Thanks to those who have submitted questions for this year’s panel discussion (see below for questions suggested so far). Similar to last year we will be making a final shortlist for you to vote for on the day:

  1. One of the conference case studies concerns a prisoner with dermatology, mental health, and addictions problems who was discharged from remand homeless. After failing to obtain housing himself, he said he wanted to re-offend to avoid homelessness. However he ended up in hospital, where a Pathway housing worker helped him to get housing. What should be done to improve prison discharge processes in terms of health and housing?
  2. We know of many homeless clients who are known to the Home Office and have no current legal status, yet they have not been detained, and are also deteriorating from a health point of view. In health we are desperately waiting for them to go over the ‘care needs threshold’ so we can get them some support. How can health care professionals influence the Home Office to enter into a discussion about a humanitarian approach to the management of these individuals?
  3. Vicarious trauma is a known issue for professionals working in this sector. What does the panel think professionals working in this sector should be doing to mitigate against this?
  4. This year NHS England issues guidance for practices on GP registration policy, saying that practices should not insist on ID for our client groups. However our experience is that this is still happening. What should be done about this?
  5. We know that homeless health services do not always produce cost savings in the short term, however we also know that the poor outcomes of these clients suggest that quality services are much needed. What outcomes does the panel suggest that homeless health services should be focusing on?
  6. What concerns does the panel have about the Immigration Act, and will it make our work any more difficult than it already is?
  7. At birth social services often offer support to children, but not the mother, presenting an unenviable choice for migrant women with no status. This tends to drives these women underground, threatening the future of both the mother and the child. What does panel think about this issue, and should more support be offered?
  8. Our experience is that it is very hard to get appropriate mental health support for homeless clients who do not have a severe and enduring mental illness, but who are often suffering from severe psychological trauma and/or personality issues. How could the current situation be improved?
  9. The number of homeless families increased 45% last year to a 12 year high. There has also been an increase in out-of-borough placements, with at least a third of homeless families now being placed outside London (2/3 in the case of Kensington and Chelsea). What does the panel think are the impacts of families being placed out of borough, and should this practice be challenged?
  10. Should patients on TB treatment always be accommodated regardless of their immigration status?
  11. Should there be a strategic clinical network for homeless and inclusion health, and if so what should be its objectives?
  12. Ensuring a flow of information between services that benefits and protects our most vulnerable clients, and manages public health risk still remains out of reach despite a general consensus that data sharing should take place in these cases. E.g. there is currently no national alerting system for transient homeless pregnant women. How can we ensure that work takes place in this area?
  13. What should be in a 5 year plan for homeless health care for London?
  14. Should peer advocacy be a core element of all homeless and inclusion health services?
  15. The DH used to facilitate clinical network meetings for Initial Accommodation staff. At the time it was felt that the network helped to share best practice, alert adverse trends, and supported the timely flow of information for individual clients (because clinicians knew who to contact), and should even perhaps be expanded to include the Immigration Removal Centre services. However the DH then withdrew from facilitating this. Unfortunately it is was no service’s individual role to keep this going, so it no longer exists. Who should be responsible for developing and maintaining this and/or other similar networks?