A breakfast roundtable for London health and homelessness leaders and providers on 8 December explored the outcomes and recommendations for services from the City & Hackney Time Credits pilot, a project between St Mungo’s and Spice in Hackney funded by City & Hackney Clinical Commissioning Group. Recommendations include increased opportunities for participation and giving back; healthy activities; better information; improved partnerships; supportive long term relationship development; addressing specific access barriers; and supporting self-management of conditions.
Discussion on the recommendations included the importance of addressing loneliness, enabling positive relationships, offering opportunities to be valued and improving wellbeing for people experiencing homelessness; things that matter to all people but are can often be inaccessible to homeless people. Loneliness in particular can be compounded by a move from rough sleeping to a hostel setting, and engaging people into activities and networks to enable them to develop new relationships can have huge impact on health and wellbeing. The group felt that Time Credits offer a specific opportunity to address these issues.
Howard Sinclair, CEO of St Mungo’s, said
“The benefits of getting involved in Time Credits are tangible. It gives back responsibility and control to people and gives them opportunities to contribute when often they have only been contributed to…the question isn’t whether we should develop this sort of scheme, it’s how.”
Jenny Travassos, Senior Manager of Rough Sleeping at Westminster City Council, said
“What I’ve seen in our hostels that are using Time Credits is an increase in self confidence. People who took part aren’t coming back into services…there has been an increase in group work and a reduction in evictions and abandonments. There is equality to relationships, staff are on more of an equal footing with people coming into the service.”
A key challenge explored was how to commission for and capture ‘softer’ outcomes like these alongside a need for clinical outcomes, particularly for health services.
“How can you put a price on loneliness?”
The challenge of joining up commissioning systems to merge shared outcomes in order to match fund and co-commission was also explored, as a way to achieve aims around service transformation at both local and national levels. Approaches that can work across different service areas, like Time Credits, can face challenges when it comes to joining up commissioning across service areas but this could offer an opportunity to explore cross-cutting ways of working.
— Rebecca Daddow (@RJDaddow) December 8, 2016
About City & Hackney Time Credits
City & Hackney Time Credits explored the potential for Time Credits to achieve positive impact in a complex needs hostel for homeless people. It aimed to improve healthy behaviours and engagement with health and other services among homeless hostel residents, and to develop recommendations to improve health outcomes & access to services for homeless people.
Over 12 months, the pilot increased engagement in activity in the hostel and participants reported improvements in wellbeing. 81 members, 52 of whom were hostel residents, earned 852 Time Credits. Key activities included peer support development, a women’s group, skills sharing, social activities and a documentary co-produced by residents on their experiences of homelessness and health. Residents spent Time Credits on activities from a tour of Arsenal and Thames Clipper trips to cinema and theatre shows, craft sessions and ice skating. Project evaluation demonstrated positive health impacts; 85% felt healthier, 92% more confident, 92% less isolated, 83% knew more about available support and services and 100% visited or saw other people more often.