Rob Ralphs is a Professor of Criminology and Social Policy and Deputy Director of the Drugs, Policy and Social Change (DPSC) research centre at Manchester Metropolitan University, England. He has conducted applied drugs research since 1997, often focusing on developing harm reduction, treatment and policy responses.

Background
In 2020, Manchester city centre police recorded 844 incidents of begging and vagrancy, 818 incidents of shoplifting, 616 illegal drug possessions and 1,167 public order offences. Drug use was identified as a key factor underpinning these offences, with nine-out-of-ten arrestees (n=885) testing positive for heroin and/or crack cocaine. In response to this, Manchester’s Street Engagement Hub was conceived as an innovative multi-agency approach aiming to address the underlying causes of drug use and street-based living, prioritising harm reduction over law enforcement. Improved access to drug treatment, including same day prescribing, was central to the Hub model. This presentation reports on its effectiveness.

Methodology
A mixed-methods approach was used involving observing 37 Hub and street engagement outreach sessions, conducting 85 interviews (47 Hub guests, 38 practitioners), and analysing routinely collected anonymised data about guests’ attendance, service engagement and outcomes.

Findings
Poor physical health and related mobility issues had previously hindered service engagement, including missing appointments, especially when this involved travel across the city. Rapid prescribing and housing support were the key hooks into the Hub. Once engaged, guests often accessed other harm reduction support (e.g., wound and tissue care, Hepatitis C testing and Naloxone provision). Co-located multi-agency provision (adult social care, medical services, banking and benefits support, housing, probation, support for sex workers, food banks etc.) at the Hub enabled guests to access a range of services in one place quickly, addressing several issues including health, housing, finance, benefit claims and criminal justice.

Conclusions
Rapid access to treatment services, including same-day prescribing, as part of a co-located multi-agency service provision is an important tool for engaging people living street-based lifestyles who have previously not attended services. Policing initiatives that support instead of punish street-based drug users are more effective in reducing drug-related harms, homelessness, crime, and anti-social behaviour.