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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.

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.

The transition to a circular economy in the built environment is key to achieving a resource-effective society. The built environment can be made more circular by applying circular building components. The purpose of this paper is to present a design tool that can support industry in developing circular building components.

The tool was developed and tested in five steps. In Step 1, the authors analysed existing circular design frameworks to identify gaps and develop requirements for the design tool (Step 2). In Step 3, the authors derived circular design parameters and options from existing frameworks. In Step 4, the authors combined and specified these to develop the “circular building components generator” (CBC-generator). In Step 5, the CBC-generator was applied in the development of an exemplary component: the circular kitchen and tested in a student workshop.

The CBC-generator is a three-tiered design tool, consisting of a technical, industrial and business model generator. These generators are “parameter based”; they consist of a parameter-option matrix and design canvasses. Different variants for circular components can be synthesised by filling the canvasses through systematically “mixing and matching” design options.

The developed tool does not yet support establishing causal links between “parameter-options” and identification of the most circular design variant.

The CBC-generator provides an important step to support the building industry in developing and implementing circular building components in the built environment.

Whilst existing tools and frameworks are not comprehensive, nor specifically developed for designing circular building components, the CBC-generator successfully supports the integral design of circular building components. First, it provides all the design parameters which should be considered; second, it provides extensive design options per parameter; and third, it supports systematic synthesis of design options to a cohesive and comprehensive circular design.

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.

The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data.

Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried’s phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England.

A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population.

To the best of authors’ knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH.

This study aims to explore the experiences of living through the COVID-19 pandemic for people who faced homelessness and dealt with mental health and/or substance use challenges.

This qualitative study was comprised of 26 1:1 interviews (16 men and 10 women), conducted between February and May 2021 with people who experienced homelessness in North East England during the COVID-19 pandemic. An inductive reflexive thematic analysis was undertaken, with input from individuals with lived experience who were involved throughout the study.

Four themes were developed. The first theme, lack of support and exacerbation of mental health and substance use difficulties, highlighted how the lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The second theme, uncertainty and fear during the pandemic, explored how the “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. The third theme, isolation and impacts on social networks, discussed how isolation and changes to relationships also played a role in mental health and substance use. Finally, opportunity for reflection and self-improvement for mental health and substance use, explored how some people used the isolated time to re-evaluate their recovery journey and focus on self-improvement.

The experiences shared within this study have important implications for planning the future delivery and commissioning of health and social care services for people facing homelessness, such as sharing information accessibly through clear, consistent and simple language.

As one of the few papers to involve people with lived experience as part of the research, the findings reflect the unique narratives of this population with a focus on improving services.

This integrated care study seeks to highlight how voluntary sector “wellbeing co-ordinators” co-located in a horizontally and vertically integrated, multidisciplinary community hub within one locality of an Integrated Care Organisation contribute to complex, person-centred, co-ordinated care.

This is a naturalistic, mixed method and mixed data study. It is complementing a before-and-after study with a sub-group analysis of people receiving input from the wider hub (including Wellbeing Co-ordination and Enhanced Intermediate Care), qualitative case studies, interviews, and observations co-produced with embedded researchers-in-residence.

The cross-case analysis uses trajectories and outcome patterns across six client groups to illustrate the bio-psycho-social complexity of each group across the life course, corresponding with the range of inputs offered by the hub.

To consider the effectiveness and mechanisms of complex system-wide interventions operating at horizontal and vertical interfaces and researching this applying co-produced, embedded, naturalistic and mixed methods approaches.

How a bio-psycho-social approach by a wellbeing co-ordinator can contribute to improved person reported outcomes from a range of preventive, rehabilitation, palliative care and bereavement services in the community.

To combine knowledge about individuals held in the community to align the respective inputs, and expectations about outcomes while considering networked pathways based on functional status, above diagnostic pathways, and along a life-continuum.

The hub as a whole seems to (1) Enhance engagement through relationship, trust and activation, (2) Exchanging knowledge to co-create a shared bio-psycho-social understanding of each individual’s situation and goals, (3) Personalising care planning by utilising the range of available resources to ensure needs are met, and (4) Enhancing co-ordination and ongoing care through multi-disciplinary working between practitioners, across teams and sectors.

Background: Rising food bank usage in the UK suggests a growing prevalence of food insecurity. However, a formalised, representative measure of food insecurity was not collected in the UK until 2019, over a decade after the initial proliferation of food bank demand. In the absence of a direct measure of food insecurity, this article identifies and summarises longitudinal proxy indicators of UK food insecurity to gain insight into the growth of insecure access to food in the 21st century.

Methods: A rapid evidence synthesis of academic and grey literature (2005–present) identified candidate proxy longitudinal markers of food insecurity. These were assessed to gain insight into the prevalence of, or conditions associated with, food insecurity.

Results: Food bank data clearly demonstrates increased food insecurity. However, this data reflects an unrepresentative, fractional proportion of the food insecure population without accounting for mild/moderate insecurity, or those in need not accessing provision. Economic indicators demonstrate that a period of poor overall UK growth since 2005 has disproportionately impacted the poorest households, likely increasing vulnerability and incidence of food insecurity. This vulnerability has been exacerbated by welfare reform for some households. The COVID-19 pandemic has dramatically intensified vulnerabilities and food insecurity. Diet-related health outcomes suggest a reduction in diet quantity/quality. The causes of diet-related disease are complex and diverse; however, evidence of socio-economic inequalities in their incidence suggests poverty, and by extension, food insecurity, as key determinants.

Conclusion: Proxy measures of food insecurity suggest a significant increase since 2005, particularly for severe food insecurity. Proxy measures are inadequate to robustly assess the prevalence of food insecurity in the UK. Failure to collect standardised, representative data at the point at which food bank usage increased significantly impairs attempts to determine the full prevalence of food insecurity, understand the causes, and identify those most at risk.

The paper aims to address the increasing issue of teacher shortages and the lack of diversity in America’s educators. Highly diverse communities need ways to support community members interested in careers as teachers. This article explores one promising approach to reach and inspire high school students considering the teaching profession. Camp ExCEL (Exploring Careers in Education and Leadership) provided a pathway allowing rising high school seniors an opportunity to explore the teaching profession. This pathway utilized the Grow Your Own framework, recruiting students from a diverse community and providing them resources and information that would further efforts to become an educator within their community.

The current study examined outcomes from an education summer camp, using qualitative thematic analysis to reflexively interpret participants’ (n = 29) feelings and beliefs about effective teaching, culturally responsive teaching (CRT), project-based learning (PBL) and their camp experience. Data were collected using Google documents and surveys. The four connected themes that emerged were obstacles and barriers to teaching, qualities of an effective teacher, the impact of culturally responsive teaching and project-based learning on classrooms, and the importance of mentorships within education.

The paper provides insight about how an education camp can support high school students as they explore a career in education. Results suggest that focus on high-quality pedagogy can support student understanding of the career. Students also suggested their perception of effective teaching that includes acknowledging the needs of the whole student, modeling high-quality teaching practices and displaying positive professional dispositions.

Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to conduct and examine education camps further.

The paper includes implications for the development of other education camps, especially in areas with highly diverse populations.

This paper fulfills an identified need to increase the number of persons pursuing a career in education. The focus on a highly diverse community is also an area of need in education. This article details the description of an education camp and the curriculum used, along with findings from data collected during the first year.