The provision of accommodation must be central to any discussions about ending homelessness. But there are many ways to provide accommodation, and in order to ensure positive outcomes for people who are experiencing homelessness, we must have robust evidence on what types of accommodation intervention are genuinely beneficial to the people receiving them. 

By rigorously synthesising the outcomes of existing research in one place, Accommodation-based programmes for individuals experiencing or at risk of homelessness: a systematic review and network meta-analysis provides the best way to consider the evidence on what works and what doesn’t. We have assessed and synthesised all the available evidence, excluding studies that don’t meet quality criteria. 

The key finding in this review is that interventions offering the highest levels of support alongside unconditional accommodation were more effective than programmes that provided low, or no support. In the main, interventions with support programmes tailored to the individual reported better housing stability and health outcomes. 

But perhaps more importantly, the evidence in this review shows that basic interventions (those that only satisfy very basic human needs such as a bed and food) may harm people: they had worse health and housing stability outcomes even when compared to no intervention. If we are to genuinely improve people’s lives, we must design provision with clear standards of support instead of focusing on very basic needs that may not be the best use of limited funds.

Whilst the results in this systematic review are promising when it comes to the impact of housing paired with unconditional support, we must recognise the context in which these studies were conducted. Twenty-five out of twenty-eight of these studies are from the USA, two from Canada and one from the UK. The effectiveness of an intervention depends on the conditions in which it is delivered, and we know that the socio-economic and political environment in the US is vastly different to the UK. 

As we find ourselves in the midst of a pandemic which has significantly worse financial and health impacts for people who are already disadvantaged, we must move rapidly, and focus resources on what works.  In order to design and deliver quality accommodation based interventions, it is vital that we produce more rigorous evidence in the UK so the sector can deliver services that are truly of benefit to the people receiving them. 

At the Centre for Homelessness Impact we are committed to helping the UK end homelessness with evidence. By making evidence accessible, filling gaps in our collective knowledge and supporting the implementation of best practise, we will equip practitioners and policymakers with the tools they need to make lasting positive change. We hope you find the insights in this systematic review useful.