Minutes of Meeting: Tuesday 25th February

8th All-Party Parliamentary Group for Households in Temporary Accommodation meeting.

Date: 25/02/2025
Time: 16.00-17.00
Location: Room W3, Westminster Hall

Joint Secretariats: Shared Health Foundation (SHF) and Justlife (JL)

Attendees in person:
Dame Siobhain McDonagh MP (Mitchem & Morden, Labour), Sam Pratt (SHF), Mike Reader MP (Northampton South, Labour), Helena Dollimore MP (Hastings and Rye, Labour), Theo Shaw (staffer to Mike Reader MP), Rhydian Crabb (staffer to Siobhain McDonagh MP), Eliza Castell (staffer to Danny Beales MP), Emily Jones (MHCLG), Andrew Achilleos (staffer to Margaret Mullane MP), Rebecca Dove (Headteacher), Dr Aaminah Verity (GP and Health Inclusion Campaigner), Erica Scott (Citizens UK), Emily Barker (4 in 10), Iva Pehlivanova (SHF), Isabel Kaner (SHF), Morgan Tebbs (Justlife).

Number of attendees online: 34

Panellists:
Theo Shaw, Staffer for Mike Reader MP and lived experience
Dr Aaminah Verity, GP and Health Campaigner
Rebecca Dove, Headteacher
Sam Pratt, Policy and Communications Lead, Shared Health Foundation

Agenda:
4pm. Introductions from Siobhain McDonagh MP, Chair (5mins)
Opening video – SAFE Campaign
4:05pm – In conversation with Theo Shaw (10 mins)
Theo has lived experience of living in Temporary Accommodation and now works for an MP in Parliament.
4:15pm Dr Aaminah Verity. GP and health inclusion campaigner (5 mins)
4:20pm Rebecca Dove. Headteacher (5 mins)
4:25 Update on the Children’s Wellbeing and Schools Bill (5 mins)
Video of Minister for Homelessness
4:30pm Comments and questions from MPs and Zoom (25 mins)
4:55pm Final words and actions from Chair (5 mins)

Meeting 

Siobhain McDonagh MP, Chair of the APPG:

Welcomes and introduces the campaign video

Sam Pratt:

To Theo – Can you tell me about your time in temporary accommodation as a child?

Theo Shaw:

I have been in temporary accommodation twice in my life – I was born in TA and lived in a mother and baby unit that was run by the local authority until I was 3, my mum was a teenager and care leaver herself so ended up in that window post-16 where she fell through accommodation gaps and ended up homeless and so that’s where I spent the first few years. 

When I was 16 I ended up in TA again and lived in two different facilities before I was 18, before moving to University. I moved local authority areas in that time, from the London borough of Havering up to Bolton in Greater Manchester. The first place I stayed at was a hostel. It had a bed, 7pm to 7am, with the expectation that for the rest of the day, you were at work or college. I then moved to a building run by a charity where you had your own flat, with other residents that were also homeless. It was funded through housing benefit that went straight to the charity. We had what was back then income support but became universal credit. You had to pay service charge and your bills out of that money and so there wasn’t really very much left over at the end of it. 

I was there for two years prior to me leaving for University. I think it is a brilliant charity and I am still in contact with them and do some work with them. I had a really positive experience with the housing side of it, but as the video shows, it’s the other parts of the experience that are difficult, such as accommodating college and letting services know. 

Something from that video I hadn’t thought about, when the little girl is falling asleep in class, just how noisy where I lived was. You’re living in a block of flats with 40 other people in the same position as you, and they’ve all got their own different issues so it was impossible to sleep. I remember being tired all the time while I was at college. 

Sam:

It sounds like there was a lot going on, with lots of moves and support services might not have been aware of what was going on. How do you think your college, GP or other support services would have responded if they knew your situation?

Theo:

My circumstances were slightly different in that I was street homeless for a couple of weeks and the way that I got help was by telling my college myself because I didn’t know anybody where I was living anymore, the family placement I had, had fallen through. I was stuck not knowing who to contact. So my friends had noticed me being more tired and dishevelled and I was too embarrassed to say anything, but they encouraged me to talk to the safeguarding team at college and I informed them myself. They are the ones that helped me get the placement through the local authority with the charity. The college was helpful once they were aware but there was no way for them to know that and the GP surgery, I actually got off-rolled when I eventually changed my address. I got a letter saying I was no longer in their area so I needed to change GPs. That was the only contact I had from the GP during that time. It was a case of, if I had not reached out to contact them and inform them they wouldn’t know. It is different at the age of 16 compared to 7 to have the foresight to do that, but the services wouldn’t have been aware at all had I not informed them. 

I had been under CAMHS for years at that point, they were not aware that I was homeless and that I had been moved out of borough. There was no communication between the services I had been working with. I had a post-adoption support worker, they were not aware I had been made homeless until the college told them. There was no network of support and no continuity of information between these services. 

This is less of a personal perspective, when I was at university I worked as a support worker for young people. A good proportion, probably about 80% of my time as a support worker, was informing these services of the changes in circumstance of the young people and keeping them informed. There is no requirement to do that, but it made it impossible to get the kids the help they needed without doing so. We often found barriers when it came to the local authority, some are different and better than others, but at least in Lincolnshire, we were getting nothing. The council were not taking proactive steps to ensure that information was being shared. It wasn’t possible to get the right support for them without it. 

My personal circumstances make it a bit different, my age definitely helped as I was able to tell them myself. But for the younger children, if they didn’t have anyone to advocate for them the information would not get passed on and it was really affecting them at school. 

Sam:

Where are you now? Where are you working?

Theo:

I work for Mike Reader MP. I was Mike’s organiser during the general election campaign. I worked for the Labour Party for a year and a half prior to the election and I’m his parliamentary lead now. 

It’s not a situation I expected to be in, I wasn’t sure that I was going to finish my A Levels as they are not really at the top of your mind when you are homeless. I was really lucky that the charity I got placed with and the accommodation I was placed in, as they gave me a support worker who I am still in touch with. He had gone to university and knew that I was quite academic, so pushed me a lot, but also helped me access support services, helped me fill out my Uni application, declare estrangement and put me forward for bursaries. Without me being very lucky in that housing provider, I probably wouldn’t have graduated and definitely would not have ended up working for the Labour Party as a result. I had a very rare positive experience with my TA because I’ve heard horror stories from my friends who never got adopted and grew up completely in foster care and then got passed between TA and moved around a lot as children. They didn’t have the same experience and have not ended up in the same place. If there is anything that can be done, like this campaign, that can mitigate the risk and lack of control to make sure that relevant services are informed and families are supported through that experience, the better. You have much more of a chance of getting outcomes like mine. 

Sam: 

Reads out written testimony. 

Rose is a parliamentary staffer to an MP also. It would be interesting to know how many other people work in this place that have similar stories as well. Rose has written this but she could not make it today. 

“When I was studying for my A Levels, my family were evicted from my childhood home that I had lived in my whole life. I was away for the entrance interview for Cambridge and had left thinking I would be away for a few days and return to the place I called home. 

My family were placed in TA 2 and a half hours away from home and my school. As I was close to sitting my exams I had no choice but to carry on trying to attend my school. I confided in a teacher who tried their best to find somewhere for me to stay locally but it didn’t work out, meaning I had a long commute every day and had to find somewhere to sleep in between lessons. 

Before we were evicted, I had been receiving support from my GP with my panic attacks and had confided in them about what was going on in my personal life. But looking back, at no point was this information communicated with my school. So it ended up just being me receiving the bits of support in silo. 

I had no desk to study so I would do my work on the floor. When the pandemic hit I was left trying to cope in TA that was very poor and dangerous. I think that joined-up support would have been able to help identify that I wasn’t living in appropriate living conditions whilst trying to stay in school for the time during lockdown. 

I am fortunate enough that I have been to uni and work here in Parliament. I am trying to use my voice as much as possible to help people experiencing this now, this is one of the reasons that I am standing for councillor in the upcoming local elections so that I can push for more support for those living in TA and can help implement the SAFE in my local area.”

What you were describing really resonates with Rose’s story, it’s you as the young person having to advocate for yourself and through your experiences so far, it must have been very difficult having to go to the school and the GP to tell them your situation. We want to remove that awkwardness and potential shame, and the barriers that young people, families and children have when placed in TA as it can be the most complex and chaotic period of your life and we want to make sure it is as healthy as possible. What did you notice about Rose’s story that resonates with yours?

Theo:

Not having a desk and nowhere to study. I was talking to Mike about when I was staying at the hostel and had nowhere to do my work, so I would sit at the bus stop near the accommodation to do my homework. The accommodation didn’t have WiFi, they would suggest you get a phone SIM with unlimited data for £20 a month, but I didn’t have the money. Finding time to do homework and trying to stay in college as late as possible to use their wifi, you don’t think about impacting your schooling. 

When you experience something like that, it can really either destroy you as a person because it is really, really hard, or you can come out of it wanting to change things. It definitely contributed to me wanting to be a support worker myself. My support worker had a huge impact on my life, so if I can do that for someone else as Rose is with her role in Parliament. I remember being absolutely shocked that informing all these services isn’t something that happens already. There are so many things in our scenarios, lots of other people I know from TA, their lives would have been so much easier if they had not had to jump between services, advocating for themselves and if it was something that could have been done uniformly for services it would have been much better. 

Siobhain: 

Introduces Dr Aaminah Verity, GP and Health Inclusion Campaigner. 

Dr Aaminah Verity:

I am a GP, I work in Lewisham, and I work in a mainstream GP practice that is in an area of high deprivation with a high proportion of people experiencing homelessness. I am currently running a programme leading GPs as health equity fellows for their primary care networks and we support them to partner with local community organisations that can design interventions to address health inequalities. 

Through my work in my own clinic room and networking with health equity fellows, we quickly identified that if we were talking about health inequalities, poor quality housing is one of the main drivers and really significant drivers of health inequalities in Lewisham. 

We partnered with Citizens UK to start supporting our residents and navigating the health and housing crisis. So many patients tell us that they are at risk of becoming homeless, they say they are in debt, in food or fuel poverty due to unaffordable housing. We are never directly informed when they then become homeless and move into TA. We do see the impacts of our patients suffering due to the uncertainty and disruption to their appointments from being moved around. They miss hospital appointments, medication supply is interrupted, they don’t attend screenings and face long commutes to see their registered GPs. Along with the psychological burden of being in TA, which is a lot of the time completely substandard. 

We see asthma cases that cannot be controlled because symptoms are constantly being triggered by environmental exposures mould and damp, leading to life-threatening emergencies and recurrent consultations as well as A&E attendance. 

We see skin conditions, accidental injuries, particularly common in children from overcrowding in unsuitable accommodation. There is a really severe burden of the impact of the mental health crisis being in overcrowded environments, lack of temperature control and damp/mould. The stress can really impact chronic health conditions that worsen as families are moved around, navigating their homelessness. 

Most practices have a separate team of staff that deals with registrations and deregistrations. When a family moves out of catchment and tries to make an appointment, the team flags the administrator and sends a letter to suggest moving to a new GP or being out of catchment area and often does not come to inform the GP. Often it is in the patient’s best interest to be registered closer to their address as registering and access is not easy away from their address. But if the patient is not able to advocate for themselves then there is no way of knowing that moving away was not their choice and can leave them without healthcare. If we are made aware that they are vulnerable then we can support them in many ways. We can make sure they have flexible appointment times. They can be linked with care coordinators who could support them with navigating referrals now they are out of area. We can open up discussions about what is the best way to support them now they are outside of the area and is it better for them to register locally or can we help support them here. We can make sure they have access to regular medications and reviews. We can also provide proactive referrals to allied professionals called social prescribers who can identify other support services to help families stay well. 

The most important is that we can make sure they are triaged appropriately and prioritised for appointments, and be on alert for safeguarding concerns. We can make sure every contact counts. We do this in Lewisham and lots of other practices are doing but this requires capacity and resources that overstretched general practice doesn’t really have. Working with Citizens has started constructive work with the council and ICS, with headteacher colleagues so we can better support families experiencing homelessness. We have identified some of the key needs and one of these is having access to transparent and more equitable ways of escalating those who have increasing needs and those who are in immediate stress. 

Working collectively has ensured we can advocate for whole system change. The level of need in Lewisham is really staggering, but we are edging towards a system that has a consistent message and offer of support that is more equitable. I believe in proportionate universalism, in general practice, we need to have more resources so we can make the extra allowances for those that are most in need and are vulnerable to achieve the same health outcomes as those who are not vulnerable. There is a lack of consensus on the cohorts that we need to prioritise and funding to match the need and the proactive identification of at-risk groups such as this campaign is really vital so we can shift the dial on health inequalities. We must go further and link this to increased resourcing for areas of deprivation where significant amounts of funding are spent supporting families through issues such as homelessness. 

Siobhain:

Introduces Rebecca Dove, Headteacher. 

Rebecca Dove:

I am a Headteacher at one of the largest primary schools in Lewisham. I am also Chair of all the Lewisham headteachers, in something called the Leadership Forum. All the headteachers were feeling very stressed with the TA situation and for those families. We worked with Citizens UK and we managed to enlist the help of Will Cooper, our local councillor. In doing that, we realised that the GPs were feeling the exact same, so we now have a group where we meet with GPs and headteachers. We work hard together, but there is still such a long way to go. We have worked with Will on getting a directory to help us know who to go to and when. One of the biggest things, for us, when a child becomes homeless, it is very difficult to work out where in the homeless journey they are. We meet so many dead ends in trying to connect them to the right support. 

I was trying to get a family help when they became homeless that morning, and I hit 15 dead ends during the day, finally getting them accommodation at 10pm that night. It is knowing how to navigate the systems. This is really complicated. We have worked with Will on the directory and an escalation policy, with a much more direct route of getting to who we need to quickly. It has worked on a couple of occasions. 

The WiFi situation is horrendous for our families. As I have left to come here, I have left a parent who is in TA, in my office using the WiFi because she has to fill out her application for benefits. The impact that is having on school and the children’s schooling is huge. There is a huge amount of pressure on attendance, but we have families travelling in from Ilford. I have a dad who brings his child to school every day but it is so far away that he cannot work and cannot get home and back in time for pick-up. He is so desperate not to leave his school place because he feels safe and supported. That is the day-to-day reality of school. Ofsted wants us to get brilliant results and improve attendance, but what is going on on the ground makes it really difficult to do that. 

We offer lots of support to our families but we only know if they tell us. Some families are very private and are ashamed. I have a little girl that is only 5 years old, and she is on her 7th place. She doesn’t have books to read, they can’t physically move them between those places. I think, on the ground, the impact of TA on children and their families is colossal. We only hear, by accident, only by us being nosey and being at the gate in the morning, or them being late, or tired or hungry, is how we find out, then we do our level best to support them. It is then how we can best navigate the system as well as educating. It lands to the Head in primary education as there is no one else. 

Sam:

Update on the amendment to the Children’s Wellbeing and Schools Bill. There is space for an amendment in Clause 4 in relation to information sharing and the single unique identifier.
We have been rallying support from MPs for an amendment, as well as trying to get into the Department for Education to try to get the Minister to table the amendment. 

Introduces the video of the Housing Communities and Local Government evidence session with the Minister on the enquiry into Children in Temporary Accommodation. 

Siobhain: 

We need to write to Rushanara and to the Education Department because departments do not work well together. 

Opens the floor to comments and questions. 

Mike Reader MP:

Nutrition was a really interesting one for me. People talk about looking for children who are hungry, but Theo, you had the reverse experience?

Theo:

Things to do with environmental issues, I actually gained a huge amount of weight when living in TA because once my service charge and my immediate bills were covered, I had £2 left over at the end of each week. I lived exclusively on food donations that were compiled into the reception of the accommodation. It was things like takeaway foods and tinned foods with low nutritional value but very calorie-dense. You were encouraged to take much more food than you needed because the food would get thrown away if it wasn’t taken. This contributed to my tiredness, it does not help children with their concentration in school as they are not getting the vitamins they need. 

Stuff that goes to food banks is prioritised locally to make sure people do get some fruit, however, this is not always possible and a lot of the packages contain unhealthy food. 

Rebecca:

There is no fridge to keep fresh produce for families in TA, there is an emergency fund at school that helped to pay for a fridge for a family to buy fresh produce. 

Theo: 

Because I was on the payment meter, when it came to my electrics, I would often choose when to turn the fridge off, as that was the most expensive appliance, and also not to use the oven because you couldn’t really afford to. I had to make sure that everything was turned off as much as possible, so you’re not really cooking but living on things out of a packet that don’t need to be cooked. There was a charity that was run by a local Mosque that would bring around food once a week that was nutritional, but it was not sustainable. There were 60 young people living in this building living on takeaway food. It is not helpful for concentration at college. 

Fiona McLeod (online):

Outlined her and her son’s negative experience of trying to get help from school and mental health services while in TA. Her son’s education and mental health were severely impacted and he was only listened to when he reached crisis point. She asked what the response should be once services are notified. Is there going to be the backing of funding to support the services that we will notify to increase the capacity and resources for them? Does there need to be more training on the impacts of TA? In her borough, you are looking at 15 years in TA, if you’re lucky. What about those children that are spending their entire primary education in a hostel or B&B? Is there funding from the Government, not local councils, so that it isn’t this postcode competition as to where you get support and how long you spend in TA due to housing stocks in different areas? 

Siobhain:

We know that the campaigns we create are not the complete solutions to problems, but they are things we think we can achieve to make things better. 

One of the reasons that families are reluctant to inform services is because they are worried those services will be taken away. In some cases, they are not always wrong in assuming this. I am constantly fighting for support from service providers to stop this. 

Jane Cook (online):

Today, it has been 25 years since Victoria Climbie died and 3 years after Victoria’s death, Lord Laeing launched the review with 108 recommendations and one of them was the notification system. I am thrilled to see this campaign is still ongoing. We had the NOTIFY system in London but this took several years for several of the councils to sign up to it and now it doesn’t function. I know from my health visitor colleagues, they often find families just by chance. Maybe going into a hotel, suddenly a family appears at a clinic, and that is the first they know about a family in their catchment area. It is a huge safeguarding issue, as well as health. 

When I talk about family hubs, we need a Magpie Project in every ICB. The Government is talking about family hubs pilots, and that is just a recreation of Sure Start. 

Sustainable funding for all of this is needed, Lisa Gavern in Surrey with a multidisciplinary team so that we are not only notifying but ensuring that they are being practically responded to. Campaigns about access to kitchens so it is the whole package that needs to come together. The standards of accommodation or people being in a hotel room for over a year, as well as constant moves. It is time for change so I am excited to see this campaign being launched. 

Siobhain:

My friend and health visitor in my constituency relies on watching delivery men around hostels and hotels to see if a family has moved in to be able to find the children. 

Helena Dollimore MP:

I represent Hastings and Rye, we have the highest number of children who live in TA in the South East anywhere outside of London. This is an issue we have been very aware of for some time, but when Shelter was able to put those figures together of that stat, 1 in 27 children in Hastings living in TA, it’s really helped us push the issue onto the agenda. I would really urge colleagues to think about, we all know the issues of TA, how can we as much as possible put this out into the public domain? The recent media coverage you had was really powerful and a step in the right direction, we need to think about how to do that more. 

I have a lot of people who are moved into TA in Hastings from somewhere else. I wondered if we have any statistics on numbers of children moved to areas from elsewhere, am I able to ask for this as the MP? 

Also, the stories of children in TA are very powerful, when we all as MPs deal with different decisions that come before planning committees and projects for building new homes when there is a good case for them to be put through, I often think that if every planning committee had been sent a letter by a child living in TA, they might think differently. 

Siobhain:

We should know how many children have been moved to the area, as councils should be notifying the receiving council when they place anyone there as it is a requirement of the Code of Guidance. The questions are are the councils doing it and are the housing department in the council in Hastings seeing them?

Sam:

There is no way to code for TA in the NHS so we have no data on accidents or illnesses. Go and ask your ICB how many kids in TA attended your local A&E this year, they won’t have that data because we don’t write it down. Same for education also. The more data we have, the more work we can do. 

Aaminah:

One of the things about asking what’s next, is how can we link this up with other Government strategies? Such as with the NHS 10-year forward plan and the prevention, community-based care and if we make TA and homelessness a priority of who are the people who health and housing and education need to be supporting, there is a real impact on having the cross-departmental and how do we support the different services? In our local ICS, we are trying to push for a population health management system to identify the most vulnerable cohorts. This includes data sharing between local councils, health and education. We need to think of this as a ‘no wrong front door’, if someone comes to a service asking for help then they need to be identified as vulnerable and provided with wrap-around support. What are the other APPGs that you could be synergising with? 

Siobhain:

Perhaps, we should contact the relevant health ministers to invite them to a meeting?

Sam:

We have invited them, and have had no response. 

A question from the room:

As a retired GP, working in Lewisham, is any research being done in this area? It does seem so incredibly key that we don’t know where the children are coming from and how long they are staying. Which boroughs are sending them? Are people being notified? That wouldn’t be that difficult to do. 

Sam:

The most recent research is, Inside Housing did a load of FOIs around how many children by age group and where they were placed last year, but that was FOI requests rather than a full research project or being able to have the data to pull and analyse the data. In answer to your question, no. 

Siobhain: 

The exponential rise of TA usage in London has meant that more and more people are talking about it and trying to get somewhere, so in my own council, which is Merton, I got all the departments together to say ‘What are we going to do and how are we going to ensure that a child dependent on special needs transport who gets moved out of the borough doesn’t lose it straight away?’. I’ve been in contact with local government bodies to try and talk about it but people are very protective and don’t necessarily want to tell others what they are doing because they are just trying to get by. But there is greater pressure to be much more transparent about the figures. 

Dilraj Kaur (online): 

Similar to GPs in Peterborough Citizens UK, we have been attempting to work with local councils to inform schools which children are homeless and placing a box on the form for councils to inform schools. Unfortunately, it is not mandated so this has proven difficult. We have had students given detention for coming into school with incorrect uniform as they are in TA and have no access to washing machines, only to find out they are homeless and have no access to free school meals. 

Locally we ran a campaign with headteachers in Peterborough for a notification system and we won 3 years ago with the local council. It was hard as there were issues with GDPR. Unfortunately, they put this on another form and only 3.6% of schools were informed about children declared as homeless. How can we learn from this situation?

In addition, can we ensure children automatically have free school meals when and if the notification is approved?

Rebecca:

Lewisham has been trialling a campaign for free school meals for notifying sources. Parents do not have to apply anymore for free school meals, it’s an opt-out system, meaning the level of children eligible has increased. We had a 15% rise in the amount of children eligible. There are systems there that can work if something similar could be done for housing. 

Siobhain: 

Final remarks and thanks. 

Meeting concluded at 5pm.

Child Mortality in Temporary Accommodation 2025

New data uncovers that 80 children have died in temporary accommodation in one year.

The APPG for Households in Temporary Accommodation can announce that out of the 3,605 child deaths in England, 80 have died while living in temporary accommodation.  These numbers were obtained from the National Child Mortality Database between 1st October 2023 and 30th September 2024, accounting for 3% of the total number of child deaths during this period.

The deaths reported account for all causes of mortality, yet the total number is significant as this is the first time this data has been collected in England. This has been due to the collaborative work from the APPG, its co-secretariats and the NCMD. In October 2023, the Child Death Overview Panel (CDOP) process was updated with questions about temporary accommodation. Whether temporary accommodation was a contributing factor to these deaths will be assessed through the CDOP process as usual.

Between 1st April 2019 to 31st March 2024, 74 children have died with temporary accommodation as a contributing factor to their vulnerability, ill-health, or death.  Of these 74 children, 58 were under the age of 1.

 

Download the report

Minutes of meeting: Wednesday 30th October 2024

7th All-Party Parliamentary Group for Households in Temporary Accommodation meeting.

Date: 30/10/2024
Time: 15.00-16.00
Location: Room T, Portcullis House

Joint Secretariats: Shared Health Foundation (SHF) and Justlife (JL)

Attendees in person:
Dame Siobhain McDonagh MP (Mitchem & Morden, Labour), Sam Pratt (SHF), Ian  Swift (Islington Council), Paula Barker MP (Liverpool Wavertree, Labour), James Asser MP (West Ham and Beckton, Labour), Margaret Mullane MP (Dagenham and Rainham, Labour), Ken Jones (Parliamentary Assistant, Margaret Mullane MP), Josh Babarinde MP (Eastbourne, Liberal Democrat), Morgan Tebbs (Justlife), Isabel Kaner (SHF), Caleb Neilson (SHF)

Number of attendees online: 50

Panellists:
Sam Pratt, Policy and Communications Lead, Shared Health Foundation
Dr Laura Neilson, CEO, Shared Health Foundation (pre-recorded)
Ian Swift, Director of Housing, Islington Council

Agenda:
3pm. Introductions from Siobhain McDonagh MP, Chair
3:05pm. Why do we need a Notification System for Homeless Families, Sam Pratt
3:15pm What can the NHS do to support children in Temporary Accommodation? Dr Laura Neilson
3:20pm How has Islington approached a notification system? Ian Swift
3:25pm Comments and questions from MPs and Zoom attendees
3:40pm Update on the Renters Rights Bill
3:45pm Final words and actions from Chair

Meeting 

Chair of the APPG, Siobhain McDonagh (SM), opened the meeting and introduced the topic of discussion being the need for a Notification System where families are placed in temporary accommodation outside their home borough. She highlighted that currently, only a few councils are using a notification system at all. The Chair introduced the first speaker, Sam Pratt (SP), Policy and Communications Lead, Shared Health Foundation.

SP provided an overview of the need for a seamless Notification System for Homeless Families.

  • Currently, there is no one seamless system that local authorities use to notify schools, GPs and Primary Care of a child’s new homelessness situation. 
    • The Local Government Association has written a good out-of-borough protocol, the Greater Manchester Combined Authority has recently approved an out-of-borough protocol but none of them mention schools or health, when surely these are the most important services in a child’s life.
    • We are also aware of Notify in London and the duty that LAs have for S201 notifications, which is the legal obligation that councils have to tell each other when placing a homeless household in their borough, but we know that these are not routinely done. 
  • No one knows the whereabouts of these children apart from the overworked, over-stressed housing officer. This leaves families and children in an area they don’t know, away from school and their health services and ultimately they fall through the gaps. This includes Primary Care, Secondary Care, Health Visitors and community midwives.
    • Homelessness for some can come with a badge of shame and alongside a fear of social services getting involved, it can stop families from telling anyone that they are homeless.
  • SP shared a story from a Greater Manchester family that the Shared Health Foundation has worked with. In the story, a mum shares her experience breaking down in the reception area of her children’s school and the staff being supportive of their homelessness situation. She then had to move her children to a school closer to where the family had been placed, and the new school provided no support. SP noted that the Notification System should be a consistent approach and no matter where families are placed in the country, they would receive the same amount of equitable care.
  • Sharing positive examples of best practice, SP highlighted Rochdale’s Housing Team trialling this exact Notification System for around a year with real successes in educational outcomes, as well as Manchester City Council just starting to notify schools – a huge step for such a large local authority with massive financial pressures. It’s easy for some local authorities to ignore this kind of innovative work but we’re really proud that some have started already.
  • This isn’t about money, this isn’t about systems and policies. It’s actually about leadership. It’s about brave leadership of all levels, locally, regionally and nationally, to say we can do better for our families. And we should start now.

Dr Laura Neilson (LN), CEO, Shared Health Foundation (pre-recorded).

LN provided an overview of what the NHS can do to support children in temporary Accommodation.

  • We know from our research that many professionals want to help children living in temporary accommodation, if only they knew. 
  • We’ve written some guidance to be published alongside the APPG material about how do GPs respond when they get these notifications.
  • The first thing we’re asking for is for the family to stay on the GP list for a short amount of time, even if they are out of area, to enable continuity of care to be prioritised.
  • Secondly, we’re asking for GPs to consider the health needs of this family, to make sure that regular medication, regular checkups are offered, and that we actively outreach to these families regarding immunisations and screening.
  • Thirdly, we’re asking GPs to be mindful that if families are moving areas or arriving into a new GP Practice and they’re living in temporary accommodation, that this is coded and particular care is made about referrals. So if a child was referred to a hospital and they’ve moved areas and the referral needs to be remade, that it’s made into the system and the child doesn’t start at the bottom of the waiting list again.
  • Despite the quite high levels of infant mortality that we see in this group of children, it hasn’t really been picked up as a health issue yet and that is disappointing. NHS colleagues have been invited to come to our meetings but they haven’t yet attended. We’d like to see that change.
  • We don’t know about accident or admission data for these children but we suspect from anecdotal evidence and case studies that it is higher in this group of children than other children. But at the moment the NHS does not collect this data because we do not ask routinely when children attend A&E whether they’re living in temporary accommodation. We would like to see the NHS talk with us about how do we better gather the evidence around health and these children.
  • We also want to work with NHS colleagues to stop this pattern that we’re seeing of children being referred into hospital in a new area and starting again at the bottom of the waiting lists. We’ve got lots of case studies of children never, ever making it to the top of the waiting list and still waiting to be assessed and diagnosed with medical issues.
  • We’d like this group of children to be tracked through the NHS Pathways.
  • We also want to work with the NHS widely about supporting mums in temporary accommodation. We know that a lot of mums struggle to access basic services they need, such as contraception, mental health support and basic access for acute illnesses.

Ian Swift (IS),  Director of Housing, Islington Council.

IS provided an overview of how Islington Council have approached a Notification System.

  • Islington Council have produced a Housing and Children Services Protocol and that changed in light of them notifying doctors and schools, etc. The Protocol was approved by the Housing Scrutiny Committee this month, it’s going to Children’s Scrutiny Committee next month, and hopefully it will be approved and rolled out, notifying GPs and schools of people living in temporary accommodation.
  • 50% of homeless households live in Islington. 45% live in neighbouring boroughs, and 5% live in other parts of London or on the outskirts of Northern London. 
  • IS highlighted the 1432 children and 1600 households living in temporary accommodation in Islington. He noted that data capture is chaotic. The council provides data on a monthly basis to London councils, on how many people are in temporary accommodation, the cost and everything. Officers provide daily data to the Ministry of Housing through H-CLIC. However, that information is only published 6 months after the event, so that is a real problem when governments or councils are trying to plan their service provision.
  • Officers sometimes forget to use Notify and that’s not what is appropriate. There isn’t really a compulsion to populate Notify like there is to populate H-CLIC. 
  • Councils have to provide data monthly to the Ministry of Housing, regarding rough sleeping, through a system called DELTA and are supposed to monitor another system by the GLA called CHAIN for rough sleeping. Islington Council also gets weekly Freedom of Information Requests from various boroughs outside of London. IS noted that it is obvious from this plethora of data why an Officer would forget to submit something to Notify. 
  • IS highlighted the need for only one system and that one system can be H-CLIC, as it is compulsory for all councils. It could bounce information not just to the Ministry of Housing, but notify other councils, Health services, and the GP Federation. The system is possible, it really is, and we just need to have one system that populates everything.
  • IS noted that Islington Council supports and recognises the criticism from this APPG in terms of why they didn’t notify GPs, schools and hospitals of people living in that area, and that is a mistake. Now they do, they have rectified it through the revised Protocol.

Questions

SM opened the panel for Q&A:

Q1:

Paula Barker MP Would it be possible for you (IS) to share your information that’s gone to your Housing and Social Services Department? I think that would be something that would be hugely helpful to Liverpool City Council.

IS Yes, of course.

Q2:

SM Sam, is the idea that we will have a campaign about this, in the way that in the last Parliament, this APPG had a campaign on amending the Code of Guidance to include access to a cot for families with children under 2? If so, would we ask the Department for Housing in Local Government, or would we write to the Local Government Association?

SP The plan is, with the consensus of the members of the APPG, that we would run a campaign on the back of this to have a National Notification System. And when we call it a “system”, we use “system” in the very loosest terms, it is just one email from the Housing Officers to the school and the GPs. We want to do a national campaign and to ask the Department but then also the Local Government Association, because they’ve already got a really good out-of-borough protocol, it just doesn’t have anything about kids, school and GPs in there. 

Q3:

James Asser MP (JA) The notification is really important but actually there has to be consistency. One of the things I have found as a Councillor is I would get people coming to me with problems and find they weren’t a new tenant, they were placed from somewhere else in London. And whilst you can go to your own Housing Department, when you’re starting to deal with other boroughs, it starts to get complicated, things get lost. I think some kind of national campaign to try and get consistency would help. 

Q4:

Margaret Mullane MP (MM) I wanted to ask Sam about a bit more clarity. If we’re going to do a campaign with the National Health Service, what would it look like? I’m just thinking about how overworked the hospitals are as people appear with their children as well. 

SP To start off, we need to get the NHS around the table. Unfortunately, we’ve invited them to every APPG meeting we’ve done and they’ve never turned up. We want to run a campaign for having a consistent Notification System so that everyone is notified. But then also, as Laura said in her video, the NHS doesn’t code for temporary accommodation at all. And all that is, is just adding an extra bit of layer, it’s a spreadsheet issue. But it’s actually getting the right people around the table to decide that this is a thing that they want to do. 

Q5:

MM With your case study as well, the parents and the children can suffer mental health as a result of being in temporary accommodation. I wonder what that notification looks like? Because it’s incredibly difficult for even MPs to escalate when things are bad.

SP Absolutely, and we know that local NHS and Mental Health Services are incredibly stretched at the moment. In terms of how does the NHS even treat temporary accommodation as a thing, that isn’t a case at the moment. Our little organisation, we’ve got a Clinical Psychologist that works in a GP Practice that works with families in temporary accommodation to do that holding space: when families are in the crisis period, when they’re in the complexity of TA, what do we do now to make the next best decision? Do we then roll that out across lots of other GP Practices? Do we work with the local Primary Care Networks on that? There’s lots of extra really great best practice that does exist but actually doesn’t have the support and network and funding to go, “We are tackling temporary accommodation, this is what we’re doing to support the kids in there.”

Q6:

Morgan Tebbs (MT) Ian, you mentioned that Housing Officers aren’t always consistent with notifying Health and Education services when a homeless household moves in. Do we think then that it might be a bit ambitious to expand the Notification System and include other kinds of services, maybe trusted third-sector services, or other core services? Do you think they should be included?

IS I think the problem is the amount of notifications we’ve got to do through the different systems. Homelessness is increasing. In Islington, it’s increased 35% in the last 12 months. The average person’s staying in Islington in temporary accommodation 64 weeks. I think the average in Newham is between 5-10 years from the data that they’re publishing. You’re likely to have a child in Newham going through Junior and Secondary school before they actually come out. For that school not to be aware that that person’s real connection’s back with Islington, is appalling. So I’m just asking for one system to populate.

Q7:

Online  It is vital that this happens, especially having over 151,000 children who are homeless. This should be a crisis and NHS really needs to respond to this. I really welcome this.

Q8:

Online Do families have to opt in for schools and GPs to be notified, first of all, and can they opt out? There was mention of children not losing their position on health waiting lists, and I support the idea as well of mental health waiting lists. Would this also apply to children not losing places for assessments or support on Education, Health and Care Plan assessments?

SP  This is an opt-in notification from the family, so the Housing Officer would work with the family and explain. It’s a nuanced thing of going, “We want to inform the GP and the school around this, are you with that?” And they would CC the family into the email to the school and the GP as well, so it’s all done under consent. And yes, they can opt out, we’re not going to force a notification if they don’t want to, families still have that right to their privacy.
In terms of families going off different lists, in terms of EHCP plans, we see that as well up in Greater Manchester. Any kind of list that a child might be on does get dropped when they get moved into temporary accommodation, across the board of any kind of support service.

Q9:

Online I just wanted to mention things that I think might be helpful in piggybacking on what’s currently happening. The Child Poverty Strategy was launched late last week and I think that would be a really good opportunity to address some of the strategies that the government’s outlined already. I think what you’re advocating for fits beautifully with what that strategy is looking to help and shape. The other thing is, I will help you make contact with colleagues within NHS England who work around Inclusion Health Groups. I think that there is a willing population out there to help support you.

Q10:

Online Going back to the NHS having a Notification System, when the families are presenting at A&E as victims of domestic violence and children, I think the Police need to be involved in this. I’m wondering if the Domestic Abuse Commissioner would be a good way of raising the profile and stimulating some collaboration with the NHS and the Police which may be of assistance.

Q11:

Ken Jones I listened very carefully to Ian’s points and I would recognise very much that point about Notify and it not really being a system which is fully in use from authorities. I think probably the most useful point would be to, as Ian suggested in terms of H-CLIC for MHCLG, to ensure that that was then forwarded to schools, NHS, Police, that contact to be made. Also, one further point to reinforce that, the updated Homelessness Code of Guidance, which does place a responsibility on local authorities within 14 days to notify the host authority, then that needs to be changed as well, to make that very clear that it goes beyond the local authority to those other organisations as well. 

Q12:

Josh Babarinde MP (JB) It seems to be a win-win, such a system existing. What have been the barriers to something like this being adopted and implemented? 

SP From working with boroughs in Greater Manchester, the will is there. There were a few conversations around GDPR, in terms of “We can’t possibly share this information”, and that was a flat “no”. But we were wanting it to be an opting system for the families as well.
There’s a few technical issues of how to fit it in, but also councils are so stretched and so overworked, and it’s expensive, and a lot of the accommodation is poor, and I guess in terms of priorities from different councils it’s like “We’ll do the notification another time.” It always seems to be dropped down.
It takes some brave leadership, which it has done, and unfortunately it’s taken us quite a while for Greater Manchester to move up quite slowly, but it has moved. They can be at the forefront of going, “Look, we tried it. Yes, it was a bit tricky. Let’s talk about all the technical stuff of how you actually make the notification.” If you’ve got families coming in every day and you’ve got the system set up, it’s actually relatively easy once it’s all up and running. Like I said before, it’s about leadership as opposed to about technical systems and money. We can make this done tomorrow and it is just an email.

SM I’m a bit more cynical. I think lots of local authorities don’t want people to know what they’re doing. I think if you don’t acknowledge it, then your members don’t know about it so you just do things to survive. People are placed in shocking accommodation in shocking locations, and to have to fess up to this causes you grief with your members but also exposes the whole issue far wider than that. I think a lot of this system stays afloat on a lack of awareness. Part of our long-term conversation has been that in local authorities, as you know, you have Ofsted looking at your schools, you have Ofsted looking at your Social Services, but no oversight looking at what your council does with half its money. It’s been an unofficial policy of this APPG to support the introduction of a regulator, Ofsted-style regulator, to be able to come into local authorities and say, “Is this council obeying the Code of Guidance, or mindful of the Code of Guidance?” And you can be absolutely sure that if a regulator came into being tomorrow, all this would happen. The forms would get sent out, councils will be notified, and if the Guidance had GPs and schools, that would happen. But because nobody’s watching, all sorts of bad practice happen. Does anybody think I’m being unfair?

JA agreed with the Chair and provided an example from Newham’s recent Housing Inspection with the worst rating ever given, the findings of which no one seemed to know about and would not have been politically acceptable.

JB suggested that the motivations for the non-adoption of a Notification System so far should inform whatever this campaign is or isn’t. He clarified that if it were technological reasons getting in the way, the work of the APPG would be to speak to technologists to come up with a piece of technology that can then be marketed to local authorities to adopt. However if the political leadership don’t feel ready to face up to the realities of their temporary accommodation situation, that’s a different kind of campaign and no amount of saying “You should have a Notification System because it’s the right thing” would pull the right levers to get that done.

SP highlighted that the Shared Health Foundation have written Guidance for Primary Care and schools on how to support homeless families, if any councils would like to give it a go. He clarified that a lot of the time schools and Primary Care are so willing to help and support but don’t know what to do. Sharing the Guidance with everyone will go on the back of the APPG’s campaign.

SM made a suggestion to ask Karin Smyth MP, Public Health Minister, to come to the APPG’s next meeting, as directional influence from her would get the NHS involved and this is a Public Health issue. She also suggests inviting the relevant Minster from the Department of Education, as well as the relevant Homelessness Minister.

IS shared that regarding the issue in terms of regulation, Islington Council have been supporting the Regulator of Social Housing and have done a pilot inspection over 12 months ago. He pointed that they could inspect 50% of their homeless cases because they were in council-owned accommodation but the other 50% they couldn’t do anything about, and that was appalling as they were the ones that in theory were the worst form of accommodation. He said that IT is equally as important as regulation in terms of lobbying.

SM guided the conversation toward an update on the Renters Rights Bill, provided by MT.

  • We have some concerns as to how far the Bill will apply to temporary accommodation.
  • Legislation doesn’t apply the Decent Home Standard (DHS) to privately provided temporary accommodation and we would like it to. It’s in Committee stage at the moment and we are working with MPs who sit on the Committee to try and make those amendments that would explicitly apply the DHS to temporary accommodation.
  • The APPG will submit written evidence to support the amendments that we would like to see.

Meeting concluded at 4pm.

Minutes of meeting: Tuesday 23rd April 2024

AGM of the All-Party Parliamentary Group for Households in Temporary Accommodation.

Date: 23/4/24
Time: 14.00-14.30
Location: Room W2, Westminster House

Co-Secretariats: Shared Health Foundation (SHF) and Justlife Foundation (JL)

Attendees in Person:

Sam Pratt (SHF), Grace Bute (SHF), Morgan Tebbs (Justlife) Siobhain McDonagh MP (Labour, Chair), Rebecca Long-Bailey MP (Labour) Bob Blackman MP (Conservative), Karen Buck MP (Labour), Baroness Lister of Burtersett (Labour), Lord Richard Best (Crossbench), Andrew Western MP (Labour), Eddie Hughes MP (Conservative), Natalie Elphicke MP (Conservative), Paula Barker MP (Labour), The Lord Bishop of Manchester (Bishops)

Independent Chair: 

Hannah Bardell MP (SNP)

Agenda: 

To vote on re-electing existing officers to the All-Party Parliamentary Group on Households in Temporary Accommodation. 

Meeting: 

Independent Chair Hannah Bardell led the meeting with the following: 

  • Highlighting the agenda for the meeting
  • Provided vote for Siobhain McDonagh to continue as Registered Chair of the APPG
  • Provided vote for Rebecca Long-Bailey, Karen Buck and Bob Blackman for their roles as Officers of the APPG
  • Provided vote for Shared Health Foundation and Justlife Foundation to continue role as co-secretariats of the APPG
  • Annual reports approved
  • Due Diligence statement approved  

Participants of the meeting voted in agreement on the above votes.

The meeting was concluded at 14:10

Households in Temporary Accommodation All Party Parliamentary Group Annual Report 2023

APPG Temporary Accommodation – Due Diligence – 2024

APPG Temporary Accommodation – Income and Expenditure – 2024

‘The Debt Trap’ report – Women’s stories of navigating family homelessness and TA in Greater Manchester

Women and children are stuck in a ‘debt trap’. This research report evidences how rental, council tax, and other personal debts are shaping families’ housing journeys into and on from homelessness and temporary accommodation. Debt not only causes, lengthens, but also outlives family homelessness.

Download: ‘The Debt Trap’ Report >