Support For London’s Rough Sleepers To Be Revisited After Closure Of Capital’s Only Homeless Drug And Alcohol Clinic

LBC previously highlighted warnings that the loss London’s only homeless detox clinic in March would “undoubtedly” lead to a loss of lives and increased pressure on A&E departments.

On Thursday – less than an hour before Mr Streeting resigned from the Government and called for Sir Keir Starmer to step down – a government spokesperson announced that plans are moving forward for replacement addiction support for the homeless in London. London local authorities will begin inviting tenders for a different, “more sustainable” service in June, the spokesperson said. The U-turn comes after LBC reported in March that London’s only existing hospital unit providing addiction treatment for rough sleepers in need of support would close on cost grounds. The de-commissioning of the Addiction Clinical Care Suite at St Thomas’ Hospital left open the possibility that homeless people in London requiring treatment for drug and alcohol addiction could be left on the streets without access to life-saving support.

At the time, LBC highlighted warnings that the loss of the clinic, which has treated 1,000 patients since it opened in 2021, would “undoubtedly” lead to a loss of lives and increased pressure on A&E departments. Mr Streeting pledged to look into the decision after he was challenged on the closure by LBC’s Nick Ferrari. Just after 12pm on Thursday – less than an hour before Mr Streeting resigned as he mulls a potential leadership bid – spokesperson for the Department of Health and Social Care confirmed:  “Rising costs meant the London boroughs determined the service was no longer affordable – with a £1 million shortfall and times when beds were underused. They are inviting tenders for a more sustainable service and ministers have requested further advice on future provision.”

The spokesperson added interim support was being provided for patients, including “additional inpatient detoxification beds and access to intermediate care beds at the Mildmay Hospital for homeless patients following inpatient care, supported through additional national funding for London.” The department explained that the pan-London Inpatient Detoxification Programme was established in 2021 to address a significant decline in inpatient detoxification provision across the capital. Central government funds were brokered resulting in the commissioning of the Addictions Clinical Care Suite at St Thomas’ Hospital, with priority access for people sleeping rough. However by 2025 the cost of delivering the service had risen beyond the level of available grant funding. The contract ended in March 2026 and the clinic closed in April.

The service will go out to tender in June with applications due by July. In the meantime, the department has put in place a series of interim measures including additional access for London residents with complex needs who previously used the service to Inpatient detoxification providers outside of the capital. There are also ongoing conversations about the possibility of extending the Mildmay pilot. The detox unit was established in 2021 to “save the lives of some of the city’s most vulnerable people and provide them with an avenue to get off the streets for good.” It provided medical supervision to homeless people battling severe addiction issues, whose withdrawal from drugs or alcohol could result in delirium tremors, seizures or, in the most serious cases, death. Shortly before Christmas, however, staff at the unit were notified that funding for the Additional Clinical Care Suite had been withdrawn.

“We have been notified by the City of London Corporation (our commissioner) that funding for the Addiction Clinical Care Suite will cease from 31 March 2026,” an internal memo from Guy’s and St Thomas’s NHS Foundation Trust, seen by LBC, says. “In recognition of the outstanding work undertaken by the team and the excellent outcomes achieved for patients,” the note continues, “Trust senior management have worked extensively to explore alternative options to sustain the service. Unfortunately, in the current challenging financial climate, this has not been possible.” Neither the City of London Corporation nor the government department appeared willing to take responsibility for the decision to close the unit.

The Guy’s and St Thomas’s NHS Trust suggested the decision lay with the City of London Corporation, which in turn declined to comment and directed enquiries to the Department of Health and Social Care – with a spokesperson subsequently stating responsibility lay back with the local authority. Data from the Museum of Homelessness shows that 710 people died as a result of drug and alcohol issues in 2024 alone, representing 44% of total deaths among the homeless community. “It’s clearly a false economy,” one insider, who spoke to LBC on the condition of anonymity, previously lamented. “All that’s going to happen is that we’re going to see more and more addicts presenting at A&E departments as a last resort, when they are seriously, seriously ill – piling more pressure on staff. Lives are going to be lost – I have no doubt about that whatsoever.”

Though the service was commissioned by the City of London Corporation, its funding was made up of a series of grants from the Ministry of Housing, Communities and Local Government as well as local authority treatment budgets, which are primarily sourced from the Department of Health and Social Care. In December, the government’s Homelessness Strategy identified “the continued delivery of targeted and specialist drug and alcohol treatment and support” as one of the measures needed to meet the objective of halving the number of rough sleepers by 2029.

Speaking to LBC, Lord Bird, who has campaigned extensively to support homeless people and founded the Big Issue in 1991, said the closure of the facility will result in significant additional pressure on a host of other services. “People end up on the streets for all sorts of reasons, [but] I would say the greatest commonality is around drink and drugs,” the non-affiliated peer argued. “These people will end up in prisons, back on the streets, being more chaotic, filling up A&E. It is a kind of terrible reality that it is a short cost-cutting exercise. What they’re really doing is passing the responsibility back to police officers, social workers, and members of the public. So really what we’re doing is pushing the problems back onto the streets.”

In an interview with Nick Ferrari, the former Health Secretary opened the door to a review of the decision to shut the unit’s doors. “I am going to go away and look at this,” Mr Streeting said. “I look at homeless people on our streets, I look at people with drug and alcohol addiction and it’s no exaggeration to say there but for the grace of God go I. There are so many people in this country who are one or two missed paydays away from being homeless. I’ve seen drug and alcohol addiction in my own family, particularly one of my grandparents, my granddad, who was in and out of prison throughout my childhood, my mum’s childhood. He had suffered terrible abuse as a child and a terrible relationship with alcohol throughout his life. So I’ve seen the worst of some of this. We can’t write these people off, we can’t just say it’s all their fault.”

The former Minister is now reportedly trying to amass the support required to trigger a leadership challenge as beleaguered Prime Minister Keir Starmer struggles to cling onto power after a poor showing in last week’s local elections which saw the party wiped out in its traditional northern heartlands.

On Thursday, James Murray was appointed as the new health secretary following Mr Streeting’s resignation. According to a 2021 review on drug treatment and recovery by Dame Carol Black, each £1 spent on treatment saves £4 through reduced demands on health, prison, law enforcement and emergency services.