Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative

Abstract Background The ‘Everyone In’ national policy initiative launched in England during the COVID- 19 pandemic provided accommodation and health and care support to people who were (or at risk of) sleeping rough. This study aims to understand what worked well and less well in implementing ‘Every...

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Main Authors: Neha Jain, Emma A. Adams, Kate Haddow, Jo Brown, Dan Bleksley, Stephan Morrison, Joanna Kesten, Kelly Howells, Caroline Sanders, Ashley J. Adamson, Eileen Kaner, Sheena E. Ramsay
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12713-w
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author Neha Jain
Emma A. Adams
Kate Haddow
Jo Brown
Dan Bleksley
Stephan Morrison
Joanna Kesten
Kelly Howells
Caroline Sanders
Ashley J. Adamson
Eileen Kaner
Sheena E. Ramsay
author_facet Neha Jain
Emma A. Adams
Kate Haddow
Jo Brown
Dan Bleksley
Stephan Morrison
Joanna Kesten
Kelly Howells
Caroline Sanders
Ashley J. Adamson
Eileen Kaner
Sheena E. Ramsay
author_sort Neha Jain
collection DOAJ
description Abstract Background The ‘Everyone In’ national policy initiative launched in England during the COVID- 19 pandemic provided accommodation and health and care support to people who were (or at risk of) sleeping rough. This study aims to understand what worked well and less well in implementing ‘Everyone In’ for improving physical and mental health outcomes for people experiencing homelessness. Methods Between January and October 2023, in-depth interviews/focus groups were conducted across England with those involved in the delivery/implementation of ‘Everyone In’ and those accommodated. Framework analysis and case study analysis were used for a contextual understanding of the implementation of the policy initiative. Results Twenty-five people accommodated through ‘Everyone In’ (28–58 years; 88% males) and 43 service providers (25–62 years; 40% males) were interviewed. Flexibility in funding and resources, ‘joining up’ services/support, and innovative responsiveness in services across health, care, and housing systems were key positive features of the initiative. In the long term, ‘Everyone In’ has provided positive learnings for delivering holistic and integrated health and social care. It has also highlighted the importance of accommodating psychosocial needs and addressing the complexities of alcohol and substance use in all homelessness strategies. Conclusions Pathways to care for people experiencing homelessness need to be flexible and responsive. Complexities such as substance use need to be approached with compassion while addressing the role of wider determinants in such health behaviours. Innovative approaches and joined-up work improve delivery of interventions and integrated care can reduce barriers to access to support.
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spelling doaj-art-ca633203f1fc44d68797e1b5812bbaa02025-08-20T02:17:57ZengBMCBMC Health Services Research1472-69632025-04-0125111010.1186/s12913-025-12713-wLearnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiativeNeha Jain0Emma A. Adams1Kate Haddow2Jo BrownDan BleksleyStephan MorrisonJoanna Kesten3Kelly Howells4Caroline Sanders5Ashley J. Adamson6Eileen Kaner7Sheena E. Ramsay8Population Health Sciences Institute, Newcastle UniversityPopulation Health Sciences Institute, Newcastle UniversityPopulation Health Sciences Institute, Newcastle UniversityPopulation Health Sciences, Bristol Medical School, University of BristolDivision of Population Health, Health Services Research and Primary Care, University of ManchesterDivision of Population Health, Health Services Research and Primary Care, University of ManchesterPopulation Health Sciences Institute, Newcastle UniversityPopulation Health Sciences Institute, Newcastle UniversityPopulation Health Sciences Institute, Newcastle UniversityAbstract Background The ‘Everyone In’ national policy initiative launched in England during the COVID- 19 pandemic provided accommodation and health and care support to people who were (or at risk of) sleeping rough. This study aims to understand what worked well and less well in implementing ‘Everyone In’ for improving physical and mental health outcomes for people experiencing homelessness. Methods Between January and October 2023, in-depth interviews/focus groups were conducted across England with those involved in the delivery/implementation of ‘Everyone In’ and those accommodated. Framework analysis and case study analysis were used for a contextual understanding of the implementation of the policy initiative. Results Twenty-five people accommodated through ‘Everyone In’ (28–58 years; 88% males) and 43 service providers (25–62 years; 40% males) were interviewed. Flexibility in funding and resources, ‘joining up’ services/support, and innovative responsiveness in services across health, care, and housing systems were key positive features of the initiative. In the long term, ‘Everyone In’ has provided positive learnings for delivering holistic and integrated health and social care. It has also highlighted the importance of accommodating psychosocial needs and addressing the complexities of alcohol and substance use in all homelessness strategies. Conclusions Pathways to care for people experiencing homelessness need to be flexible and responsive. Complexities such as substance use need to be approached with compassion while addressing the role of wider determinants in such health behaviours. Innovative approaches and joined-up work improve delivery of interventions and integrated care can reduce barriers to access to support.https://doi.org/10.1186/s12913-025-12713-wHealth policyHomelessnessIntegrated systemsHealth and housing
spellingShingle Neha Jain
Emma A. Adams
Kate Haddow
Jo Brown
Dan Bleksley
Stephan Morrison
Joanna Kesten
Kelly Howells
Caroline Sanders
Ashley J. Adamson
Eileen Kaner
Sheena E. Ramsay
Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
BMC Health Services Research
Health policy
Homelessness
Integrated systems
Health and housing
title Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
title_full Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
title_fullStr Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
title_full_unstemmed Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
title_short Learnings from providing integrated health, housing and wider care for people rough sleeping during the COVID- 19 pandemic: a national qualitative study of the ‘Everyone In’ policy initiative
title_sort learnings from providing integrated health housing and wider care for people rough sleeping during the covid 19 pandemic a national qualitative study of the everyone in policy initiative
topic Health policy
Homelessness
Integrated systems
Health and housing
url https://doi.org/10.1186/s12913-025-12713-w
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