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The purpose of this paper is to focus on the denial of social support to homeless persons and related societal effects of new local governance arrangements.

Analysis of new data and secondary evaluative and comparative data on the policies, administrative structures and management styles of Copenhagen, Glasgow and Amsterdam have brought better understanding of the elements of local governance arrangements that influence the number of homeless persons who are denied access to services and the number of persons sleeping rough who are not eligible for social support. Theoretical explanations for the impact of governance arrangements on these processes and societal effects are considered.

It appears that while the body of research, reports and policy documents on non-eligibility for homelessness services is growing, legal responses at best remain vague, and policies are still in the process of being developed. Modest progress on policy goals, and even more so on policy instruments, leading to less detrimental outcomes, can be explained by centralising and decentralising trends and the relationships between state and society. The latter may also be indicative of how the increased focus on the legal problems of some EU migrants can be explained.

The two points in time documented for the case studies are relevant in understanding processes underlying the current circumstances of homeless persons and homeless migrants and offer an interdisciplinary insight into governance and politics, law, and public and health service perspectives.

Good policy practice, as this paper shows, can lead to a difference in individual lives.

Much is unknown about considerations inside government. This paper contributes by combining theoretical and insider perspectives.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. The paper aims to discuss these issues.

The authors examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals.

The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems.

If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing.

This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon architecture and community planning principles.

This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the participants' narrations, important main themes appeared in order to avoid suicide, among which family, the certainty of finding a solution and the will to live. However, the suicide ideation inheres in about 30% of participants, almost all believers, addicted and/or alcoholics. Results suggest that religiosity and meaning of death neither prevent from substances abuse and alcoholism, nor is a protective factor against suicide ideation. Meanings of life are the most important reasons for living, and when they are definitively considered unworkable, alcohol and drug help to endure life in the street. A specific model is discussed.

This study aims to explore homeless-support workers’ perceptions of homeless welfare recipients and their experiences of navigating new conditions placed upon them by UK welfare reform. It examines support workers’ views of the most punitive feature of the welfare system, sanctions, on those recipients.In 2012, the Conservative and Liberal Democrat Coalition Government introduced the largest and most radical overhaul of the UK benefit system, significantly increasing the level of conditionality and sanctions for non-compliance, part of a shift in welfare, suggesting that rights must be balanced by responsibility and the “culture of worklessness” and “benefit dependency” should be addressed.

Welfare reforms in the UK and the increased use of sanctions as part of welfare conditionality are reviewed. Data are collected from eight semi-structured interviews taking place in five housing support groups in the South East and South West of England in 2019–2020. The interviews followed an approach from interpretive phenomenological analysis.

Findings from this study indicate that the government’s reforms serve as a disciplinary measure for the poor, reinforcing inequality and social marginalization. To mitigate the effects would require a comprehensive review of universal credit prior to its full rollout to claimants. Data are analyzed thematically.

Welfare conditionality and welfare reform is well-researched in the UK. There is also a significant volume of research concerning homelessness. This paper, however, fills a gap in research concerning the experiences of those working in housing support agencies working with homeless people in the UK.

This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.

The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.

The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.

To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.

This study aims to investigate the role of relational asymmetries in influencing the coping strategies adopted by frontline workers to deal with the policy–client role conflict.

A comparative analysis of three different services highlights the role of the service relationships characteristics in explaining similarities and differences in the strategies adopted by street-level bureaucrats (SLBs). The research is based on the secondary analysis of three case studies conducted in Italy: the reception system for homeless people, the job brokerage service in the public employment service and the dispute settlement procedure in the labour inspectorate.

The results underline the interaction between the characteristics of the service relationship and the different coping strategies adopted to deal with the policy–client conflict.

The contribution of this study is threefold. Firstly, the authors focus on the influence of the characteristics of the service relationship in terms of agency resources over SLBs’ strategies to face with users’ expectations. Secondly, the authors intend to discuss these issues analysing SLBs not only as agents with individual preferences. Thirdly, the research design allows the authors to return to the street-level bureaucracy theory its comparative essence, proposing a comparative strategy with an explorative intent.