Prof Sarah Johnsen

Operating in five areas encompassing six local authorities (Aberdeen City and Aberdeenshire, Dundee, Edinburgh, Glasgow and Stirling), the Pathfinder is serving as a key litmus test regarding the opportunities and challenges involved in scaling up Housing First as it increasingly becomes the default response for homeless people with complex needs across Scotland.

Compiled by I-SPHERE in partnership with ICF Consulting, and commissioned by Corra Foundation with funding from Social Bite, the interim report documents the key achievements, challenges and lessons learned during the design, mobilisation, and early implementation phases of the Pathfinder. It draws on interviews with more than 100 providers, partners, service users and external stakeholders, together with Pathfinder tracker monitoring data, and project-level costs data.

The main headline finding is that the Pathfinder has to date been highly effective at supporting homeless people with multiple and complex needs to sustain their tenancies. At the end of June 2021, by which time 531 people had been housed, the Pathfinder had achieved an overall 12-month tenancy sustainment rate of 84% and 24-month tenancy sustainment rate of 82%. These figures are commensurate with tenancy sustainment rates reported internationally, despite the Pathfinder having operated in the context of the COVID-19 pandemic for more than a year.

The experiences of Pathfinder service user interviewees were extremely positive on balance. Some described the effects on their lives as transformational. They explained that the relationality, stickability, flexibility and longevity of Housing First support set it apart from other services they had used in the past. These attributes had in their views not only strengthened their ability to sustain a tenancy but also facilitated their willingness to engage with support and fostered their recovery from addiction and/or poor mental health.

The interim findings indicate that Housing First provision can be successfully scaled up, and relatively quickly so, even in areas where housing supply is constrained. The process has not been easy, however, with many difficulties encountered and lessons learned across all five areas. Scaling up has been especially challenging in contexts with large and/or complex systems involving many stakeholders and requiring integration or adaptation of multiple organisational procedures. Moreover, the nature and location of ‘sticking points’ vary depending on a range of factors (e.g. local housing markets, degree and nature of statutory body involvement) and tend to shift over time as services are mobilised and become more established.

Sourcing the required number of suitable properties in areas that the people being supported want to live has been a key challenge. This issue has been especially acute in high pressure housing markets (most notably Edinburgh) and was compounded by the hiatus in property allocations during the pandemic. There is a shared ambition to increase the speed of property allocations going forward, not least given evidence that lengthy delays can be demoralising for some Housing First clients. That said, it must be acknowledged that in exercising user choice some clients actively prioritise location (e.g. proximity to family or amenities) or property attributes (e.g. multi-storey level or access to garden), over the likely time taken to receive a housing offer.

It is clear that Housing First providers face a particular challenge in balancing: a) maximisation of user choice with regard to housing location/type; with b) minimisation of risk of harm (to both Housing First tenants and their neighbours); and c) time taken to source housing. A key task for frontline workers is to support service users to make informed choices regarding housing (and other aspects of their lives), such that they are aware of the full range of options available to them and are supported to assess the potential benefits, limitations, and risks associated with each.

The report documents a number of factors that have facilitated the mobilisation and early implementation of Housing First, including for example strong political commitment at national and local levels, a high level of buy-in from a number of housing providers, and availability of training in Housing First principles and practice. It also identifies factors which have inhibited the design and delivery of Housing First, including amongst others the limited supply of suitable housing in some areas, limited understanding of the Housing First approach amongst some housing providers, difficulties with staff recruitment, and divergent levels of risk appetite amongst key stakeholders.

Dissonance between the flexibility of Housing First and relative inflexibility of many of the systems it works within and alongside remains a perennial challenge for providers and partners. The need for collaborative problem solving in attempts to resolve these issues is widely recognised. The fact that a number of barriers (to essential healthcare for example) have been successfully removed in some areas during the pandemic has given some grounds for optimism regarding the possibility of positive change going forward.

Looking to the future, whilst the need to implement Housing First in slightly different ways in different local contexts is widely acknowledged, there is a strong call for the preservation of commitment to fidelity to the key principles as the approach is rolled out more widely across Scotland. Consideration of fidelity in the proposed Housing First Check-Up appraisal process to be facilitated by Homeless Network Scotland in partnership with the Scottish Government is therefore very welcome.

The full interim report and an executive summary are publicly available. Future evaluation outputs will document learning during later stages of Pathfinder delivery, including during the 2021/2022 transition period when Pathfinder services are mainstreamed. These will also report outcomes for the individuals being supported across a range of domains including health and wellbeing, community integration etc. and calculate cost-benefits.