Published: 06/05/2004, Volume II4, No. 5904 Page 42

Inspired by a New York project, healthcare workers and homeless people could benefit from Urban Village, a holistic scheme which provides affordable housing.

Last year, Pink Floyd guitarist David Gilmour had a house in London he no longer needed and wanted to do something useful with it. Rather than hand it over to charity, he sold the house and gave the proceeds -£3.6m - to homeless charity Crisis. An admirable gesture, certainly, but one you would think has little to do with healthcare.

However, Mr Gilmour's philanthropy helped kick-start a scheme that will help to keep health workers in London and, by giving homeless people a secure place to live, save the NHS millions.

Crisis and the King's Fund had been itching to start such a project, based on a New York scheme, Common Ground, which houses former street homeless and key workers in a former hotel in Times Square.

Progress with the London project had stalled but planning is now underway to develop a£50m project of 400 units divided equally between ex-street homeless people and key workers, known as the Urban Village scheme.

The New York building houses Ben and Jerry's ice cream and Starbucks coffee shops, which offer employment to tenants, in addition to mental and physical healthcare and practical support to help them find employment and continue to live in the project.

Though commercial partners have not yet been announced for the London scheme, Crisis project manager Josephine Lee says the approach will be much the same.

'This kind of holistic approach does not currently exist in the UK. It offers housing, health, regeneration and support in one package - all to support ex-homeless people and help them break the cycle of homelessness.'

Only single people are allowed residence in the scheme New York, and this rule might also apply in London. But all tenants can stay as long as they can pay the rent and some have lived there since the scheme began in 1996.

In London, either a new build or a refurbishment will be considered; this is far less of a concern than finding the right affordable site. The site needs to be big and space in London is at a premium, but 'two or three' sites are under consideration. A decision is likely to have been made by the end of April.

'It will have to be a minimum of 150,000 square feet and upwards, ' explains Ms Lee. 'It is not easy finding a site that big in London.

It needs to be a vibrant area that is convenient for key workers and has good transport links. Of course, all that means It is going to be expensive.'

Having a 50/50 split between tenant types will be essential.

'We want to create a cohesive community. Key workers can provide a model for the exhomeless tenants, some of whom will not have been in work for a very long time. It is important they are surrounded by people who get pay cheques and are able to buy nice things, rather than people who have also have been out of work for a long time, ' says Ms Lee.

Health services in the Common Ground facilities are designed to be discreet so as not to attract attention to anyone going to them, and there should be no obvious way of spotting which tenant is a key worker and which used to live on the streets.

'One of the reasons we have always been supportive of this scheme is that we are interested in the broadest sense of improving health, ' says King's Fund director of grants Steve Manning.

'Clearly this will help improve the health of former homeless people. Evidence from the New York model suggests that the annual saving to the public purse, for every 200 former street homeless people housed, could be from£700,000-£1.2m a year.

'Homeless people are heavy users of emergency services, and often their health has degenerated to the point where they become users of specialist services. Over 10 years, we calculate there could be savings of up to£10m.'

Though a provider has not been named, it is thought likely that a primary care facility that would also be used by other local residents could be based in the scheme.

While Common Ground began by offering a wide range of health services, the model has changed as the tenants became less dependent on them and started to lead more independent lives.

'The philosophy has changed, ' adds Mr Manning. 'These are ordinary homes and the people in them want the support to be able to lead ordinary lives. They do not want to be a in a quasimedical institution.

'It will be a community within a community. There is the potential to make a real difference to an area and help regenerate it.'

Support facilities based in the building - which may be provided by the key worker tenants - will provide advice on retaining tenancies, paying bills, healthy eating and maintaining physical and mental health.

Quality will be key. The Common Ground project foyer contains a grand piano and a chandelier; the aim is for the building to look like any other swish New York apartment block.

It is redecorated to a high standard every three months.

'This is not a hostel, ' says Mr Manning.

Both he and Ms Lee emphasise that it is too soon to give an opening date; 2006 is the earliest that has been mooted so far.

But there are plans to build similar projects across the country. 'We have the will to make it happen, ' says Ms Lee.

'We will prove the project with a pilot; this will not be a single project. We are always on the lookout for sites.'