Health visitors & housing link worker

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The context

A number of factors make health visitors natural agents in preventing family homelessness. They provide a universal service, take an early intervention approach, stay in contact with a family from a child’s birth to school age, and visit the home. This offers a unique vantage point to build trust and gather insights on a family’s wider environment and dynamics, including homelessness risk factors, with more impact than a health professional simply asking about someone’s housing in an office setting.

In Glasgow, housing is recognised as a key element in health visitor assessments. But the city’s notoriously complex housing system, with 55% households renting from almost 70 different social landlordslxxix and over 30,000 registered PRS landlords, makes it challenging for non-housing partners to identify, let alone engage with, a family’s landlord when attempting to act on housing concerns. In this context, dedicated health and housing ‘link workers’ play a pivotal role.

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The intervention

Glasgow’s Health and Social Care Partnership (H&SCP) has long understood the need for link workers. Health and housing leads were seconded from NHS to the H&SCP in the early 2000s, as large hostels were decommissioned, to ease access to mainstream H&SC services for people moving to tenancies. Link workers outlived the hostel resettlement programme, as the value of embedded, single points of contact/information on housing and H&SC, with no caseload, became clear. The roles work in two ways: making the housing system intelligible and navigate-able for H&SC professionals, and vice versa.

The health and housing lead facilitates training and resources on housing for health visitors, including sessions on the PRS from the Council’s PRS Hub. Student health visitors receive housing training as part of professional learning and induction before they go to a patch. This ensures they know enough about housing to ask the right questions. If a family they’re working with has a housing issue, they can use their knowledge to act directly, or complete a simple referral to the health and housing lead for advice, navigation or advocacy. The lead can identify who the landlord is, has agreed contact names in all RSLs, and set up a referral pathway to the PRS Hub for private tenants.

The families health visitors work with frequently experience problems with overcrowding, domestic abuse, debts and repairs. They often find families open up to them about housing problems, or about other problems which can impact on housing. Often supported by the lead, health visitors can advocate for additional support for a family, explore options for resolving rent issues, progress repairs, engage with a landlord on a family’s behalf, help a family move or refer onto legal or other advice.

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The outcome

Over the past calendar year, the health and housing lead noted 100 referrals related to social housing. Homelessness was prevented in 92% of those, with interventions by health visitors leading to arrears being cleared or written off, families rehoused (without becoming homeless) and additional support being provided.

Since offering training and setting up a referral pathway with the PRS Hub, health visitors have become the Hub’s second most prolific referrer (after housing teams), making high quality referrals. To date, the Hub has prevented homelessness for 85% of the households it has worked with. This shows what can be achieved when health visitors use their unique position with families, centred around on a trusting relationship, to ask about and act on housing issues.

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Key insights

• health visitors can at times make headway with families in addressing housing problems (or problems which impact housing) which their landlord, or other professionals such as social workers, cannot
• asking about housing is a natural part of health visitors’ holistic approach with families - but a linking, navigating or coordinating role from the housing sector is needed to meet them halfway
• as universal (cross-tenure) workers, health visitors have the potential to be particularly effective reducing housing risks for families renting privately, who can often be more ‘hidden’ from support

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Find out more…

Jaclyn Robertson, Health, Housing & Homelessness Lead, Glasgow H&SCP
jaclyn.robertson3@ggc.scot.nhs.uk