Homes for health Gill Leng Housing & health lead, PHE HSUG 28 September 2015

What do we mean by housing? Unhealthy and unsafe homes Bricks and mortar impact Unsuitable homes Home environment does not meet needs: disabled people, changing health & care, overcrowding Precarious housing and homelessness Home is at risk, or household is homeless Planning for new homes & neighbourhoods Housing-related services (all tenures) On offer to enable people to live independently in their own home, or to move from crisis into own home An estimated workforce of c. 250,000 people Regular contact with households facing some of the greatest inequalities, in most deprived communities

The problem? Public health impact A wider determinant of health & driver of health inequalities –21% (4.8m) homes hazardous to health – 88% private sector –Affecting 3.6m children, 9.2m working age, 2m pensioners –Need 245k new homes p.a. to meet new demand –Currently building homes rate of 0.5% of existing stock p.a. Homelessness –A consequence & cause of poverty, social & health inequality –Average LA works with 1,470 people facing multiple needs p.a. –Average age of death of single homeless 47 years –Over 90,000 children in temp. accommodation (Dec 2014) –Rough sleeping increased 55% between 2010 and 2014

Cost to the NHS? Sources: Nichol S, Roys M, Garret H (2015) The cost of poor housing to the NHS, BRE; Healthcare for Single Homeless People March 2010 Office of the Chief Analyst Department of Health; HES/PSSRU 2012/13 The cost of poor housing is estimated to be between £1.4bn and £2.5bn p.a. (first year treatment costs only) Single homeless people consume around four times more acute hospital services than the general population, costing at least £85m p.a. The cost of delayed hospital discharge for housing reasons £26m in 2012/13

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

The right home environment ‘Evidence’ suggests it can: Improve health & wellbeing & prevent ill-health Enable people to manage their health and care needs Allow people to remain in their own home for as long as they choose Ensure positive care experiences And it can ‘contribute’ to: Delayed & reduced need for primary care & social care interventions, including admission to long-term care Timely discharge & reduced hospital re-admissions Rapid recovery from periods of ill-health or planned admissions

What we would like to do Enable local areas & professions to understand The profile of homes and populations & health relationship The implications of national changes & local decisions on this What this means for policies & plans to improve health & wellbeing The effectiveness of their interventions How working together they can plan for better health & mitigate impact Focus efforts where we can make the most difference Children and families: adults with multiple & complex needs tomorrow Working age: homes, health & a job – connecting economic growth Ageing well: enabling care closer to a healthy home Pressure points across life course (healthcare public health) Harnessing partners in private & community sectors Raise public awareness – home ownership has health implications

PHE commissioning support Homeless health needs audit & annual report – Homeless Link Health and homes resource – CIEH Home adaptations & integration – Care & Repair Workshops & briefings to support commissioning eg, Homeless Link & NHS; Housing LIN Analyse PlanDo Review Standards in evidence – HACT Rapid evidence review: homeless prevention – Homeless Link IBAs in housing settings – Middlesex University Healthy eating & social landlords – 5 landlords Workforce development – SITRA Inclusion health E- learning resources– Pathway

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