Housing for Health & Wellbeing – the way forward

1. Housing for Health & Wellbeing – the way forward Domini Gunn: CIH Director Health & Wellbeing

2. Content • NHS & Housing • Impact of changes • Current LA pressures • Generational needs & responses • Building partnerships/ co-production • What we need to do • Some tools that might help • Interesting facts

3. NHS Constitution 2012 ‘[The NHS] is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives.’

4. Housing Constitution 2012? Committee on Economic, Social and Cultural Rights, the principal U.N. body entrusted with overseeing the realization by governments of the right to adequate housing, “the right to housing should not be interpreted in a narrow or restricted sense which equates it with, for example, the shelter provided by merely having a roof over one’s head or views shelter exclusively as a commodity. Rather it should be seen as the right to live somewhere in security, peace and dignity.” • V. Annex 1, General Comment No. 4 on the right to adequate housing (Article 11, § 1), § 7, • adopted 13 December 1991.

5. The Universal Declaration of Human Rights (1948) “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (Art. 25)

6. NHS structure before reforms

7. New delivery structures

8. Joseph Rowntree • 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.

9. Cost of poor housing to the Health purse • Pick a number between £1.5b - £2.5b per annum • Included & some unknown additional costs • delayed & unsustainable hospital discharge • admissions to A & E • repeat GP visits • other emergency interventions • prescription costs………………..etc

10. Meeting generational needs

11. Health & Social Care Act 2012 • Clinical Commissioning Groups – CCGs • Health & Well Being Boards • Public Health – LA role Other critical legislation: • Care & Support Bill (May 2013) • Welfare Reform

12. LA Housing drivers • Strategic housing role (where is it?) • Planning framework (supported housing) • Housing needs (FACS impact/ JSNA / DFGs) • Housing options (choice & control, personalisation) • Homelessness • Private rented sector • Commissioning and/or delivering housing related support (HRS) • Welfare reform/ future impact Universal Credit • Care & Support Bill incl Adult Safeguarding panels

13. Business model for partnership working & co-production

14. Fit for purpose?

16. VFM TOOL – Quality Assist

17. Health spend…£20b to be saved • More than 70 % of hospital bed days are occupied by emergency admissions • 10% of patients admitted as emergencies stay for more than two weeks, but account for 55 % of bed days • 80% of emergency admissions who stay for more than two weeks are patients aged over 65

18. Life expectancy • 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% • Of babies born in 2012, 135,000 men and 156,000 women are expected to still be alive by age 100 compared to a total 14,500 centenarians in 2012.

19. Thank you Domini Gunn, Director Health & Wellbeing Chartered Institute of Housing domini.gunn@cih.org