Homelessness

Question 1

Define homelessness

Answer 1

Homelessness is that a household has no home in the UK or anywhere else in the world available and reasonable to occupy.
Not just people who are sleeping rough
((Including they are at risk violence from any person
* they are unable to secure entry to their accommodation
* they live in a moveable structure but have no place to put it))
(Housing Act 1996)

Question 2

Why did rough sleeping decrease in 2020 and how much by?

Answer 2

Due to COVID-19, declined by 37% in 2020

Question 3

Describe the general trend of homelessness in London

Answer 3

Homelessness and rough sleeping has increased
substantially since 2012 with the exception of 2021/2022 due to COVID

Question 4

Where has the highest number of people sleeping rough in the UK?

Answer 4

London

Question 5

Which boroughs have the highest number of rough sleepers in the UK?

Answer 5

Westminster, Camden, Lambeth, Ealing and Newham

Question 6

Define rough sleeping

Answer 6

The Ministry of Housing, Communities and Local Government (MHCLG) defines people who sleep rough as:
* People sleeping, about to bed down (sitting on/in or standing next to their bedding) or actually bedded down in the open air (such as on the street, in tents, doorways, parks, bus shelters or encampments).
* People in buildings or other places not designed for habitation (such as stairwells, barns, sheds, car parks, cars, derelict boats, stations, or “bashes” which are makeshift shelters often comprised of cardboard boxes).

Question 7

What does the government’s Rough Sleeping Strategy, published in 2018, commit to?

Answer 7

Halving rough sleeping by 2022 and ending it by 2027.

Question 8

What are the causes of homelessness and rough sleeping?

Answer 8

Question 9

What are the risks to health when considering homelessness?

Answer 9

Question 10

Has rough sleeping increased or decreased since 2010?

Answer 10

Increased
The largest increases have been in urban areas, with rural areas and some seaside towns seeing smaller increases.

Question 11

Name 3 prevalent needs homeless people have in regards to their health

Answer 11

Question 12

Why is homelessness relevant to dental teams?

Answer 12

Duty of care
GDC principles
Multi-faceted area of safeguarding- which can be intricate and complex

Question 13

Name some NICE recommendations of how we can integrate health & social care for the homeless

Answer 13

-Models of multidisciplinary service provision (esp long term)
-The role of peers in delivering and designing service
-Improving access
-Intermediate care: These may be for people who are discharged from hospital (step-down care) or referred from the community who are at acute risk of deterioration and hospitalisation (step-up care).
-Transitions between different settings: street, hostels, Housing First and other supported housing, hospital, mental health services, social care, residential or community drug and alcohol treatment
-Designate a lead for safeguarding
-Staff support and development: understanding the needs, duty of care and training in trauma-informed care

Question 14

Name some charities working with the homeless in the UK

Answer 14

Pathway
Groundswell

Question 15

Name some OH challenges to homelessness

Answer 15

1. Living in poverty (financial difficulties, lower nutritious diet, high sugar food & diet
2. OH maintenance poor/low priority (high prev of caries & gum disease)
3. Substance misuse, poor social/phycological wellbeing
4. Access to healthcare: poor access, discrimination/stigma/lack of awareness by staff/lack of facilities ie phone, internet, access, transport

Question 16

Name some OH promotion strategies concerning homelessness

Answer 16

1. Integration of OH and general health, focusing on prevention (OH assessment, diet advice, fluoride availability, VBA for tobacco or alcohol)
2. Dental workforce training: Knowledge & skills, accommodating services
3. Multi-displinary approach to care: health, housing & social care collaborations, signposting to local NHS dental services