ADD2028 Homeless Health Advocacy Project

Type of decision: 
Assistant Director's decision
Date signed: 
19 September 2016
Decision by: 
Jamie Ratcliff, Assistant Director, Housing

Executive summary

Approval is sought to grant fund the Homeless Health Peer Advocacy Project (HHPA). This funding will contribute to the provision of health promotion events and provide peer mentors to ensure that rough sleepers attend medical appointments. As the initial aim of this project was to seed-fund, we anticipate this to be the final year of grant-funding the HHPA.


That the Assistant Director of Programme, Policy and Services, Housing and Land approves:

1.  The award for 2016-17 of £50,000 of grant funding to Groundswell for the Homeless Health Advocacy Project.                      

Part 1: Non-confidential facts and advice

Introduction and background

1.1    The Mayor has committed to tackling the “scourge of homelessness” and in particular has noted that the rise in rough sleeping over recent years is a growing source of shame that we have a “moral imperative” to stop. In his manifesto he pledged to look at preventing rough sleeping and to develop a ‘No Nights Sleeping Rough’ initiative, a London-wide taskforce to oversee the implementation of the Mayor’s rough sleeping work and funding priorities. The Homeless Health Peer Advocacy Project will assist by ensuring rough sleepers attend medical appointments as well as carry out health promotion events.  

1.2    The Mayor has responsibility for funding and commissioning a range of pan-London rough sleeping services. These are services for rough sleepers, or initiatives to tackle rough sleeping, that cannot or would not be provided at a London borough level, as they are pan-London or multi-borough in their remit. A budget of £33.8 million for these services was approved for the period 1 April 2016 to 31 March 2020 granted through MD1532. 

1.3    The shape and nature of these services is underpinned by the Mayor’s Rough Sleeping Commissioning Framework, which includes a priority ‘to work with boroughs and partners to meet the physical and mental health needs of rough sleepers’. In order to meet this priority, the GLA has, since 2012, been grant-funding Groundswell to provide the Homeless Health Advocacy Project, whereby peer advocates accompany rough sleepers to attend health appointments and assist them to sustain health treatment. The project, which won the Andy Ludlow Homelessness Award in 2014, and the GSK Impact Award in 2016, has enabled rough sleepers to attend almost 5,000 medical appointments between 2012 and 2016. We have grant-funded this project as seed funding to enable it to be rolled out across London, as Groundswell are the only organisation to carry out this type of work. It expanded into 3 areas last year, and should a GLA grant be forthcoming Groundswell intend to expand into another 4 areas during 2016-17, and it is anticipated this will be the final year the GLA will fund the project at this level.

1.4    The support of the GLA has enabled Groundswell to expand the service and increase the range of funding that the service receives. At the beginning of 16/17, the HHPA received funding from 5 CCGs with the GLA contributing just 10% of the total. By the end of 16/17, the GLA’s funding will make up just 6%.

Year of funding


Areas of operation







Westminster, Camden, Lambeth, Hammersmith and Fulham, Hackney





Westminster, Camden, Lambeth, Hammersmith and Fulham, Kensington and Chelsea, Hackney





Westminster, Camden, Lambeth, Hammersmith and Fulham, Kensington and Chelsea, Hackney





Westminster, Camden, Lambeth, Hammersmith and Fulham, Kensington and Chelsea, Hackney, Hounslow and Wandsworth




2016-17 (proposed)

Westminster, Camden, Lambeth, Hammersmith and Fulham, Kensington and Chelsea, Hounslow, Wandsworth and Tower Hamlets





















1.5    The support needs of those on the streets remains at a high level with 74% of those on streets with a alcohol, drug or mental health need (or a combination of all three). The Homeless Health Advocacy project aims to improve the physical and mental health of rough sleepers through peer engagement, ensuring that health appointments are attended and health support obtained for this vulnerable group. Given this, it is proposed that the Homeless Health Peer Advocacy Project is extended for a further year. This will enable Groundswell to approach further boroughs to roll out the service, with the aim to expand into a minimum of a further four boroughs this year.  

1.6    Funding and targets have recently been negotiated with Groundswell resulted and we have now introduced employment targets into the funding agreement but with the same amount of funding as last year (See Appendix for more information). 





Objectives and expected outcomes

Project/service to be funded


Expected outcome

Homeless Health Peer Advocacy Project


Annual grant agreements for 2012-16, approved through DD667, DD1047, DD1149 and ADD375 were issued to the provider. An additional year’s funding would enable the project to be expanded to additional areas of the capital.

Proposed GLA funding: £50,000 for 2016/17.

To meet the physical and mental health needs of rough sleepers, in line with priority 8 of the Mayor’s Rough Sleeping Commissioning Framework

To carry out a minimum of 1,300 1:1 engagements and 700 health promotional activities.  

Equality comments

3.1    Of those seen rough sleeping in 2015/16:
•    59% were non-UK nationals
•    46% had a mental health need
•    15% were women
•    most of those seen rough sleeping (58%) were in the 26-45 age group
•    10% were under 26 years old
•    11% were over 55
•    4 people were under 18.

3.2    As rough sleepers are over-represented among those with the protected characteristics of race and disability, the proposals in this paper are likely to have positive impacts on these groups.

Other considerations

a) Key risks and issues

Risk description



Mitigating action


Rough sleepers refuse to engage with Homeless Health Peer Advocacy Project


The experience of the project to date is that rough sleepers are willing to engage, primarily because of the innovative use of former rough sleepers as peer advocates.

b) Links to Mayoral strategies and priorities

The objectives of the proposals are in line with the Mayor’s Rough Sleeping Commissioning Framework 2016 priority 8, as well as the Mayor’s statutory London Housing Strategy which includes the following priorities: to work with boroughs and other partners to ensure that no one new to the streets sleeps rough for a second night, no one lives on the streets of London and the flow of new rough sleepers onto the streets is minimised.

c) Impact assessments and consultations.

The Mayor’s Rough Sleeping Commissioning Framework 2016 was made available for consultation with key stakeholders and partners and was subject to a full equalities impact assessment. The statutory London Housing Strategy has been subject to a full-integrated impact assessment and undergone statutory consultation with the London Assembly and functional bodies and with the public.

Financial comments

5.1    This decision seeks approval to expend £50,000 to grant fund Homeless Health Peer Advocacy Project (HHPA) run by Groundswell, a registered charity. Funds are available from Mayor’s Rough Sleeping services, which have been allocated with total funding of £8.49m for the 2016/17 financial year. 

5.2    The Programme, Policy and Services Unit of the Housing and Land Directorate, will be responsible for monitoring and managing the grant and ensuring that all activities and associated expenditure comply with the Authority’s Financial Regulations, Contracts and Funding Code and Expenses and Benefits Framework. Any changes to this proposal, including the requirement of additional funds, will be subject to further approval via the Authority’s decision making process.

Planned delivery approach and next steps

6.1    The GLA will continue to monitor the service on a quarterly basis to assess performance against targets. The performance of the service will be reported to the quarterly internal Rough Sleeping Group convened by the Deputy Mayor for Housing Land and Property, which is anticipated to continue under the new Mayor.

Appendices and supporting papers

Appendix 1 Previous Performance targets 2015/16




Advocates support homeless people to attend health appointments




Health Promotion In Reach sessions




Expansion into new local authority areas



Appendix 2 Performance targets 2016/17



Advocates support homeless people to attend health appointments


Health Promotion In Reach sessions


Expansion into new local authority areas


Clients entering into paid employment


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