Independent: new approach stops councils stonewalling vulnerable homeless

Tony Gosling tony at
Mon Feb 17 13:25:17 GMT 2014

Special report: New start for the homeless that saves lives – and money

A one-to-one mentoring scheme is helping the most 
needy residents of one affluent city break out of 
a cycle of drugs, alcohol, family breakdown and sleeping rough

 Sunday 16 February 2014
Tommy Rice had been homeless in Cambridge for 
more than 20 years before he finally got real 
help. Addicted to alcohol and heroin, he was 
habitually kicked out of night shelters and 
forced to sleep in one of the city's car parks.
A year ago he met someone who changed everything. 
That man was Tom Tallon, who runs a project in 
Cambridgeshire that has found a new way of 
reaching homeless people with the most complex needs.
"I'm totally clean now," Mr Rice said, rolling up 
his sleeves to show arms with no fresh needle 
scarring. "Look!" He lives in a flat with a 
garden, "the first place I've had in my life", is 
receiving methadone treatment for his heroin 
addiction and is gradually coming off the booze.
The method that got him there is simple: assign a 
worker to the most hard-to-reach homeless people 
and help them to navigate through the health, 
justice, addiction, mental health and housing 
systems until their life is better. Called Making 
Every Adult Matter (Meam), it has been 
established by a coalition of charities to 
revolutionise the way Britain deals with the 
cases 60,000 of homelessness that are hardest to 
solve. The bespoke service sounds costly, but two 
years on in Cambridge it saved taxpayers an 
average of almost £1,000 a month per homeless 
person – money not spent on emergency treatment, housing and policing.
A report out this week analysing the pilot in 
Cambridge, along with two others in Somerset and 
Derby, shows the Meam model can bring down public 
spending on individuals by more than 20 per cent 
on average, as well as dramatically improving their quality of life.
Mr Tallon and another caseworker, Liam Stewart, 
act as a personal assistant and counsellor rolled 
into one for Tommy Rice. They make sure his 
appointments do not clash (and that he gets to 
them), as well as lobbying on his behalf for 
housing, rehab and other practical concerns.
"I thought I was going to spend the rest of my 
life on the street," Mr Rice said. "I haven't had 
help like this in 20 years. They can sort me out 
with my [methadone] script or my housing or 
setting up my bills. I'd be screwed without them."
Oliver Hilbery, national project director of 
Meam, said of the system: "Everything day to day 
pushes people back to service models that we know 
are ineffective. This allows you to push for a flexibility of response."
Mr Tallon, who runs the project in Cambridge, 
said: "There should be no reason for my role. In 
theory, all the services should work together in 
harmony but they have their own focus. Often with 
a complex client there are six or more services 
they're working with, such as police, mental 
health, the GP, addiction programmes and housing 
all pulling in different directions. Often you 
might have three appointments across the city at 
the same time and you have to decide between your 
liberty, health and survival. My role is to 
organise things so that doesn't happen."
Making appointments happen can also involve more 
prosaic action. Mr Tallon explained: "We drive 
people to appointments if we need to, and if we 
can't find them and it's something important, we 
traipse round the streets to find them, stick 
them in a car and take them there."
Over the past four years, Mr Tallon and two 
colleagues have worked with 45 people in 
Cambridge. Some are off their books after eight 
weeks; others take more than three years to get 
back on track, but almost all have seen their lives improve.
The savings in money spent on policing, emergency 
NHS care and highly staffed shelters have also 
been dramatic, according to an independent report 
on the Meam model out this week from Pro Bono 
Economics and FTI Consulting. After two years on 
the programme, the cost of each client to the 
public purse had gone down by 26.4 per cent in 
Cambridgeshire, a saving of £958 per client per month.
"By getting people engaged with treatment and 
improving their well-being, their offending goes 
down and their interaction with the criminal 
justice system drops through the floor," said Mr Tallon.
"Planned treatment rather than emergency 
treatment in hospital is also cheaper."
Tim Battrick, the author of the report, said: 
"There's no magic solution that saves money 
instantly, but if you follow through with this 
then you can save a lot. Even if this didn't save 
money, it's a worthwhile thing to stop people 
being homeless. The fact that it does save money is a bonus."
At Cambridge Access Surgery, a GP practice 
dedicated to homeless people, lead practice nurse 
Anthea Parsons said she has noticed a difference 
in the patients that Mr Tallon and his team work 
with. "Clients often hadn't had any medical 
treatment for quite a while and a lot were not 
good at attending appointments. Now they do. I 
can think of one person in particular who comes 
regularly to replace dressings, and we're beginning to heal their wounds."
Improving their access to healthcare prevents 
these patients from becoming another of the 
city's grim statistics. The average life 
expectancy of a homeless person in Cambridge is 
44, compared with 80 in the city's population as a whole.
In a memorial garden behind Riverside homeless 
centre, a semicircle of wooden posts with 98 
plaques on them bear the names of homeless people 
who have died in Cambridge since 2007. Another 56 
still need to be added to bring it up to date. 
"Without help, that memorial just gets bigger and bigger," Mr Tallon said.
Emma Hyde, 40, is a project worker with homeless 
people at Jimmy's Assessment Centre in the city. 
She said: "I was sleeping rough in Cambridge for 
six years. I used to have a really good job in 
Formula One journalism, and within six months I 
got breast cancer, my husband walked out and my 
father died. I was very ill and on my own and I hit the bottle."
Pregnancy helped her to give up alcohol, and for 
the past five years her life has been back on 
track. But she believes intervention of the kind 
offered by Mr Tallon would have saved her much 
faster. "Not everyone is a tick-box, and some 
people will never settle in a hostel system. 
People either spend years navigating through it 
or die. Having someone like [Mr Tallon] to act on 
your behalf makes all the difference." 
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