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Housing solutions from a public health perspective

This article explores the importance of a safe and affordable home environment for promoting health and wellbeing. It discusses key features of a home and highlights the impact of housing on health outcomes. It also examines the opportunities and challenges in the housing sector for improving public health.

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Housing solutions from a public health perspective

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  1. Housing solutions from a public health perspective Gill Leng Housing & health lead, PHE

  2. Our vision • The right home environment is essential to health and wellbeing, throughout life • A home in which to ‘start, live & age well’ • Key features of home (permanent & temporary): • Warm & affordable to heat • Free from hazards, safe from harm • Enables movement around the home and is accessible • Promotes a sense of security and stability • Support available if needed

  3. MoU delivery plan outcomes 15/16 • The vision is integral to the activities of each of the national signatories • The model is used at a local level to improve health & wellbeing & reduce health inequalities • Local areas understand their populations, their housing and health needs • Evidence of the impact of the home/housing on health and wellbeing is more widely understood • Effective, efficient, innovative and integrated health, care and support, and housing interventions adopted

  4. MoU delivery plan outcomes 15/16 • Learning opportunities by each partner, involving others – housing as one voice • Support local areas and organisations piloting/implementing new models • Homeless Link health needs audit & evidence review, and CIEH housing and health resource • Consultation on standards for evidence (HACT) • SITRA wider workforce learning resources, LGA/SITRA integration publication, Care & Repair Home Adaptations, Housing LIN

  5. Local implementation?DevoManc

  6. Devolution in Greater Manchester Three agreements • Greater Manchester Devolution Agreement - powers over areas such as transport, planning and housing, and a new elected mayor. Ambition for £22 billion handed to GM. • MOU Health and Social Care devolution NHS England plus the 10 GM councils, 12 CCGs, NHS and Foundation Trusts. Estimated budget of £6 billion each year from April 2016. • Prevention (place based) Agreement to cement prevention as a core strand of devolution signed on

  7. Prevention at the centre • Fastest possible improvement to the health and wellbeing of the 2.8 m citizens • Substantial reduction in demand for health and care services • Supports NHS 5 year forward view • Links prevention & health improvement to economic growth and jobs • Local leadership to improve health and wellbeing in the local population

  8. Prevention MoU • Five transformation programmes • Public health, reform and growth – Place based approach to public health, employment and prevention • Nurturing a social movement for change - Enabling & engaging people to make informed life-style choices • Starting Well – Early Years– improve school readiness & address determinants of service demand • Living Well - Work and Health - tackling complex dependency & supporting residents to be work • Ageing Well – Age- & dementia friendly communities • Four enabling priorities • Housing & health • Place based intelligence, evidence, workforce development

  9. Review - housing enabling priority • Does the plan communicate how • The right home environment for health and wellbeing, across the life course, will be enabled? • The housing sector will be engaged in improving outcomes and reducing inequalities? • Considered • Health priorities and programmes of transformation • Plans: full range of local ambitions but not lengthy • Reflection of strong local discussion & agreement • GM Strategic Plan will draw on best examples & propose new strategic frameworks • Likelihood that enablers will need to be collectively developed eg, workforce

  10. Home and housing confident? • Extent to which home and housing circumstances recognised in relation to ambitions? • Unhealthy homes: primary focus on older people • Fuel poverty (4) • Home safety (5) • Unsuitable homes: primary focus on older people • Lack of supply of alternative options (5) • Home adaptations / falls service (4) • Technology (6) • Precarious housing/homelessness • Multiple and complex needs (2) • Extent to which housing sector potential recognised? • Scope and extent not reflected • Limited to existing eg, development, adaptations

  11. Opportunities – across life course • Shifting to prevention & care closer to home • Self-help & self care • Enable informed decisions about housing options • Action to improve quality/suitability of private sector • Demand on health care and better outcomes • Impact of homelessness on health and social care • Hospital discharge • End of life at home • Mental health and wellbeing, and work • Carers • Enabling priorities • Community engagement & building capacity • Workforce development & integrated working

  12. Opportunities – life course • Starting & developing well • School readiness & determinants of long term demand • A strategy to support this through the home & housing? • Living and working well • Harmful drinking: workforce opportunities? • Multiple and complex needs • Unemployment & good employment • Ageing well • In existing homes? • Dementia – beyond friends, existing home, discharge etc, • Falls: systems based approach

  13. The GM plan • The right home environment is essential to health and wellbeing, and economic wellbeing. • To secure the greatest and fastest possible improvement to health, we need to realise the salutogenic value of the home. • Immediate priority to reduce demand for health care through integration of housing interventions at the points of hospital admission and discharge • Will identify further opportunities to prevent and delay the need for health care and social care for other populations,

  14. Our focus

  15. The GM plan • Why are we doing it? • Unhealthy, unsuitable, precarious housing and homelessness affect the health and wellbeing of Greater Manchester citizens • Housing interventions are effective in improving health and wellbeing • What is the cost? • What are we going to do? (next) • Who will direct and enable?

  16. The GM plan – what? • Systems leadership • Research & intelligence • Evaluation and revision • Implement new/revised models • Establish integrated pathways, protocols, data sharing to underpin • Workforce development of health, care and housing sectors

  17. Action • ‘No new ideas’ • ‘Working with housing is so positive’ • ‘Vertical integration does not cost less’ • Horizontal? • Do it with and not to people • Co-produce & commission • You can do most of this already • We don’t need permission • Build and they will come!

  18. Contact • Gill Leng • Tel: 07766 660799 • Email: gill.leng@phe.gov.uk

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