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The research explored three case-studies in NSW, Victoria and Tasmania, looking at the COVID-19 emergency period from January 2020 to October 2021. Each case-study region faced different challenges, highlighting the localised nature of public health responses across Australia.

Strong pre-existing relationships helped

Successful health agency responses to people experiencing homelessness came from strong partnerships that
existed between health and homelessness agencies before the pandemic. These relationships enabled quick
coordination, trust-based teamwork and fast implementation of targeted responses.

Collaboration and communication are important

Strong communication and coordination between support agencies helped successfully deliver health services. This
effective collaboration meant emerging issues could be identified and addressed quickly.

Outreach health services proved vital

Health agencies already active in outreach work were crucial for delivering health services during the pandemic. The existing outreach structure allowed these services to quickly adapt to increased demand and logistical challenges.

Government agencies created a supportive environment

Governments had a key role in effective health responses. Government agencies created a policy environment
characterised by flexibility and strong support from senior officials. This encouraged organisations to work together and go beyond their usual limits, allowing more responsive and innovative approaches.

Support was uneven across regions

All three case studies showed uneven delivery of health services. There were gaps in coverage for people outside city areas and for groups other than rough sleepers.

Other barriers included difficulties sharing sensitive information and tensions between organisations with different working cultures. These differences hindered the development of shared understanding, which is critical for effective multi-agency work.

Health responses were not designed to meet the needs of unaccompanied children under 18 experiencing homelessness. This group faced difficulties complying with public health orders such as lockdowns, stay-at-home orders and social distancing rules.

Treat homelessness as an ongoing public health emergency

Health agencies and services should take a proactive and sustained role in addressing homelessness as an urgent
public health crisis—and not just as a social issue. This involves creating policies and practices that prioritise
homelessness prevention, ensuring vulnerable people receive support before they become homeless.

Teamwork between health and homelessness services is essential

Strong coordination between health and homelessness services across all regions is vital for effective delivery of health services to people experiencing homelessness.

A well-resourced, centrally authorised framework for interagency communication is needed. This framework could
bring together health, housing, homelessness agencies and NGOs to improve collaboration and information-sharing.

Formal partnerships between health and homelessness services should clearly define roles to strengthen these relationships.

Continue targeted responses beyond emergencies

To build on the success of targeted health initiatives during COVID, it is essential such approaches continue. Ensuring people experiencing homelessness can access health services in familiar and trusted settings is crucial for ongoing health improvement.

Mobile and outreach-based services are key parts of a complete strategy to address the health needs of people experiencing homelessness.

This research includes a literature review and interviews with representatives from community services, health sector, and government agencies in New South Wales, Victorian and Tasmania.

The New South Wales study focused on health service delivery to people rough sleeping in inner-city Sydney.

The Victorian study focused on health service delivery to people experiencing homelessness, including those sleeping rough, in Melbourne.

The Tasmanian study explored how youth and homelessness services working with unaccompanied homeless children navigated public health measures.