‘Helpful, compassionate, life- saving and life-changing.’1Comment made by a member of hospital staff as part of the initial evaluation report, unpublished.
At the beginning of 2020, Southwark Law Centre (SLC) launched a project to provide advice and legal representation to homeless hospital patients. It is funded for two years by the Guy’s and St Thomas’ Samaritan Fund
. The project provides advice to staff on the hospitals’ homeless teams and accepts client referrals of immigration, housing and welfare benefits cases. In addition, the Law Centre is building capacity in hospital staff through delivering training and second-tier advice. Ruth Mercer, a solicitor and Justice First Fellow working on the project, says:
The clients referred to us are some of the most vulnerable people we work with at the Law Centre, many of whom would not have been able to access legal support if they had not been referred by the hospital homeless teams.
The COVID-19 pandemic has impacted the project through greatly increased pressures on hospital staff to discharge homeless inpatients, and through SLC staff no longer being able to attend hospitals in person. The project required a rapid redesign and has been able to continue almost without pause, liaising with hospital staff and patients remotely.
Immigration, housing, welfare benefits and human rights
The initial evaluation report showed that immigration was the most in-demand area of law and made up 54 per cent of all support queries.2Statistics from the initial evaluation report, unpublished.
Hospital homeless teams often come into contact with vulnerable rough sleepers with immigration issues but cannot give advice on immigration/asylum matters themselves as they are not regulated to do so. The project allows individuals to be referred for specialist legal representation, and cases taken on have ranged from asylum and trafficking, to EU settlement, to private life rights and Windrush.
Housing, welfare benefits and human rights were also significant, including homelessness applications, Care Act 2014 challenges and universal credit challenges. The hospital homeless teams are able to provide crucial medical evidence and support SLC’s legal challenges.
By the end of July, SLC had taken on 21 complex client referrals from the homeless teams, exceeding the target by 40 per cent. Almost 40 per cent of clients had legal problems spanning more than one category of law and requiring representation (eg, immigration and housing issues, or housing and welfare benefits issues), resulting in 28 separate matters. SLC has the expertise to deal with each separate issue in a holistic way.
One of the clients referred had no immigration status and had been sleeping rough for two years. SLC submitted a fee waiver and human rights application, while also applying for Immigration Act 2016 Sch 10 immigration bail. The client has now been housed, proudly reports he has gained weight, and has not returned to A&E.
Better health outcomes
Impartial legal support enables patients to obtain immigration status, and challenge negative housing and welfare benefits decisions, which assists in ending their rough sleeping. In addition, 88 per cent of hospital staff said that this helps patients to obtain better health outcomes:
Definitely – by supporting getting [no recourse to public funds] restrictions lifted has enabled people to have access to benefits, by getting people settled status has enabled people to have access to housing, reduced destitution and so had a massive impact on health (as evidenced by reduced revolving door and A+E attendances).3Comment made by a member of hospital staff as part of the evaluation.
However, it was less clear whether the project has reduced delays in discharging patients. Fifty-four per cent felt that the SLC service had helped to reduce delays in discharge, 36 per cent disagreed and 10 per cent were not sure. This is an issue on which we are seeking further evidence as the project develops.
Patient/client feedback obtained through telephone interviews was overwhelmingly positive. All clients surveyed would recommend the service, even though they weren’t all happy with the outcome of their cases. One simply said: ‘Everything is very good.’
Want to find out more?
SLC will be presenting an updated evaluation report at an event in January 2021. It will be relevant to other agencies considering similar services as well as potential continuation funders. If you are interested in finding out more, please contact: Sally.Causer@southwarklawcentre.org.uk