Health and Homelessness standards
Section 1: Introduction
The Health and Homelessness Standards are the Scottish Executive's next step towards improving the health of homeless people in Scotland. They build on the considerable progress which has been made in delivering the aims of the Health and Homelessness Guidance (Scottish Executive, 2001) and resulting Health and Homelessness Action Plans. They are not, however, clinical standards as existing clinical standards, for example for heart disease, asthma, etc., also apply to health care for those who are homeless. Rather, these Standards are strategic and aimed at the corporate level of NHS Boards in recognition of the critical importance of strong leadership in tackling health inequalities.
The Standards are intended to be challenging as it is only by increasing the drive to improve homeless people's health that there will be a real and lasting change for these vulnerable individuals. The Scottish Executive accepts that it will take some time before all NHS Boards will meet all aspects of these Standards but will seek, through the performance assessment process, clear evidence of progress. Health improvement and tackling health inequalities will be priorities for discussion at Accountability Review meetings and the Health and Homelessness Standards will form part of such discussions. In recognition of this challenging agenda support to meet the Standards will be provided by the Scottish Executive Health Department and NHS Health Scotland.
Whilst NHS Boards will hold the strategic responsibility for the Standards it is expected that delivery will in the main be through Community Health Partnerships (CHPs). CHPs will need to consider and plan for the needs of homeless people and so the onus will be on NHS Boards to ensure that there is appropriate accountability in place to ensure continuous improvement. The health improvement and health inequalities guidance for CHPs (forthcoming, Scottish Executive) will be helpful in meeting these requirements.
The Health and Homelessness Standards sit within the broader holistic Scottish Executive framework to prevent and alleviate homelessness. The totality of this approach is challenging for all of those working with homeless people. Consequently it is crucial that good partnerships are in place to support complementary work across the NHS, Local Authorities and the voluntary sector. Delivering the Health and Homelessness Standards should sit within such a framework and will also include taking forward the health recommendations made by the Homelessness Task Force, which can be found at Annex A.
The Standards apply to all groups of homeless people. To assist in understanding the heterogeneous nature of homelessness, the Homelessness Task Force definition of homelessness can be found at Annex B. It is vital to note that in addition to the significant issues for single people, children and families who are homeless are very vulnerable and may have specific health needs. Therefore, in addressing the Performance Requirements, NHS Boards will need to ensure that they take into account such differing needs. This will require excellent strategic linkages, for example including homeless issues in Children's Services Plans, which in turn will ensure appropriate responses from maternity services and screening, surveillance and immunisation for homeless children.
The Standards also relate to the Scottish Executive's equality and diversity approach and should assist NHS Boards in using the Equality and Diversity Impact Assessment Toolkit.
The Health and Homelessness Standards will be implemented by NHS Boards from April 2005 onwards. The performance assessment process is outlined in Section 5.