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.