Our NHS (National Health Service) is facing colossal challenges to deliver healthcare from the beginning of our lives until the end. Bringing care out into the community along with implementing preventive health measures across the UK will prove vital to achieving quality care for all. Housing providers have a role to play in collaborating with the NHS on transformation partnerships and sharing expertise to improve health outcomes through improved housing provision.
The evidence that quality housing supports good health is well established; the challenge lies in healthcare provision and housing providers working together to improve health and make valuable savings on precious services. Across the UK the greatest example of the future integration of the built environment and healthcare is in the building of NHS Healthy New Towns; the creation of communities that put people’s health at the centre of their design.
As of yet, there is no overarching set of policies that architect an integration of housing and health. This is in part because like the housing sector, the NHS is not one body but a collection of NHS providers across varied organisations that have specific roles and circumstances to comply with depending on the local population. However, work is being done to establish more connected working between housing and health. Inside Housing has suggested that healthcare and social services alongside housing services should take “equal status” in Sustainability and Transformation Partnerships.
In theory there is everything to be gained from the health and housing worlds working closer together, all too often they operate in silos and are disconnected and detached from each other.
What are Sustainability and Transformation Partnerships?
A planning framework for NHS services was introduced in 2015 for 44 local areas to develop a 5-year plan from 2016-2021. The ambition was for 44 areas representing on average 1.2 million people each to transform how they meet the national criteria for public health.
For Sustainability and Transformation Partnerships (STPs) to succeed, the NHS, local government and service providers have had to engage in joint working and break down silos to offer greater efficiency. According to think tank, the King’s Fund, 26 housing and health organisations alongside NHS England and local leaders have collaborated to reduce health inequalities and build a framework to provide healthy homes through cross sector partnerships.
What are the aims of STPs?
- To address the health and wellbeing gap, by addressing health inequality and focusing on prevention
- To harness innovation and technology to ensure quality improvement of local care is fairly distributed across the UK
- To apply funding where it is most needed to achieve financial sustainability and to transform services
It is clearly in the interests of the NHS to work more closely with housing.
Where does the housing sector fit in?
Of the three aims, addressing the health and wellbeing gap is the most pertinent to the housing sector. Housing providers are already adept at providing those in housing with extra support but there is a contribution to be made in utilising their entrenched relationships with and knowledge of local communities, and their ability to manage multiple assets and interests and to raise capital for development and investment.
As part of a long-term STP strategy, Bedfordshire, Luton and Milton Keynes have committed to building local centres where health and housing services are co-located. One Housing Group, in partnership with the Camden & Islington NHS Foundation Trust provide supported housing for residents living with mental health issues that might otherwise see them in hospital beds. Exploring these models of care can achieve significant savings to the public purse. Their claim is that the equivalent support in hospital costs the public purse £3,000 per week as opposed to £600 per week in supported housing.
Of the 44 STP plans submitted, 75% include housing in their strategy to deliver health and social care, with Nottingham and Nottinghamshire being the areas whose 5 year plan named housing as a core element. This included ill health prevention measures, such as ‘warm homes on prescription’ to ensure heated homes in the winter are more affordable. Housing providers who can identify tenants at risk of fuel poverty would benefit from these schemes being available to protect their residents and properties.
The STPs – in their current form and as they evolve in accountable care systems – won’t succeed if they are driven by an approach that looks only to the immediate future and seeks only to alleviate financial pressures. Equally, they will fail to achieve their vision if they omit working with key partners, such as housing organisations. Of all providers in the housing sector, housing associations are ideally placed to help relieve pressures on the NHS, and are ready and willing to be involved.
The role of technology in STPs
For housing providers, technology can be an essential tool for delivering targeted support to those at risk. Public health issues ranging from fuel poverty to domestic abuse can be identified by harnessing the power of data. Getting a picture of the individuals living in housing stock and understanding when interventions need to take place to support wellbeing is key to any wider health initiative.
Our tenancy analytics solution draws on multiple internal and external sources of data to piece together a full picture of the living situation of social housing tenants, enabling housing providers to proactively identify those at risk and intervene early.
The domestic abuse module within our Streetwise software meanwhile, gives safeguarding teams the ability to tackle domestic abuse in their homes. Housing Association, Poplar HARCA uses this to manage cases and identify repeat offenders so they can take action to protect their tenants. Using the case management system, “You can see linked incidents through the perpetrator and victim tab when you click on the address. This is really helpful when deciding on action to take against repeat perpetrators and also when considering what other support can be put in place for someone who may have experienced repeat victimisation.”
It is essential that local authorities, housing associations and the services that assist them articulate what they can offer in partnership with the NHS in terms of life-long health. Long-term joint working is becoming embedded across social housing to address societal challenges like domestic abuse and antisocial behaviour. This could take the form of building more opportunities for integrated care to happen in the home, conducting repairs for ageing residents to stop preventable falls or utilising technology and data to identify residents at risk of preventable ill-health. Sustainability and transformation plans are a springboard for an integrated care system, where good quality housing is central to life-long health.