Homelessness Health Needs Assessment


The Homelessness Health Needs Assessment (HHNA) detail research, findings and stakeholder engagement related to homelessness and health in the borough. The document also outlines recommendations for stakeholders and service providers to consider in the context of identified gaps and needs. The majority of research and engagement was carried out in 2022 and the report was finalised in 2023.

Homelessness is a complex problem and, in all its forms, has been increasing over a number of years nationally. The direct and indirect health impacts of homelessness are far-reaching, with people who experience homelessness being more likely to be subject to existing health inequalities and higher rates of mortality.

The full document is available in:

PDF format: Wandsworth Homelessness Health Needs Assessment 2023 (PDF)

Word format: Wandsworth Homelessness Health Needs Assessment 2023 (Word)

The aim of the need assessment was to:

      • Understand the scale of homelessness.
      • Understand health inequalities experienced by people who are homeless.
      • Identify unmet needs.
      • Consider implications for provision of services for people experiencing homelessness locally.

A rapid needs assessment was undertaken, the approach included:

      • Desk-based research and review of local data
      • Engagement work with stakeholders in the local area working in homelessness services or services supporting homeless populations in the form of informal, semi-structured interviews which informed a SWOT analysis.
      • An audit with the homelessness outreach service provider; and
      • Stakeholder engagement sessions to discuss and feedback on draft recommendations.

Key aspects to note from the findings include:

      • Increases in homelessness rates (statutory and rough sleepers) in the borough due to a number of reasons including issues of affordable housing, living with family and friends coming to an end, personal circumstances, relationship breakdown and financial issues.
      • Wellbeing issues particularly in the context of mental and physical health needs, substance misuse and comorbidities (i.e. existence of more than one disease or condition) as well as the complex nature of some cases.
      • Availability and appropriate location of health and wellbeing services, especially in the context of unpredictable living arrangements, digital exclusion, cost of travel and the physical appearance of rough sleepers.
      • Need for better coordination of support services including data sharing. Those who are homeless are often bounced between support services, with individuals having to re-tell their stories and issues multiple times.
      • Need for a wrap-around service with more outreach work, especially to tackle entrenched rough sleepers.
      • Need for multidisciplinary approach (involving housing, adult social care, NHS, police, voluntary sector, and others) for homelessness case management including complex cases.
      • Need for more affordable housing, as well as specialist housing for those who are homeless with health conditions/comorbidities.

The needs assessment made recommendations to address the health inequalities experienced by homeless people, including:

      • To increase collaborative working in the homeless sector to improve the health of people experiencing homelessness.
      • To improve the mental health offer for people experiencing homelessness.
      • Reconsider where and how health services are delivered for rough sleepers.
      • Improve access to appointments to primary care for rough sleepers.
      • Improve access to preventative health support, dentistry, podiatry, and musculoskeletal services for people experiencing homelessness, particularly rough sleepers.
      • Carry out targeted, collaborative work to reduce health inequalities in people experiencing homelessness.
      • Increase social support for people who are homeless to support and maintain relationships beneficial for health.
      • Adapt as a network to support residents and meet needs when resources are not available.