough sleeping, enhance overall health outcomes, and foster sustained engagement with healthcare services. The evidence generated will be critical in guiding policymakers, commissioners, and service providers toward more effective homelessness interventions nationwide. For more information, please visit the Centre for Homelessness Impact project page.
This project, led by the Centre for Homelessness Impact (CHI), partners with Change Grow Live (CGL) and selected local authorities to assess the impact of embedding health-focused nurses within homeless outreach teams. While health-focused outreach is not entirely new, this initiative represents the first standardized, randomized evaluation of such an intervention.
Eight selected areas will receive one nurse each for an 18-month period starting in January 2025, while eight additional authorities will serve as control sites, providing baseline data for comparison. CHI and Cardiff University will jointly conduct a randomized controlled trial to assess the effectiveness of these interventions, with each control group area receiving a £10,000 incentive to support data collection efforts.
The trial will capture both quantitative and qualitative data, including individual health assessments, case outcomes, and insights from focus groups. By systematically assessing health interventions within outreach teams, this project aims to establish a strong evidence base for future funding and policy development in homelessness health support.
The application process, managed via CHI’s FlexiGrant platform, opened in May, with eligibility criteria requiring authorities to demonstrate an active outreach team and significant health needs among their rough sleeper population. Authorities without similar health-focused services were prioritized to ensure clear intervention impact.
Based on the designated 16 areas for this project, potential pilot and monitoring area pairings have been outlined within the Randomized Controlled Trial (RCT) framework. Each area with a high rough sleeper count has been selected as a pilot site to support robust evaluation and comparison.
| Pilot Area | Monitoring Area |
|---|---|
| Liverpool | Preston |
| Peterborough | Solihull |
| Tameside | Oldham |
| Waltham Forest | Ealing |
| Croydon | Kingston upon Thames |
| Haringey | Greenwich |
| Hounslow | Watford |
| Christchurch and Poole | Bournemouth |
These pilot and monitoring areas were chosen based on regions with the highest rough sleeper counts, with high-need areas designated as pilot locations to assess the full impact of embedding healthcare within outreach teams. Monitoring areas serve as comparison sites, enabling rigorous evaluation of the intervention’s effectiveness across diverse settings, including urban and suburban areas.
Each pairing considers geographical proximity and, where possible, similar demographics and homelessness challenges. This helps control external variables and enhances the validity of comparisons. For instance, pairing Liverpool with Preston allows for regional analysis within the Northwest, while Croydon and Kingston upon Thames represent comparable urban environments within Greater London, albeit with varying rough sleeper rates.
This pairing structure supports the project’s goal of generating insights into the effects of integrated health support within outreach teams on health outcomes, healthcare access, and homelessness rates in high-need areas compared to similar regions without the intervention. This approach aims to contribute to a strong evidence base for scalable solutions to reduce homelessness across England.
This project is part of the "Outreach with Health Specialism" initiative under the Test and Learn Program, funded by the Centre for Homelessness Impact and the Department for Levelling Up, Housing and Communities. It aims to rigorously evaluate the impact of embedding qualified health specialists within homeless outreach teams across England, specifically targeting the health, safety, and well-being needs of individuals experiencing rough sleeping. By integrating healthcare interventions into outreach work, the program seeks to improve access to medical services, reduce emergency care dependency, and support pathways out of homelessness.
The primary objectives are to assess how embedding healthcare within outreach teams can enhance health outcomes, increase sustained service engagement, and ultimately reduce rough sleeping. This project aims to build robust evidence for future policies and provide a model that local authorities and agencies can replicate across diverse regions, including urban, suburban, and rural areas, while addressing the unique healthcare access challenges in these varied settings.
In the Research Practitioner role, I will apply the following methods to assess the program's impact:
This study forms part of a £15 million government investment in evidence-based homelessness interventions across England. By testing this healthcare integration model through a randomized controlled trial (RCT), the project will generate high-quality, independently validated evidence to support future funding, policy decisions, and program expansions. In collaboration with Cardiff University and leveraging CGL’s multi-agency expertise, this initiative aims to create scalable, impactful strategies to improve healthcare access and housing stability for vulnerable populations.
| Area | Rough Sleepers (2023) | Population (2021) | Area (mi²) | Substance Misuse Service | Outreach Service | NHS Trust(s) | Homelessness Prevention Grant (£) | Funding Notes |
|---|
This project is a comprehensive, multi-agency initiative designed to embed healthcare specialists within homeless outreach teams across England. Involving 16 areas—8 pilot and 8 monitoring sites—the project will require extensive collaboration across local and national entities to successfully implement and evaluate the intervention.
Given the project's scale, effective multi-agency collaboration is vital. Key areas of coordination include:
The project’s extensive scale emphasizes the need for seamless collaboration across sectors and agencies. Embedding healthcare specialists within outreach teams offers a unique opportunity to create a holistic, health-centered approach to addressing homelessness. Through this model, healthcare and homelessness services will operate in synergy, establishing a scalable and sustainable solution for vulnerable populations nationwide.
This project utilizes multiple data streams to enable thorough analysis and monitoring of health interventions within homeless outreach teams. These data sources provide valuable insights into service user needs, treatment outcomes, and healthcare access, supporting evidence-based evaluation and reporting.
Data collected from these streams will inform key performance indicators, outcome measures, and long-term impact assessments. By integrating quantitative data from systems like NDTMS and TOPS with qualitative feedback from surveys and case records, the project aims to create a comprehensive evidence base to validate the effectiveness of integrating healthcare within outreach services, specifically in improving health and housing stability outcomes.
My blend of practical experience and adaptability uniquely positions me for the Research Practitioner role, enabling me to navigate the diverse needs and complexities inherent to this project. My extensive work across various environments, especially within Nottinghamshire’s multi-agency settings, has deepened my understanding of local dynamics and the flexibility required to effectively support participants from different geographical and socioeconomic backgrounds.
Throughout my career, I have excelled in collaborating across multidisciplinary teams, working closely with local authorities, healthcare professionals, social workers, and outreach teams to deliver integrated support. My audit experience, which involves coordinating with external agencies, reinforces my ability to ensure clear communication, regulatory compliance, and meticulous record-keeping—all critical skills for a multi-agency research role.
With experience covering extensive geographic areas independently, I am well-prepared for the travel demands of this role. My adaptability and dedication to navigating new settings enable effective data collection and participant engagement across varied study sites, contributing to the project’s reach and impact.
My background in data management equips me with advanced skills in data collection, handling, and analysis, ensuring research integrity and precision. My experience with electronic patient record systems supports my capacity to manage complex datasets responsibly and securely—crucial for handling sensitive research data in this role.
I am committed to upholding the highest standards of ethical research and am fully prepared to complete certifications such as Good Clinical Practice (GCP). My commitment to continuous learning through academic events and training aligns with best practices in research, reinforcing my dedication to ethically sound and impactful contributions.
In summary, my combination of hands-on experience, adaptability, technical skills, and dedication to ethical standards makes me a strong candidate for the Research Practitioner role. I look forward to contributing meaningfully to this pivotal study, supporting positive health outcomes for vulnerable populations.
This project utilizes a robust, secure, and integrated Microsoft technology stack to manage, store, and analyze data collected across outreach teams, healthcare records, and survey responses. The data management approach focuses on ensuring data integrity, scalability, and compliance with GDPR and other regulatory requirements.
The database schema is structured to categorize data into core themes, such as healthcare engagement, treatment outcomes, housing stability, and service satisfaction. This structure supports detailed KPI tracking and aligns with the project’s goals of measuring health outcomes and engagement consistency across the intervention.
Our data management strategy prioritizes security and compliance. Features like data masking, encryption, and regular audits are employed to protect sensitive information. Compliance with GDPR is ensured through secure access controls and data-sharing agreements, enabling responsible and transparent data handling across multi-agency partners.