Housing’s offer for health

1. Housing’s offer for health Sarah Davis, Nov 2013

2. A Revolution in a Century Addressing the health and social problems arising from poor housing were key drivers of early housing improvement

3. A Revolution in a Century • Life Expectancy in 1901 was 49yrs (women), 45yrs (men) • Life Expectancy 2008 was 82yrs (women), 77yrs (men) with 50% living to 80 • Start of the NHS in 1948 48% died before 65yrs - now it is less than 18% • Healthy Life Expectancy at birth is 63.5 years for men and 65.7 for women. • Increase in life expectancy is currently outstripping the increase in Healthy Life Expectancy

4. Housing impacts • Respiratory problems • Cardiovascular problems • Increased risk of infections • Falls and accidents • Hypothermia and excess winter deaths • Depression • Mental health • Emotional and educational impacts • Decent homes: 65% O/Occ,22% PRS, 13% social

5. Housing & Health Why it matters & what we can do together

6. The Housing Sector Challenge Can we rebuild the health connection and put housing centre stage again? Does Housing understand health sector priorities? The NHS needs to make £20 billion of efficiency savings Integration with social care Role of Public Health Are we able to clearly set out how housing can contribute?

7. Cost of poor housing to the Health purse • Pick a number between £850m - £1.5b per annum • Included & some unknown additional costs • delayed hospital discharge • admissions to A & E • repeat GP visits • other emergency interventions eg asthma, cold homes, end of life • prescription costs incl anxiety, stress……etc

8. Practical housing examples • Hospital 2 Home • Blue light falls service • SHOOTS • Smoking cessation • Exercise classes • Cookery lessons • Loneliness & social isolation • A Good Death • Housing conditions • Range, quality, choice • Decent and accessible neighbourhoods • Thriving communities • Connected neighbourhoods – facilities, transport, opportunities • Mental and physical wellbeing • Inclusion, involvement, safety • Health inequalities and PH messages • Quality of life

9. JRF reports • Housing, health and social care agencies are not effectively collaborating to provide services for vulnerable people • There is little evidence of three-way links between all the agencies. • Links between social services and health are reasonably good, but both tend to exclude housing.

10. Ready for ageing? HoL committee on public service and demographic change: Government and our society are ‘woefully underprepared for ageing’ ‘ A better health and social care system to support people to stay living independently needs adequate housing and support in the home’ • Adaptations and repairs needs to be universal • More specialist housing

11. Housing & Health Policy Drivers What’s hot

12. Wider policy & practice drivers • Public Health – demography & inequality • Welfare reform • Rising demand for health & social care services • Health & Social Care Act • Care Bill • BUDGET REDUCTIONS • Skills & capacity

13. What Housing needs to know Health structures & opportunities

14. What Housing needs to know • Local structures – Health & Wellbeing Board, Public Health & CCGs • Local priorities – all of the above & JSNA • Local drivers – demographic profile, housing needs, current provision, public sector cuts, welfare reform • National and local outcomes frameworks

15. What Housing needs to do • Work in partnership across the local area • Build a concise, costed and outcome focussed housing offer • Demonstrate VFM, impact and outcomes across the outcomes frameworks • Identify local champions • Lobby, inform and evidence Housing needs, impact and contribution • Celebrate successes!

16. Real time example West Leics CCG – strategic priorities • Early identification and prevention • Improved self management • Supporting independence • Increase planned care • Targeting inequalities • Reduced hospitalisation • Supporting early discharge and reablement • Supporting death in usual place of residence

17. Rhetoric to Reality Chartered Institute of Housing: www.cih.org source of information, support and professional membership Hospital 2 Home resource pack www.dh.gov.uk/health/2012/10/hospital-2-home/ Integrating Housing Help into the Hospital Setting ‘If only I had known…’ www.careandrepair-england.org.uk [go to Home from Hospital] – Cost benefit evaluation and ‘how to’ info Housing LIN www.housinglin.org.uk/

18. Targeting partners’ priorities Older people

19. An ageing resident profile? 2.4million more older households by 2036 9 million people over 65 in England can currently access just over 1.35 million places in specialist housing or care homes. Over 40% of households in social housing have a disability or are over 65. This figures is set to rise People with dementia over 65 years of age are currently using up to one quarter of hospital beds at one time But majority of older people live well at home into older age

20. Older people’s housing • Older people spend 70-90% of their time in their home • 2.4 million older households live in non-decent homes. Conditions are worse where occupants: - are aged over 75 - have lived in the same house for over 30 years - are from black and minority ethnic communities

21. Housing our ageing population 90% of older people live in ordinary housing Nearly 70% are home owners, the remainder are predominantly in social housing Supported housing for older people accounts for less than 5% of the market (729,818 units) 1.5m individuals report having a medical condition or disability that requires specially adapted accommodation Shortfall of 240,000 specialist housing with care to keep pace with demand, including housing for people with dementia

22. And… • Average cost of dementia care is £24,647 pa more than average UK salary, and • Falls cost Govt £981m, 59% on NHS • £121m every month could be saved on care home places if support at home was available • Social isolation impacts

23. But…. • In June 2013 there were over 1 million workers over the age of 65 in the UK – the highest since records began. • 28% of those aged 75 and over have internet access in their home. 3% of over 75s own a smart phone. • A poll by the Royal Voluntary Service found that one in five - around 2.2 million people over the age of 60 - help out with at least two different charities

24. Creating housing choices for life Your views & ideas please

25. Specialist housing

26. Getting us ready for ageing A new vision of and role for retirement housing Positive models – how can we build on these? What will make it possible? http://www.cih.org/resources/PDF/Policy%20free%20download%20pdfs/Creating%20housing%20choices%20for%20life.pdf CIH/ Housing LIN

27. Options Legacy: Remodelling/converting Retro-fitting/refurbishment Upgrading, maintenance and repairs Decommission Change of use Service models: Hub and spoke Clusters New development – housing with care and support fund

28. Thank you Contacts for further thoughts project ‘scribe’: Sarah.davis@cih.org Domini Gunn, Director of Health and Wellbeing CIH, domini.gunn@cih.org www.cih.org Jeremy Porteus, Director of Housing LIN j.porteus@housinglin.org.uk www.housinglin.org.uk

29. Thank you for listening. Happy to take questions. sarah.davis@cih.org www.cih.org Thank You