Housing’s engagement with health needs to change – and the revolution starts here!

By Andrew van Doorn - on 06/02/2014

With the recent launch of HACT’s Mental Health and Housing Development Programme, Andrew van Doorn, Deputy CEO at HACT, unearths the hard truths about the housing sectors' engagement with the NHS.

I have lost count the number of times I have heard someone from housing bemoan the lack of joined up approaches with health. If I had £1 for every time someone said ‘they don’t understand us’ I would be entering retirement a little sooner. It’s true, health and housing integration always feels a long way out of reach, even though many a fine paper (some of which are my own) have been written about it.

It’s great that the Government is increasingly recognising the importance of housing in delivering health and social care outcomes. It’s also great that they’re pushing £3.8bn of funding into cracking the integration nut (though how much of this will see the light of day and find it’s way to housing is yet to be seen).

But for all this advancement, little seems to be changing at the frontline, with housing and health still worlds apart. As housing associations, we have struggled to get traction in the world of health. And we’ve been frustrated at every turn.

But the truth is, we’ve got to up our game. Housing has fallen into a rather lazy consensus about health, blaming them for our problems with engaging. We’re fixated by the commissioning agenda. Obsessed with chasing the money and then happy to be fed crumbs on the edge. We kid ourselves that we have the solutions even when we struggle to articulate what it is that we actually do (or how we measure it and how we know if it’s any good).

We seem programmed to always ask what we can get from health (£), rather than be secure in proposing what we can give. We never seem to have a conversation that promotes our success as asset managers, with capital and access to finance that health needs and doesn’t have. Our offer (for what it’s worth) is argued from a standpoint that shows no real understanding of how health works, how it’s financed, what matters to them and why (arguing that by doing x saves health y really doesn’t wash). We don’t look to the NHS as potential customers of our skills and expertise.

We speak to the wrong people all of the time (this is part of our commissioner worship) and expect them to have all the solutions (and then moan that they don’t when it is obvious from the start that they wouldn’t).  We spend far too much time trying to influence the Health and Wellbeing Boards, when the real discussions about innovation don’t happen there.

We need to look more towards the providers of NHS services, than to the commissioners. Reconfiguring the supply chain is important, and only the suppliers can come forward with new and innovative solutions. We need to understand that the NHS Trusts are the major providers of healthcare in this country, and work with them to reform the system. They are our future customers and we need to bring convincing business cases to them.

CCGs don’t and won’t have the answers, and will, anyway, be stuck in a perpetual process of politically driven restructuring. But really, why all this attention on commissioners, who do we really think spends the £125bn of health money each year?

There are huge opportunities to do things differently. Parts of the NHS are crying out for the expertise, assets and community connections that we have. The demographics and economics alone demand a future that looks quite different.

So the real issue is, will housing associations rise to the challenge, or will they be swept aside by the private sector moving in? Surely we are better placed to work alongside other non-profit NHS organisations? Surely we can bring forward the new solutions needed to achieve integration?

But there is a long way to go before we can sit round that table, confidently and intelligently, to begin our collaboration. To move this forward we’ve launched our development programme for housing associations serious about entering new healthcare markets with NHS Mental Health Trusts. Seventeen housing associations have signed-up to building their skills, competences and capacity, ending with new collaborations with the NHS. 

Working with Peter Molyneux of Common Cause Consulting and Steve Appleton of Contact Consulting we are bringing new expertise and perspectives to the group, and building on previous collaborations with the NHF and the NHS Confederation Mental Health Network and their strategic work with the DoH.

To accompany this development programme, we will publish a series of blogs that will debunk a few myths about health with a view to constructing a new narrative, offer and engagement for housing. Along the way we may tread on a few toes, ruffle a few feathers, and upset some of the comfy housing sensibilities. But by the end, we’ll be better placed to perform in the healthcare market. We hope you’ll come on this journey with us… 

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