21. People experiencing homelessness
Source: gov.uk (2025-11-28)

How to provide tailored alcohol treatment for people experiencing homelessness. It covers strategies for improving access and engagement, highlighting the need for multi-agency integrated care to address alcohol use, housing and wider needs while reducing health inequalities.

21.1 Main points

People experiencing homelessness also experience multiple disadvantage that requires an integrated response across local systems and services.

Alcohol treatment commissioners and services should work with homelessness services, health, social care and community services to plan and provide integrated models of care such as co-located services, in-reach sessions, or multi-agency forums.

People experiencing homelessness should have a multi-agency assessment and care plan (treatment and recovery plan) that addresses alcohol treatment, housing and wider health and social care needs and is co-ordinated by a named keyworker.

People experiencing homelessness experience personal barriers (such as the impact of trauma) and service barriers (such as inflexible appointment systems) to accessing alcohol treatment services.

To reduce barriers to treatment, services need to offer flexible engagement arrangements tailored to the needs of people experiencing homelessness, such as assertive outreach or open access services.

Individual practitioners and services should work with a compassionate, non-stigmatising and trauma-informed approach to support ongoing engagement with people experiencing homelessness.

Services need to tailor treatment and recovery support to the needs of people experiencing homelessness such as offering long term support and increasing support before, during and after the move to independent housing.

A harm reduction approach is often appropriate for people experiencing homelessness. This could aim to reduce the physical and mental health and social harms associated with problem alcohol use and homelessness.

For people experiencing homelessness with alcohol dependence and who want to stop drinking, services should consider offering inpatient medically assisted withdrawal followed by planned treatment and access to appropriate housing and support.

People with lived and living experience of problem alcohol use and homelessness should be involved in commissioning and planning services and offering peer support to people in treatment and recovery.

Practitioners working with people with problem alcohol use who are experiencing homelessness should be trained and supported to identify adult safeguarding concerns. They must act in line with statutory guidance as homelessness, particularly rough sleeping, is associated with increased safeguarding risks.

21.2 Introduction

The chapter provides guidance about support and treatment for people experiencing homelessness with alcohol dependence or who drink at harmful levels.

21.2.1 Alcohol treatment for people experiencing homelessness

Alcohol treatment services should provide inclusive, targeted and flexible support tailored to the needs of people experiencing homelessness, including rough sleeping. They should work together with homelessness and housing support, health, social care, and community services to make sure people experiencing homelessness can access integrated care.

Commissioners and services should be aware of and work in line with the National Institute for Health and Care Excellence (NICE) guideline Integrated health and social care for people experiencing homelessness (https://www.nice.org.uk/guidance/ng214/) (NG214).

21.2.2 Definition

Homelessness: applying All Our Health (https://www.gov.uk/government/publications/homelessness-applying-all-our-health) sets out a definition of homelessness, which is that a household has no home in the UK or anywhere else in the world available and reasonable to occupy.

The same guidance gives examples of homelessness, including:
- rooflessness (without a shelter of any kind, sleeping rough)
- houselessness (with a place to sleep but temporary, in institutions or a shelter)
- living in insecure housing (threatened with severe exclusion due to insecure tenancies, eviction, domestic violence, or staying with family and friends known as ‘sofa surfing’)
- living in inadequate housing (in caravans on illegal campsites, in unfit housing, in extreme overcrowding)
People can move in and out of periods of homelessness. It can be temporary and some people experience repeated episodes of homelessness, moving in and out of short-term accommodation.

21.3 Addressing health inequalities

People experiencing homelessness experience some of the most extreme health inequalities. Office for National Statistics Deaths of homeless people in England and Wales: 2021 registrations (https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsofhomelesspeopleinenglandandwales/2021registrations) shows that the average age at death for people experiencing homelessness was 45.4 years for men and 43.2 years for women. This is more than 30 years lower than the average age at death of the general population of England and Wales. National Records of Scotland data on homeless deaths in 2023 (https://www.nrscotland.gov.uk/publications/homeless-deaths-2023/) shows that half (50%) of homeless deaths in 2023 were people aged under 45.

People experiencing homelessness often find health and social care services (including alcohol treatment services) difficult or impossible to access. Commissioners and services often need to make more effort and target approaches to providing care to this group of people. They should aim to reduce the health inequalities affecting people experiencing homelessness by allocating resources and tailoring services to meet their specific needs. This is so alcohol treatment is available and accessible to people experiencing homelessness and provided to the same standards and quality as it is for the rest of the alcohol treatment population.

21.4 Integrated care

21.4.1 Integrated care for people experiencing homelessness and problem alcohol use

People experiencing homelessness and problem alcohol use often experience multiple disadvantage and their needs require an integrated response across local systems and services, including:
- alcohol and drug treatment services
- primary care
- acute health care
- community, inpatient and crisis support mental health care
- social care
- homelessness, housing and housing support services
- peer-support organisations
- domestic abuse services
- local community and voluntary sector services
All integrated care should be based on a trauma-informed approach and care environments should be psychologically informed (see section 21.5.2 on supporting and maintaining engagement below). There is guidance on trauma informed practice in section 2.2.8 in chapter 2 on principles of care.

21.4.2 Commissioning and planning integrated services

NICE NG214 recommends that commissioners and planners of services for people experiencing homelessness involve commissioners of other relevant health and social care services in their planning.

Alcohol treatment commissioners and services should be aware of:
- how alcohol treatment fits into the local model of integrated care aimed at addressing the needs of their local population experiencing homelessness
- the legal obligations on their local authority to provide housing support
Commissioners and planners of alcohol treatment and of services for people experiencing homelessness should work together to agree pathways between services and joint working arrangements. This will support effective joint working at a service delivery level.

21.4.3 Providing integrated care

Models of integrated care for people experiencing homelessness vary. In areas with high numbers of people experiencing homelessness, NICE NG214 recommends that multi-agency teams provide integrated care (including alcohol treatment) through one service. In areas where multi-agency teams do not exist, alcohol treatment services and practitioners should work with homelessness and housing services, and relevant health and social care services, to provide integrated treatment and support.

Models for providing integrated care can include:
- direct and rapid links between alcohol treatment services and local housing, street outreach and rough sleeping services
- practitioners from homelessness services providing regular sessions in alcohol treatment services, for advice and referral (known as in-reach)
- practitioners from alcohol treatment services providing regular sessions for street outreach teams, rough sleeping services and temporary accommodation
- peer- support and lived experience recovery organisations being involved in the design and delivery of the service
- a regular multi-agency forum that assesses, co-ordinates, plans and reviews support for vulnerable people experiencing multiple disadvantage, in an integrated way (see section 9.7 in chapter 9 on assertive outreach and a multi-agency team around the person for more guidance on multi-agency forums)
- a multidisciplinary, multi-agency team formed around one individual to assess, co-ordinate, plan and review support for a person experiencing multiple disadvantage in an integrated way (see chapter 4 for more guidance on assessment and treatment and recovery planning)
- alcohol treatment services, mental health services and services for people experiencing homelessness operating on the principle of ‘no wrong door’ for people with co-occurring problem alcohol use and mental health conditions, so they can access care from any point across any of these services (see section 2.3.4 in chapter 2 on principles of care for more guidance on a ‘no wrong door’ approach)
You can read more about care for people with co-occurring problem alcohol use and mental health conditions in chapter 18 on co-occurring mental health conditions.

‘Making Every Adult Matter’ outlines the benefits of integration. This may include:
- building skills
- exchanging knowledge, experiences and examples of good practice
- leading local innovation and systems change
21.4.4 Individual integrated treatment and support

Alcohol treatment services should make sure their staff know when a person needs to be referred to specialist homelessness support services, including specialist homeless health and social care (where these exist). Services should also have processes in place to make sure referrals are made without delay.

Staff from alcohol treatment services and staff from homelessness services should contribute to multi-agency assessment and person-centred, treatment and recovery planning, using local arrangements. There is guidance on multi-agency treatment and recovery planning in section 4.10.4 in chapter 4.

While it is often important to involve staff from several services in the person’s care, careful planning is needed so the person does not feel overwhelmed by contact with several services. There should be a named lead worker who co-ordinates care and is the main person to communicate continuously with the person throughout their treatment and recovery journey.

Staff from alcohol treatment services and staff from homelessness services should give people accessible information about their rights to health and social care services and how to access them.

Staff from alcohol treatment services and homelessness services should be aware that people have the right to register with a GP without a permanent address. Part B, section 4 on ‘GP patient registration standard operating principles for primary medical services’ of the Primary medical services policy and guidance manual (https://www.england.nhs.uk/long-read/primary-medical-services-policy-and-guidance-manual-pgm/) makes this clear for England, and the Health Literacy Place toolkit (https://www.healthliteracyplace.org.uk/toolkit/access-to-healthcare/) provides similar information for Scotland.

GP access cards are available in several languages that state that everyone in England, Scotland and Wales has a right to register with a GP without providing proof of address or identification. Staff should give people information on how to register with a GP, provide a GP access card where possible (see resources section below) and support them to register. Peer supporters or other advocates may accompany the person to help them with this process.

You can find guidance and resources for registering with a GP at the end of the chapter.

21.4.5 Training for staff in alcohol treatment services and in services for people experiencing homelessness

Staff in alcohol treatment services need basic training on:
- main support needs of people experiencing homelessness
- information about local pathways and services
- when and how to refer people experiencing homelessness to local services
Staff working in services for people experiencing homelessness need basic training on:
- main support needs of people with problem alcohol use
- how to recognise signs and symptoms that require emergency treatment in hospital including complications in withdrawal, such as seizures, delirium tremens and Wernicke’s encephalopathy (WE) (see section 10.4 in chapter 4 on pharmacological interventions for guidance on complications in withdrawal)
- basic alcohol harm reduction advice (see section in chapter 8 on harm reduction)
- information about local pathways and services
- when and how to refer to local services for alcohol treatment
It may be helpful for staff with appropriate expertise from local alcohol treatment services and local services for people experiencing homelessness to provide training for each other.

21.5 Reaching people experiencing homelessness and tailoring treatment to meet their needs

People experiencing homelessness should have access to the full range of evidence-based interventions (described in chapters 1 to 12 of this guidance), based on individual assessed need. This section outlines additional considerations for reaching people experiencing homelessness and tailoring treatment to meet their needs.

21.5.1 Increasing access to alcohol treatment

People experiencing homelessness may not be able to access alcohol treatment services for reasons that relate to past trauma, such as a difficulty in forming trusting relationships. They might also experience barriers that are service-related such as stigmatising services with inflexible opening times or procedures for missed appointments.

Alcohol treatment services and staff need to reduce barriers that prevent people accessing and engaging in treatment.

One way to improve access is to bring the service to people who need it. This can include outreach on the street and in-reach in services for people experiencing homelessness, like day centres, hostels, and other forms of temporary accommodation. Outreach and in-reach both help to remove barriers to engagement. You can find guidance on assertive outreach in chapter 9 on assertive outreach and a multi-agency team around the person.

Other ways that services can improve access include:
- direct access services where people can drop in without an appointment on some days or any day of the week
- flexible opening times and appointments, including broad appointment times, like a whole morning rather than a fixed time
- co-locating alcohol treatment services with homelessness services or relevant health and social care services
- service bases that are close to where people are staying and easy to access by public transport
- providing practical help, for example with transport costs or data for phones.
- giving people the option of referral to the service either by self-referral or by a professional
- having peer support and advocates available when needed
- allowing people to contact the service and have some appointments by phone and online - but also recognising that some people will not have relevant skills or access to the internet or a phone and will need in-person contact
- providing professional interpreters and translation where needed.
- providing accessible information about alcohol treatment taking into account people’s literacy, language, sensory disabilities, cognitive disabilities, and neurodiversity
- using a harm reduction approach (see section 21.7 below)
Alcohol treatment services and staff should realise there are many reasons why a person may not be able to provide proof of their identity or their address. If a person says that they live in the area covered by a service, but cannot produce proof, they should not be refused access.

Alcohol treatment services and practitioners in England should be aware of the Department of Health and Social Care Guidance on implementing the overseas visitor charging regulations (https://www.gov.uk/government/publications/nhs-cost-recovery-overseas-visitors) (section 3 on ‘Exempt and out of scope services’, relevant case study 1). This explains that community drug and alcohol treatment services (which it calls “first point of contact services”) are free of charge to overseas visitors, regardless of immigration status, if the providers consider the services provided are ‘equivalent services’ to primary medical services (if they do not then the services may be chargeable). This can include people who have a no recourse to public funds status. Services and staff in Scotland, Wales and Northern Ireland should be aware of charging regulations for overseas visitors in alcohol treatment services.

21.5.2 Supporting and maintaining engagement

Building a trusting relationship

Building and maintaining a trusting relationship is vital to help people stay engaged in treatment. Alcohol treatment services and staff should use a compassionate, non-judgmental, and non-stigmatising approach, treating people with dignity and respect. These principles should underpin all alcohol treatment, but they are particularly important for people experiencing homelessness because they are more likely to experience stigma and discrimination.

You can read more about principles of care that should underpin all alcohol treatment in chapter 2.

A longer period of contact is often required when working with people experiencing homelessness. For many people, this includes time to build relationships and remove barriers to engagement before they decide to make changes in their alcohol use.

Trauma-informed practice

Hard Edges: mapping severe and multiple disadvantage in England (https://lankellychase.org.uk/publication/hard-edges/) shows that many people who have experienced homelessness have also experienced significant trauma during their lives and may continue to experience traumatic events while in treatment or while experiencing homelessness.

A trauma-informed approach recognises that trauma can affect a person’s ability to feel safe in services, develop trusting relationships with their staff or manage their emotions. Trauma-informed practice seeks to remove the barriers that people affected by trauma can experience when accessing care and services.

You can read about a trauma-informed practice in section 2.2.8 in chapter 2 on principles of care.

A trauma-informed approach includes the way staff communicate with people and support them. It also includes creating service environments that are psychologically informed. Psychologically informed environments are based on an understanding of the psychological needs of people with a history of complex trauma. They are organised to address these needs, and to support people to make changes. Community alcohol treatment services should be psychologically informed, and alcohol treatment staff can also contribute to psychologically informed environments in services where they provide in-reach (such as hostels and day centres).

See resources section below for more on psychologically informed environments.

Addressing diverse needs

Services and practitioners should provide inclusive person-centred care, to address the diverse range of needs of people experiencing homelessness and tailor treatment and support appropriately. For example, needs and risk vary across age, sex, ethnicity, sexual orientation and gender identity. And the issues that have led someone to become homeless also vary.

Proactive engagement approach

Practitioners should proactively try to engage people experiencing homelessness. This can include making repeated attempts to contact them and following up missed appointments in an encouraging way. Practitioners should be flexible in the way they make contact and communicate about appointments and use whatever method the person prefers and has access to, including text, phone, internet, letter and in-person visits.

Flexible delivery of interventions

Commissioners and services need to be flexible in the way they deliver alcohol treatment interventions to meet the needs of people experiencing homelessness.

The following recommendations are based on NICE NG214 (https://www.nice.org.uk/guidance/ng214/) and on clinical consensus of the alcohol guidelines development group.

If services have waiting lists for assessment or specific treatment interventions, they should consider giving priority to people experiencing homelessness. This is because their circumstances could mean they are at higher risk of their condition deteriorating and even premature death.

People who have experienced homelessness, especially rough sleeping, may need long term support to help them sustain recovery. Services should consider offering extended periods of treatment and support so the person can form trusting relationships with individual keyworkers. Longer term support can also help the person if their circumstances become stable enough for them to engage with structured alcohol treatment and achieve positive outcomes.

Wherever possible, each person should have one keyworker throughout their treatment to help develop a good therapeutic alliance. Services should consider reducing caseloads for practitioners working with people experiencing homelessness, so they can provide flexible and regular contact over an extended period.

People experiencing homelessness may find it difficult to attend appointments due to their life circumstances. So services should not have policies that require them to discharge people after a particular number of missed appointments.

Services and practitioners should be aware that the transition to independent living can be very stressful. The additional responsibilities may increase their risk of returning to previous behaviours, including problematic alcohol use. So, practitioners should consider increasing the support they offer before, during and after these transitions. End of treatment planning (including recovery check-ups and re-engagement plans) is particularly important for this group of people.

You can read guidance on end of treatment planning in section 4.10.6 in chapter 4 on assessment and treatment and recovery planning.

Assertive outreach is an approach that can be useful when working with people who experience multiple disadvantage, including those experiencing homelessness. There is guidance in chapter 9 on assertive outreach and a multi-agency team around the person.

21.6 Peer support and involving people with lived experience

21.6.1 Involving people in service provision

People with lived and living experience of homelessness can play a valuable role in service provision, by helping to improve the quality of targeted services. So wherever possible, alcohol treatment commissioners and services should include people with lived and living experience of problem alcohol use and homelessness in all aspects of service provision including:
- needs assessment
- service design
- commissioning processes
- quality governance processes
- service promotion
- service delivery
21.6.2 Peer support

Peer support is a valuable component of treatment for people who are homeless or experiencing rough sleeping. For example, peers can:
- show that change and recovery are possible
- help someone to form good relationships with services and practitioners
- make sure the person attends their appointments
- act as an advocate for the person in different situations
- involve people in recovery-oriented activities organised by peers
People with lived experience of homelessness and problem alcohol use may be particularly welcomed by people experiencing homelessness.

Any peer support should be provided as a component of a personalised treatment and recovery plan and not instead of it. Commissioners of peer support initiatives should make sure that the peers involved have access to training, supervision and support from treatment services.

You can read more on the role of people with lived experience and peer support in chapter 6 on recovery support services and in sections 5.5.3 and 5.5.4 in chapter 5 on psychosocial interventions.

21.7 A harm reduction approach

21.7.1 Taking a harm reduction approach

The alcohol treatment practitioner and the person should consider alcohol use goals as part of the person’s holistic treatment and recovery plan. This should be based on a comprehensive multidisciplinary assessment.

A harm reduction approach will often be appropriate for people experiencing homelessness, particularly those experiencing rough sleeping.

You can read guidance on agreeing alcohol use goals, including a harm reduction strategy, in section 4.7 in chapter 4 on assessment and treatment and recovery planning.

A harm reduction approach aims to reduce immediate and longer-term harms, risks and health inequalities that the person is experiencing. It involves actions to address a person’s physical health, mental health and social care needs, including housing needs. The person may not be ready to reduce their alcohol use initially, but meeting these needs is a positive outcome. This can encourage the person and increase their motivation to engage in alcohol treatment at a later stage.

Service provision targeted at practical needs such as putting on breakfast clubs and serving hot food and drinks may help to reduce harm by providing nutrition, reducing isolation and beginning to build relationships.

People experiencing homelessness often have poor nutrition and may be at higher risk of WE due to a deficiency in thiamine. WE can lead to both short and long term brain damage. Advice and support for nutrition is an important harm reduction intervention. Alcohol treatment clinicians should follow the guidance on identifying risk of WE and administering oral or parenteral (intramuscular or intravenous) thiamine (see section 10.4.3 in chapter 10 on pharmacological interventions).

You should read chapter 8 on harm reduction which provides guidance on several harm reduction interventions appropriate for people experiencing homelessness, including rough sleeping.

21.7.2 Making changes in alcohol use

A focus on reducing harms may be the most useful way to work with a particular person experiencing homelessness. But practitioners should never assume that the person is incapable of making significant reductions in their alcohol use or achieving abstinence. Practitioners and the person should regularly review the person’s goals with this in mind and adjust the goals as appropriate.

Where the person continues to drink harmfully or dependently, the service should regularly review their health or arrange for this to take place and take action to address any deterioration.

21.8 Access to medically assisted withdrawal and residential treatment

21.8.1 Medically assisted withdrawal

For people experiencing homelessness with alcohol dependence and who want to stop drinking, services should consider offering inpatient medically assisted withdrawal, including for people who are not severely alcohol dependent. People experiencing homelessness are likely to have several physical or mental healthcare needs and will require a safe, stable setting for medically assisted withdrawal where their health can be monitored.

For more information on the criteria for referring people for specialist inpatient medically assisted withdrawal, see section 12.4 in chapter 12.

The person, the alcohol practitioner and relevant members of the multidisciplinary team should jointly assess whether this treatment option would meet the person’s needs. And if it would, the practitioners should make sure the person has adequate support before, during and after each stage of the treatment and recovery journey. This is important because transitions to and from inpatient or residential treatment can be very stressful times.

Staff in the specialist inpatient medically assisted withdrawal unit should make every attempt to build a rapport with the person early in their stay to help them engage. It will also be helpful if the community alcohol treatment practitioner (or trusted keyworker from another service, where appropriate) continues contact with the person throughout their time in inpatient or residential treatment.

21.8.2 Residential treatment and housing

There should be an agreed multidisciplinary plan so that the person has adequate support immediately after the medically assisted withdrawal and in the longer term. They will need ongoing support and treatment, such as a residential treatment or an intensive structured day programme, after medically assisted withdrawal. This is because they will be at risk of returning to problematic drinking and its associated risks to physical and mental health and potential threats to safety. So, the plan should include arrangements for ongoing treatment after medically assisted withdrawal and suitable accommodation when they leave treatment (either by completing it or dropping out).

Ongoing arrangements should include support for their physical health, mental health and social care needs alongside accommodation. There should also be support for building recovery resources such as supportive family and social networks, peer support, education volunteering, training and employment support. The housing and support offered should be based on their individual assessed recovery, health and social care needs. The identified keyworker should make sure care is co-ordinated and relevant information shared between all the services working with the person.

It is important that alcohol treatment services and their staff are aware of the different housing support options available to people in their local area, including any options tailored to the needs of people with problem alcohol use and those in recovery. Some local areas across the UK commission the ‘Housing First’ model (see resource section below) which provides housing and open-ended support tailored to the needs of people experiencing multiple disadvantage, including problem alcohol use. The person is offered personalised support, but the offer of housing is not dependent on their involvement in treatment and support.

Alcohol treatment services need good links with services that provide specialist homelessness and housing support and advice, so that the person benefits from appropriate specialist advice and support.

21.8.3 End of life care

People experiencing homelessness die 30 years earlier on average than the general population. Some people may require end of life care. Practitioners (in alcohol treatment and homelessness services) working with people experiencing homelessness should be trained and supported to recognise signs of deteriorating health. Health services should provide end of life care and practitioners should also contribute to a multi-agency personalised end of life care plan, to provide appropriate and respectful care.

21.9 Safeguarding

Homelessness, and particularly rough sleeping, is associated with increased safeguarding risks. People experiencing homelessness are more likely to be a vulnerable adult at risk of abuse or neglect, including self-neglect. They may also be a safeguarding risk to others, including vulnerable adults or children. Alcohol treatment and homelessness commissioners and services should be aware of findings of adult safeguarding reviews relating to people with problem alcohol use experiencing homelessness and recommendations for practice (see resources section below).

Commissioners and services should support alcohol treatment practitioners to understand and apply laws and related statutory guidance that are relevant to people experiencing homelessness. Support from commissioners and services should include training for practitioners so that they can recognise signs of abuse and neglect (including self-neglect) and know how to make adult safeguarding and child safeguarding referrals. Practitioners should also know how to assess mental capacity to make a specific decision or should be aware of the organisational procedure for assessing mental capacity where there is a proper reason to believe that a person may lack capacity to make the decision in question. There should also be clear organisational procedures for practitioners to access support and supervision for safeguarding concerns.

Practitioners must make safeguarding referrals in line with legislation, statutory guidance and organisational procedures.

You can find information on adult safeguarding legislation and statutory guidance in annex 1.

21.10 Resources

The Revolving Doors report Evaluation of the impact of psychologically informed environments (https://revolving-doors.org.uk/publications/bcft-impact-psychologically-informed-environments/) describes what psychologically informed environments are and evaluates the impact on staff and on services of introducing training on the topic. The evaluation took place in several services for vulnerable people with multiple needs.

The Homeless palliative care toolkit (http://www.homelesspalliativecare.com/) provides information and resources for frontline staff supporting people who are homeless and who have significant health needs.

The Local Government Association has published reports that provide good practice recommendations based on an analysis of adult safeguarding reviews and homelessness. They are:
- Second national analysis of Safeguarding Adult Reviews: April 2019 to March 2023 (https://www.local.gov.uk/publications/second-national-analysis-safeguarding-adult-reviews-april-2019-march-2023)
- Adult safeguarding and homelessness: a briefing on positive practice (https://www.local.gov.uk/publications/adult-safeguarding-and-homelessness-briefing-positive-practice)
- Adult safeguarding and homelessness: experience informed practice (https://www.local.gov.uk/publications/adult-safeguarding-and-homelessness-experience-informed-practice), which includes input from people with lived experience
The Doctors of the World GP access cards for England, Scotland and Wales (https://www.doctorsoftheworld.org.uk/gp-access-cards/) provide information on the right to access a GP that people can show to GP surgeries. Practitioners can print them and use them to provide information to people experiencing homelessness and people with concerns about their immigration status. They should encourage people to use them and follow up on whether they were able to register.

For Northern Ireland, the Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015 (https://www.legislation.gov.uk/nisr/2015/27/made) covers GP access and information on charges for healthcare for people not ordinarily resident.

Housing First is a housing and support approach that:
- gives people who have experienced homelessness and long-term health and social care needs a stable home from which to rebuild their lives
- provides intensive, person-centred, holistic support which is open-ended
- places no conditions on individuals but they should want to have a tenancy
You can find more information about Housing First on the Homeless Link website (https://homeless.org.uk/areas-of-expertise/housing-first/) or the Scottish Government’s Housing First: monitoring reports (https://www.gov.scot/publications/housing-first-monitoring-reports/)

The Changing Futures programme (https://www.gov.uk/government/collections/changing-futures) is an initiative between the UK government and The National Lottery Community Fund. It seeks to test innovative approaches to improving outcomes for people experiencing multiple disadvantage, including homelessness, drug and alcohol problems, mental ill health, domestic abuse and contact with the criminal justice system.