This comment piece was originally published in 24Housing on 23 September 2019
Eight months ago, the NHS long-term plan was published, setting out the priorities for healthcare over the next decade, as well as explaining how the NHS funding settlement would be used. As government continues to focus on reinvest in health and healthcare, it’s clear that housing has a critical role to play. The issue, however, is whether housing realises this is the case.
The long-term plan recognised that to address the needs of the population now and in the future, there needs to be investment in community-based solutions at a preventative level, as well as in redesigning healthcare services to bring together new delivery partners. It brought to the fore the potential role of housing associations as anchor institutions in the work they do in neighbourhoods.
This potential role isn’t just about the provision of supported housing. Housing also has a role to play through its community investment activities, as well as in alleviating some of the pressures on the NHS workforce, for example. The role of housing in place-based population health will, in fact, be crucial to the future success of the NHS.
To understand why, we need to look at the concept of population health, which has now come to the fore. Whereas in the past the focus of healthcare investment had been on dealing with health at the point where it deteriorated by, for example, investing in hospitals, population health asks what needs to happen earlier in order to help people live healthier lives for longer. In other words, how can we invest in services that prevent future hospital admissions.
Housing associations clearly have a role here. Before they take this step, they need to understand the building blocks of population health.
There are three building blocks:
- • Primary Care Networks (30-50,000 people);
- • Integrated Care Networks (200,000 people); and
- • Integrated Care Systems (1-2 million people).
The role of housing in Primary Care Networks and Integrated Care Networks is very important, because housing has the assets and resources to make a difference not only to their residents’ lives, but also to their local communities.
But understanding that environment, and what is shifting and shaping the health sector, is challenging.
There are some housing providers who are delivering exceptional health services. Notthingham City Homes is leading the way in demonstrating the role that housing can play with health. They estimate that their Housing to Health service saved the public purse over £2.1 million last year.
Similarly, Radian and Polar HARCA are pioneering social prescribing services in their local areas. The GLA has now embraced the role that housing associations can play in delivering social prescribing services in the capital.
HACT is also working with numerous housing and health providers, helping them to understand each other, building trust and confidence so that they can make this new integrated approach to health become a reality. We’re also running a development programme for housing associations, so they can learn about Integrated Care Systems in more detail.
In October, HACT, in partnership with the Northern Housing Consortium and the Centre for Excellence in Community Investment, and supported by 24Housing, is hosting a housing and health conference that will focus on the role of housing in place-based population health.
As well as looking at the opportunities for housing in Primary Care Networks and Integrated Care Systems, we’ll also be examining the changes that are forthcoming in specialist care in the NHS, for example in mental health and disability learning. Here the role of housing and supported housing is something that can drive forward health outcomes in a community setting, although it will take time to build confidence between the two sectors.
What should be noted, though, is that underneath a lot of these recent developments is a general feeling of tiredness within the NHS about the competitive tendering process. There is a sense that it hasn’t delivered the healthcare improvements that it was meant to deliver.
So now there is a drive within health to find collaborative rather than competitive solutions. Now, more than ever, the time is for housing to get involved. In the next ten years of the NHS, it’s clear that housing has a big role to play.