Integrating health, care and housing – don’t wait to be asked

Within the media stories, there is rarely a mention of the other important piece of the jigsaw – housing. The delayed hospital discharge costs to the NHS in England are estimated to be in the region of £820 million annually (National Audit Office 2016). Being able to return to suitable housing, with the care and support you need, is the key to reducing these costs. More broadly, we know if we want to maintain good health, feel in control and improve quality of life in later life, we need to live in a suitable home.

Outside of the media headlines, there is much debate about the integration of health, social care and housing amongst professionals. Judging by the number of requests I and colleagues have had in the past month to attend or speak at conferences on the subject, it feels like today’s hot topic! Indeed, Ageing Better, Anchor and Hanover recently hosted a seminar in Birmingham.

It was clear that in the room were a committed bunch of people who agreed with the principle of more joined up health, housing and social care services and believed that this could lead to better care, support and quality of life for people in later life. It was equally clear that there were huge barriers in the way, making it often seem too difficult within the current system. These barriers were named in the discussions but were also made visible by who was not in the room (work pressures preventing some from attending and a dominance of housing and social care professionals).

Since the seminar, we have seen the Government publish a Housing White Paper, with reference to our ageing population. The Spring budget delivered £2 billion of new funding for social care for the next three years and a commitment to publish a green paper outlining options for future funding. The Communities and Local Government Select Committee launched an Inquiry into Older People’s Housing. Positive signs maybe, but more detail (and action) is needed.

There were many different voices in the room that day in Birmingham but common themes and ideas emerged for action:

Identify and share examples of innovative new housing and care models that are better suited to the changing needs of the ageing population. Mental health services have experience of how to successfully integrate health services with housing from which to learn.

Ensure innovative examples are evaluated and generate evidence of what works, for whom and in what contexts. A common set of outcomes that focus on wellbeing (not just health) and a common approach to evaluation would help.

Ask the Department for Communities and Local Government, the Department of Health and the Department for Work and Pensions to come up with concrete plans following the Housing White Paper to invest in better, more diverse housing options for our ageing population. Establishing a fair funding settlement across housing, health and care is part of this.

Encourage the NHS to trial new models of integrated health, care and housing, for example, through the NHS Vanguard sites, with shared objectives and outcomes, aligned planning and financial time horizons, and sustainable risk and return models.

Encourage other local authorities to follow the example of London, where lifetime standards have become mandatory for new housing. We also need to support planners to respond to the requirements within the Neighbourhood Bill to plan for future needs of an ageing population. This should include existing housing stock as well as new homes.

Ensure people in all housing tenures have access to reliable information and advice about available housing options in their local area as well as how to access funding to support adaptation of their current homes.

Housing, health and care services need to better understand people’s social networks and the assets in communities that can provide social support to enable people to remain resilient.

Of course, as ever, these things are easier to say than to do. However, another important message from the day was ‘don’t wait to be asked’. We can’t wait for a radical change to the system before acting. Despite the challenges and pressures, we can all do something.

Ageing Better, Anchor and Hanover have launched a report from the seminar and are looking at how we can work together to help create change in relation to housing, health and social care.