Test & Learn

Outreach services with a health specialism for people rough sleeping – optimisation and pilot cluster randomised controlled trial.

Background and study aims

People experiencing homelessness, particularly those rough sleeping, have poorer health outcomes than people who are housed. This study focuses on nurses working with outreach teams to support people rough sleeping who are living on the streets. The study aims to find out if the support given by outreach teams with nurses helps more people settle into housing and improves health.

Study design

The intervention will embed nurses into the outreach service, working directly on the streets. This will remove barriers to access as individuals will not have to attend a healthcare centre. Eight Local Authority areas will deliver outreach health services, running for 17 months to support people to exit rough sleeping, assess health needs and help access mainstream health services such as a GP.

Participation criteria

16 local authority (LA) areas in England are participating in the study. Eight are delivering outreach with a health specialism (intervention) and eight are continuing with usual practice control). LAs estimate they will collect routine data from 640 people living on the streets during the baseline data collection period at the start of the study.

Study approach

LAs will collect routine data for people rough sleeping living on the streets at baseline, three, and six months. Cardiff University will interview some staff and service users in six LA sites (three intervention and three control), aimed at understanding lived experience of those delivering and receiving the service. Some sessions will be observed on the street and the cost of the intervention will be calculated and weighed up against any benefits.

Expected study duration

The pilot cluster randomised controlled trial is starting in January 2025 and is expected to run until January 2026.

Funder

This work is funded by the Ministry of Housing, Communities and Local Government (MHCLG)* via the Centre for Homelessness Impact (CHI) as part of the Test & Learn and Systems-Wide Evaluation Programme, a £15m programme of work to improve the evidence-base and understanding of what works to end rough sleeping. This was part of the 2022 ‘Ending Rough Sleeping for Good Strategy’.

*formerly known as the Department for Levelling Up, Housing and Communities (DLUHC)