COVID-19 and rough sleepers: a randomised controlled trial to evaluate models of housing and support to reduce infection and homelessness

As part of the government's response to COVID-19, 15,000 rough sleepers have now been offered self-contained temporary accommodation in England, mainly in hotels. This approach, which has involved the decanting of hostels, shelters and similar shared provision for rough sleepers, is a short-term response. When the lockdown ends, decisions will need to be taken about how to house former rough sleepers in line with the UK government's commitment to prevent people from going back to the streets - including, potentially, through the re-opening of shelter-type accommodation. Existing temporary accommodation with shared facilities might make it impossible for people to comply with government social distancing advice. So these decisions will impact on the risk of a second wave of infection from COVID-19 and possibly any mutations. This proposal outlines a unique time limited opportunity to conduct the first ever randomised controlled trial in the UK, to evaluate the effectiveness and cost-effectiveness of permanent housing on the risk of COVID-19 infection and housing stability for people experiencing homelessness. That many homeless people are currently waiting to be housed means they can be randomly allocated to different housing solutions at scale quickly. The insights drawn from the short-term impacts of permanent housing can be used to inform other local authorities' responses to the challenges of COVID-19 and the cost-effectiveness of accommodation alternatives more broadly.