The term ‘homeless’ is often associated by the public as people who sleep rough, in this context the term includes anyone who does not have a home.
For example, people whose accommodation is insecure; those facing eviction, living in temporary accommodation, squatting, people at risk of violence, those housed in property potentially damaging to their health, and those who cannot afford their current accommodation.
Data is collected nationally for England on the number of people reported as homeless, including rough sleepers and those seeking accommodation support. Published in the government, the Homelessness statistics data show an increase in all categories.
Health outcomes for those who are homeless are significantly worse than the general population.
In a report commissioned by Crisis, Homelessness: A Silent Killer (2011) the average age of death of a homeless person was reported as 47 years for men and 43 years for women (compared to 77 years for the general population).
- Drug and alcohol abuse are particularly common causes of death amongst the homeless population, accounting for just over a third of all deaths
- Homeless people are over nine times more likely to commit suicide than the general population.
A study from the charity Groundswell Room to breathe (2016) estimated that smoking rates in homeless people to be 85% in comparison to around 18% for the rest of the population.
The Queen's Nursing Institute (QNI) facts about homelessness and health demonstrate that those who are homeless suffer significantly more than the general population against a range of different diseases and illnesses.
Access to health care NHS
Many homeless people experience problems and stigma when trying to access primary care GP practice health care. When coupled with the fact that many people also have mental health issues this serves as a significant barrier.
The NHS guidance states that to register and receive treatment at a GP practice:
- you do not need a fixed address
- you do not need identification
- your immigration status does not matter.
GP practices will often ask patients for ID, primarily so they can get records from previous doctors. People should be advised that they may be asked for ID but the practice cannot refuse if you don’t have these.
For more information see:
- Faculty for Homeless and Inclusion Health. An inclusive membership organisation for people involved in health care for excluded groups, such as homeless people, gypsies and travellers, vulnerable migrants and people involved in the sex industry.
- Groundswell. Women, homelessness and health. Read the research and listen to the podcast.
- Healthy London Partnership. Homeless health
- Homeless Palliative Care Toolkit. This toolkit aims to support staff working with homeless people who have advanced ill health
- King's College London. Safeguarding, homelessness and rough sleeping: An analysis of Safeguarding Adults Reviews
- London Network of Nurses and Midwives Homelessness group
- Public Health England have an e-learning for health portal on All Our Health: Homelessness. If you haven’t already done so you need to create an e-learning account. This is free of charge.
- Public Health England- Health Matters: Rough sleeping. This edition of Health Matters focuses on the scale of rough sleeping in England, the causes and consequences of rough sleeping (including the links with poor physical and mental health, prevention and effective interventions) and relevant calls to action.
- Queen's Nursing Institute. Transition to Homeless Health Nursing Learning Resource
- Queen's Nursing Institute. Nursing care for people experiencing homelessness'.This report gives insight based on the views of 206 homeless health nurses working across the UK
- Queen's Nursing Institute. Homelessness health programme. This programme aims to provide support for those working with the homeless. The programme "Provides the right support to tackle entrenched medical, personal and social problems, making it possible for people experiencing homelessness to secure positive health – a foundation for rebuilding more secure and stable lives."
- Queen's Nursing Institute. Homeless health guidance and reports
- Queen's Nursing Institute. Homeless health assessment tool
- Royal College of Midwives. Duty to Refer Guidance for Midwives on the Homelessness Reduction Act (2017)
Career development for nurses working with homeless people
The Queens Nursing Institute has published Transition to Homeless Health Nursing which provides resources to support people wishing to develop their career in working with homeless people.
How much do you know about the Homeless Reduction Act (HRA) and the duty to refer where a risk of homelessness has been identified? Read this blog to find out more.
Read our response to the Ministry of Housing, Communities & Local Government on tackling homelessness together.
- Public Health England, 30 September 2019. This edition of Health Matters focuses on the scale of rough sleeping in England
- King's College London, 3 September 2019. Safeguarding, homelessness and rough sleeping: An analysis of Safeguarding Adults Reviews
- NHS England, 19 October 2019. Towns with high rates of homelessness are set for investment in specialist mental health care, as part of NHS services for rough sleepers across the country
Page last updated - 07/12/2023