Integrating Health, Housing and Employment: A Mixed‐Methods Evaluation of the East Sussex Well‐Being and Employment Service

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Context Homelessness is a significant public health issue associated with complex needs and poor health outcomes. The East Sussex Well‐being and Employment (ESWE) service was developed to provide holistic, person‐centred support for individuals at risk of or experiencing homelessness, integrating housing, health, well‐being and employability coaching. Methods A mixed‐methods evaluation was conducted using the Consolidated Framework for Implementation Research (CFIR) to assess service effectiveness, fidelity, implementation and economic value. Data were collected from stakeholder and customer interviews, group discussions, surveys and administrative records. Thematic analysis and economic indicators were used to evaluate outcomes across four service pillars: mental and physical health, social isolation, lifestyle behaviours and employability. Results The ESWE service demonstrated positive impacts across all outcome areas. Customers reported increased well‐being, confidence and social connectedness, with improved engagement in health and employment pathways. Housing and Well‐being Coordinators (HWCs) employed flexible, relationship‐based approaches using motivational interviewing and goal setting, although fidelity varied. Co‐location with housing officers and strong local integration were key implementation enablers. The economic evaluation, based on a 12‐month commissioner perspective, showed the service delivered value for money with stable workforce costs and outcome‐related indicators within accepted thresholds. Conclusion The ESWE service is a promising model for integrated support that bridges gaps between housing and health systems. Its adaptable, customer‐centred approach improves well‐being while offering cost‐effective service delivery. Future refinement of outcome tracking and fidelity monitoring could enhance consistency and support scale‐up.

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