Multi-agency rough sleepers hub (MARSH) – Derbyshire Constabulary

The multi-agency rough sleepers hub (MARSH) is a problem-solving, public health response to rough sleeping in Derbyshire. 

The MARSH has a list of individuals who repeatedly rough sleep or are at high risk of return to rough sleeping, which is regularly updated. Agencies have fortnightly meetings to discuss individuals of concern, and whose complexity requires multi-agency problem-solving to make progress. 

Multiple mechanisms to safeguard and support this vulnerable group have been implemented by the MARSH, including:

• Safe Space – a 24/7 hub in Derby 
• a rough sleeper engagement and support team
• a rough sleeper paramedic
• a partnership enforcement programme

Rough sleeping and repeat homelessness were key issues in Derby, particularly in the city centre. Prior to the MARSH, there were approximately 70 individuals in Derby who were at high risk of eviction, abandonment of their accommodation and rough sleeping.

This group were vulnerable individuals, many of whom were disproportionately both perpetrators and victims of crime and anti-social behaviour (ASB), particularly in relation to substance misuse. A number of these individuals also had long-term physical and mental health problems, learning difficulties, had suffered adverse childhood experiences (ACEs) and post-traumatic stress disorder (PTSD). Additionally, women in this group required enhanced safeguarding, many having been victims of domestic abuse and some linked to sex work.

In the city centre, the ASB and acquisitive crime of this vulnerable group negatively affect the economy, vibrancy and appeal of the city centre to residents, visitors and businesses. This became a high-profile problem, receiving significant media attention, which heightened community fears.

Prior to the MARSH, agencies supported these individuals in Derby independently, leading to overlap between agencies and limited success. Continuing to tackle this problem in this way was financially unsustainable as valuable resources were not being maximised. Staff morale within agencies was low, due to continually failing to make progress with this vulnerable group.

The MARSH was created to enable a multi-agency response to rough sleeping. It aimed to establish a structured and coordinated approach by creating a rough sleeper pathway. This would focus on the most problematic individuals and have a clear direction of response. 

The pathway encouraged a collective responsibility to eradicating rough sleeping, bringing together practitioners and their expertise, skills and knowledge.

Agencies

Agencies involved in the MARSH included:

• housing 
• probation and resettlement services
• adult social care and the multi-agency safeguarding hub (MASH)
• liaison and diversion
• drug and alcohol treatment services
• a rough sleeper paramedic 
• policing – integrated offender management / safer neighbourhood team / neighbourhood safeguarding team
• public protection officers
• mental health trust

Over 30 agencies joined problem-solving conversations on request for their expertise. These ‘fast track’ connections are increasingly being developed to expedite responses and decisions.

Principles

MARSH’s overarching principles shaped the response to rough sleeping.

• More effective solutions enacted without avoidable delay.
• Avoidance of repeating the same response to the same problem with minimal effectiveness.
• Monitoring progress and learning across the system.
• Creating accountability and ownership of partners.
• Increased efficiency and use of each partner’s resources, eradicating duplication and creating a one-stop multi-agency forum.

Objectives

MARSH also has clear objectives underpinning its response.

• No one new to the streets spends a second night out.
• No one lives on or returns to the streets.
• The health and wellbeing of rough sleepers or individuals at risk of rough sleeping is protected and interventions are clinically driven.
• The flow of new rough sleepers onto the streets is minimised.
• The vulnerabilities associated with rough sleeping are recognised and managed to reduce harm.
• ASB impact is minimised and public safety and economic footfall is protected.

Multi-agency collaboration 

MARSH has a list of individuals who repeatedly rough sleep or are at the highest risk of losing their accommodation and returning to rough sleeping, which is regularly updated.

All agencies can identify individuals to add to the MARSH list. Individuals must meet the following criteria:

1. be on the rough sleeper engagement team case load 
2. progress the individual has made to move away from the street has halted, increasing their risk

MARSH meetings 

Agencies have fortnightly Microsoft Teams meetings, co-chaired by a police MARSH coordinator (originally an inspector but now a police staff role) and senior housing lead. They discuss individuals of concern and whose complexity requires multi-agency problem-solving to help make progress.

In the meeting, lateral thinking is promoted to resolve the complex problems individuals are facing. The meeting has a regular format.

• Review the individuals on the MARSH list, with a focus on individuals with a high-risk grading
• Assess whether actions have been completed and how effective these have been in practice. This often results in:
  • further problem solving 
  • re-evaluating the individual’s risk grading 
• Managing a prison list. This allows agencies to keep tabs on those on the MARSH list who have gone to prison. This often results in using prison time to interact with vulnerable individuals, for example working with prisons to complete social care assessments and health care assessments

Professional intelligence notices 

It was identified that a significant amount of intelligence on vulnerable individuals was held by partner agencies but never shared between them. Professional intelligence notices (PINs) were re-established to make information sharing between agencies simpler and more accessible. This helped partners access the information they needed to support individuals. 

Training was provided to assist partners in using PINs, which helped to improve relationships between partners and increased confidence in sharing this information efficiently.

Supporting vulnerable women 

MARSH has a designated workstream around vulnerable women to ensure vulnerable women are safeguarded. Derbyshire Constabulary’s safeguarding team and MARSH have built mutually supportive relationships with several third sector organisations and victim services for vulnerable women with complex needs. 

Furthermore, the police and partner agencies have collaborated more on domestic abuse. This helps them to identify those vulnerable to domestic abuse and enhance the support victims receive.

Safe Space

Funded by the Office of the Police and Crime Commissioner (OPCC) and NHS, Safe Space is a 24/7 hub located in Derby city centre. It provides a single supportive location to receive housing advice, health care, substance misuse advice, support and shelter.

The building was bought and provided by the charity Derby City Mission, repurposing an old job centre. This location allows MARSH partners to collaboratively work from facilities in the building, which include:

• daytime accommodation for around 12 to 20 people 
• night time accommodation for nine people, including two overnight beds dedicated for police drop-offs 
• a fully-equipped clinical room
• two appointment rooms
• living room / TV area
• kitchen facilities
• toilet / shower area 

Any agency can take individuals to Safe Space to help them access the support and services they require. However, only people on the daily agreed list or those dropped off by police or ambulance can be accepted for night time accommodation.

Safe Space allows support agencies to see clients in person and virtually. Additionally, individuals can be discharged from hospital to Safe Space to continue clinical support. A multi-agency clinical team meets weekly to resolve clinical needs and respond to this cohort, who experience significant health inequalities. They are less likely to access support and engage in services the rest of the population do. 

Rough sleeper paramedic

A senior paramedic has been funded by the NHS to treat vulnerable rough sleepers. This role has been pivotal in connecting the local health system with the MARSH. This paramedic can triage injury and illness in the community, helping this group of vulnerable people who otherwise would likely forgo medical attention.

Additionally, the paramedic distributed COVID vaccinations, further protecting this group. As a result of the paramedic’s work, indications are that the death rate of this vulnerable group has decreased.

Tackling substance misuse and ASB in the city centre

The MARSH established the Partner Enforcement Programme (PEP). This tasking group directs partnership resources to tackle visible, problematic substance misuse and ASB in the city centre. This includes police enforcement through: 

• additional patrols 
• a mobile police office
• tackling ASB criminality and begging through dispersal orders and criminal behaviour orders (CBOs)

This work takes place alongside dedicated resource from the council. This includes housing outreach officers, drugs outreach workers and substance misuse workers.

MARSH logic model

• View logic model as a poster

Establishing a multi-agency response 

Coordination of MARSH  

In 2020, responding to the COVID-19 pandemic, multiple agencies in Derby ran a hotel for the homeless. The success of this collaborative working during the pandemic highlighted how continuing and improving this way of working could best support this vulnerable group. 

As a result, Derby Homes seconded two to three days of an experienced inspector’s time through Rough Sleeper Initiative funding (via the Department for Levelling Up, Housing and Communities (DLUHC)). Their role was to act as a dedicated lead to respond and coordinate disparate agencies into a cohesive and high-functioning unit, managing the risk of rough sleeping. 

The inspector was tasked with developing a systematic, structured partnership approach to the management of repeat rough sleepers, forming the MARSH. At present, the MARSH has a police staff member fully paid for by DLUHC Rough Sleeper Initiative funding and is looking to extend this beyond March 2025.

Funding

The Rough Sleeper Initiative grant from DLUHC initially paid for the coordination of the MARSH. However, throughout the COVID pandemic, Derbyshire Constabulary paid for the inspector’s involvement in this work. 

Since the pandemic, Derbyshire Constabulary has additionally supported this work with restricted officer time and by nominating a safeguarding lead to assist. The force safeguarding lead has been pivotal in the MARSH, enabling ongoing communication and updates to problem-solving plans.

Rough Sleeper Engagement and Support Team 

The Rough Sleeper Engagement and Support Team (REST), made up of nine paid rough sleeper outreach workers, is a key agency in the MARSH. Its role is to:

• identify rough sleeping individuals where progress has stalled or was in reverse, with multiple concerns and no obvious solution
• progress actions discussed at MARSH and ensure these actions are taken forward
• retrieve updates from other support workers to take to the MARSH and relay any actions from MARSH
• use and promote the Safe Space as a point of multi-agency contact 
• use Safe Space staff as an extension of their role in and out of hours to keep ‘on message’ with the individual’s support plan

The roles are funded though the council and the Rough Sleeper Initiative grant and hosted by housing. The team was formed prior to the MARSH, with the role changing over time due to the increase in the new entrants to rough sleeping. The team works closely with safer neighbourhood sergeants and plays a pivotal role in the MARSH.

Media campaign 

Alongside implementation, MARSH conducted a hearts and minds media campaign to counteract negative publicity surrounding ASB, drug use and criminality, which was often unfairly levelled at rough sleeping groups. This aimed to help the public re-evaluate their preconceptions of this group. 

A key milestone in this was the Derbyshire Telegraph’s article, ‘A day out with rough sleepers and homeless people’, published in 2021. This article helped to convey a more accurate view of the reality on the streets and the key work being carried out, including the work of the MARSH.

Initial assessments have shown tangible results in reducing rough sleeping. The MARSH has removed demand from front-facing agencies and changed the public’s experience of the city. It has created positive outcomes for a vulnerable and hard-to-engage group in our society.

Safeguarding has been a significant achievement of the MARSH. Prior to this, very few rough sleepers had either their vulnerabilities noted or were provided specific support in relation to them. The MARSH approach has identified individual needs. These include social care needs, learning difficulties which may prevent individuals taking action, repeat victimisation and risk of domestic abuse.  

Additional key outcomes include the following.

• Since its creation, a number of individuals have been managed through the MARSH. Some are now living in properties bought on the open market and furnished specifically for rough sleepers who were a high risk of causing ASB.
• Many rough sleepers have been reintegrated into mainstream society. They are holding down tenancies and employment, which would have been unthinkable prior to MARSH intervention. 
• Between April 2023 and March 2024, a total of 459 individuals accessed Safe Space’s services. This 12-month figure is almost double the number of individuals accessing Safe Space in its first two and a half years after opening.
• While vulnerable individuals have received support, resulting from MARSH meetings, the Safe Space and related services, reductions in ASB records have been observed.
• The city centre safer neighbourhood team has reported a reduction in the number of dispersal orders issued, from 396 in 2018 (prior to Safe Space opening) to 60 in 2024. 
• Accident and Emergency attendances and 999 calls for an ambulance for the cohort have reduced. Most individuals now access support through diversionary and engagement pathways through Safe Space. They contact their GP in a more proactive and timely way, reducing demand on emergency services.
• The MARSH and associated partnerships have had a huge positive impact on the quality of life experienced by users of the city centre. This has been monitored through various measures, for example length of tenancy sustainment and individuals’ visibility in the city and related criminality.

The MARSH has changed the way partners work together, revolutionising operational processes. The unanimous view from all agencies is that MARSH workstreams enable efficiency. This happens through immediate and effective response and engagement with complex and vulnerable individuals who do not access or interact with statutory services in conventional ways. Financially, MARSH creates large annual savings to policing, prison and probation services, emergency and hospital services.

Derbyshire Constabulary highlighted the following key learning for other forces to consider when implementing a MARSH or related work.

Partnership working 

• Use existing connections and networks. In Derbyshire, connections built due to increased collaboration during the COVID-19 pandemic helped to establish the cross-agency partnerships fundamental to MARSH.
• Connect with agencies using common problems. In MARSH, agencies all had a common problem of tackling rough sleeping, so even though agencies had different objectives, this enabled conversations to create change.
• It is critical to provide evidence to justify a large, expensive group of professionals and resources at key stages. Throughout MARSH, data has been collated to support this process and tell the story of the impact of the approach.
• Though the majority of partnership working was positive throughout the MARSH, there was initial reluctance and ‘can’t do’ attitudes from some partners. For example, certain services had set inflexible criteria and were working in isolation. A variety of techniques have been used to overcome this issue. These include: 
  • having challenging conversations about statutory responsibilities
  • being prepared to escalate to funding bodies where issues persist
  • looking for data to show the amount of work rough sleepers are already creating for organisations to evidence the value of getting involved
• SARA (scanning, analysis, response, assessment) methodology is new to many partner agencies, therefore use SARA beyond policing issues. 

Other learning   

• Continuously monitor progress to identify promising work and what isn’t working. Use this to review and reshape practice. To support this, a MARSH impact evaluation tool is being developed to assist with business case development.
• Access government funding streams, such as the Rough Sleeper Initiative grant from DLUHC.
• Visit other projects to see how they operate and bring any learning into your work.
• Conduct regular sessions on problem-solving methodology. This will help ensure a culture of challenge, identifying repeated unsuccessful practice and ensuring more effective solutions are developed.