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The purpose of this paper is to consider how a South East project approached systems change to improve unsupported temporary accommodation (UTA) and the changes made for people experiencing multiple disadvantage (“multiple and complex needs”). This paper also covers some matters that are hard to change or uncertain, such as housing shortages and financial constraints. The paper focuses on a case study of the East Sussex Temporary Accommodation Action Group (TAAG) – a multi-agency action group.

A qualitative case study involving a thematic analysis of seven semi-structured interviews, with a review of published literature and internal documentation.

This example of setting up a TAAG shows us the value of having a dedicated forum to look at a part of the system that requires changing and to identify what works well. Creating a collaborative and democratic space with a common purpose brings different stakeholders and perspectives together and opens discussions to new ways of working. Equalising partners creates an opportunity to create change from the bottom-up within a system traditionally governed by statutory bodies. This study found that the TAAG has facilitated learning around trauma-informed practice and nurtured more sustainable changes towards a Standards Charter and women-only safe UTA.

This is one of the first qualitative case studies of a local systems change approach to improving UTA for people experiencing multiple disadvantage in East Sussex.

People who are homeless and have a learning disability tend to be more vulnerable and have greater health needs than homeless people who do not have a learning disability (Leedham, 2002). However, the literature on the experiences of this population is very limited. This paper investigates the experiences and views of professionals from a range of settings who work with people who are homeless and have a learning disability. Semi‐structured interviews were conducted with 23 professionals working for health, social care, probation, employment and voluntary agencies. Professionals described how people who are homeless and have a learning disability have a range of complex personal, health and social needs that are often not met by current accommodation and support provision. Improvements to the quality of temporary accommodation and the on‐site support offered are needed in order to react effectively to episodes of homelessness. In addition, improvements in the quality of outreach support and a greater choice of suitable housing might help to prevent homelessness among this client group. Another paper on a difference aspect of this research (Hebblethwaite et al, this issue) will report on the personal experiences of homeless people with a learning disability.

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

‘THhis,’ wrote Mr Mackenzie a few weeks ago, ‘is the first formal report on the working of the Library; it covers a period of rather less than a year—from 16th September, 1963, when the Librarian arrived in Lancaster with half a dozen books in his brief‐case, until 31st July, 1964, when an effective library was in operation with a stock of over twenty thousand volumes.’ There, if we forgive Mr Mackenzie for his poet's licence, is the essence of the accommodation problem with which each new university is being faced. We are not being asked to expand existing book and reader accommodation, or to replace it by new building. We have started with nothing and we have to be operational a year or eighteen months afterwards.

This article is based on a research study conducted for Crisis UK into capability and resilience among 87 people who used the Crisis Open Christmas Service (COC) in December 2006 and the Crisis Skylight/Learning Zone in Spitalfields. Both services are in London, UK. The study took a ‘capability’ approach, focusing on the values, interests and needs of people in the study as defined by them, and on the outcomes of formal and informal support. This article reports the range of capabilities and resilience among the people in the study, the different ways in which they used services, and the outcomes for them. Interviews were undertaken by co‐researchers who themselves had been homeless.

Reviews and integrates UK and North American research on job relocation relating to managerial and professional employees. Notes evidence which indicates an increasing level of reluctance by such employees to relocate for job reasons. Examines barriers to domestic relocation, including those related to financial and personal reasons, and organisational interventions designed to overcome them. Recognises that traditional forms of organisational intervention to alleviate barriers to relocation may be becoming less effective despite careful targeting. Analyses research data from the UK local authority sector to explore the effectiveness of organisational interventions to overcome barriers to relocation. Uses force field theory to evaluate the relationship between these barriers and organisational interventions in relation to organisations in general and UK local authorities in particular. Draws conclusions about the nature and use of organisational interventions to overcome barriers to domestic relocation, and discusses the applicability of the findings drawn from the UK local authorities research data.

The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding.

This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures.

Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care.

The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.

The objective of this study is to investigate the concept of “earthquake resistance” in high-rise buildings and assess the current level of structural strength in the areas where these structures are situated. The study aims to identify and implement necessary measures to enhance resilience in these areas. A comprehensive literature review was conducted to develop a conceptual framework focusing on earthquake resistance's meanings, stages and physical elements to achieve these goals.

This study focuses on Istanbul, a city known for its high earthquake risk, specifically targeting the Atasehir district. The research utilizes the DEMATEL (Decision-Making Trial and Evaluation Laboratory) method to evaluate urban resilience parameters. Additionally, the Fuzzy TOPSIS (Preference Ranking Technique by Similarity) method is employed to analyze the location of five buildings in Atasehir, using criterion weights derived from this methodology.

The findings indicate that resilience varies depending on the distance of the buffers. Moreover, the amount and quality of urban equipment in the study areas have a significant impact on the earthquake resistance level of the surrounding areas where high-rise buildings are situated. Building upon this analysis, the study suggests the implementation of measures aimed at augmenting the quantity and quality of urban facilities in the study areas, consequently enhancing urban resilience.

The originality and value of this study lie in its examination of seismic resilience within the context of high-rise buildings and the identification of necessary measures to increase resilience in areas where these structures are prevalent. By focusing on Istanbul, a city with a high earthquake risk, and specifically selecting the Atasehir district as the study area, this research provides a comprehensive conceptual framework for understanding urban resilience and its physical components. Moreover, the study offers a fresh perspective on urban resilience by highlighting the influence of tall buildings on the surrounding areas. Ultimately, it provides practical recommendations for architects, urban planners and other stakeholders to improve regional earthquake resilience.

Finding an appropriate place for temporary housing after an earthquake is one of the main challenges of disaster risk management, especially in developing countries. Therefore, it is necessary to create pre-disaster location plans for the homeless population. This study aims to systematically find safe places and select suitable sites according to influential factors.

The research methodology used is a descriptive–analytical method. A field survey with a quantitative–qualitative approach is applied to recognize physical vulnerabilities and select suitable sites for temporary settlements. Due to the occurrence of several earthquakes in recent decades around the city of Isfahan, Iran, this area has been studied. Fuzzy analytic hierarchy process, geographic information system and rapid visual screening have been used for data analysis.

According to the site selection and vulnerability criteria and their prioritization, the findings indicate that 60% of the study area is vulnerable. Moreover, vacant lots, stadiums and public green spaces that can be used as multi-purpose sites are the most appropriate options for the temporary settlement.

The research criteria are generalizable and can be used for decision-making, concerning urban fabric vulnerability and site selection of temporary housing in cities exposed to earthquake risk.

Cultural features, accessibility, land conditions, the slope and type of land, availability and construction materials were addressed in locating temporary settlements. In addition to vacant lots and open spaces, safe buildings were also identified for temporary housing, and religious minorities and similar communities were considered.

Homeless people experience extreme health inequalities and high rates of morbidity and mortality (Aldridge et al., 2017). Use of primary care services are low, while emergency healthcare use is high (Mathie, 2012; Homeless Link, 2014). Duration of admission has been estimated to be three times longer for homeless patients who often experience poor hospital discharge arrangements (Mathie, 2012; Homeless Link, 2014). This reflects ongoing and unaddressed care and housing needs (Blackburn et al., 2017). The paper aims to discuss these issues.

This paper reveals how GPs employed in secondary care, as part of Pathway teams, support improved health and housing outcomes and safe transfer of care into community services. It draws on published literature on role of GPs in working with excluded groups, personal experience of working as a GP in secondary care, structured interviews with Pathway GPs and routine data collected by the team to highlight key outcomes.

The expertise of GPs is highlighted and includes holistic assessment, management of multimorbidity or “tri-morbidity” – the combination of addictions problems, mental illness and physical health (Homeless Link, 2014; Stringfellow et al., 2015) and research and teaching.

The role of the GP in the care of patients with complex needs is more visible in primary care. This paper demonstrates some of the ways in which in-reach GPs play an important role in the care of multiply excluded groups attending and admitted to secondary care settings.