Joining up Commissioning Sue Adams, Care & Repair England

Housing and Health Causal Links  Many of the chronic health conditions experienced by older people have a causal link to, or are exacerbated by, particular housing conditions  These include heart disease, stroke, COPD/ respiratory conditions, mental health, arthritis and rheumatism  Housing also linked to acute problems eg. falls The Building Research Establishment quantifies the costs to the NHS of specific aspects of poor housing as over £600 million per year

 Health - a key driver for any public expenditure, including housing related  Public health now a local authority function  Failure of housing will impact on health and care service demand  Integration - Better for people

The Ageing Link  People over 65 account for: ◦ 37% NHS Primary Care spend (c.£27bn) ◦ 46% Acute Care spend (c.£ 27bn) ◦ 12% of total NHS budget is on community health care (largely older people) (c. £12bn)

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 over 65

Where older people live 90% in mainstream housing 75% home owners Older people living independently at home are high priority for older people, social services and health

 Fast adaptations to existing home  Fast smaller odd jobs & repairs eg. to enable hospital discharge, falls prevention  Information and advice about housing and care – housing options workers, including move on help  Good supported housing options (all tenure)

Rhetoric into Reality Integrating Housing Help into the Hospital Setting ‘If only I had known…’ two reports Cost benefit evaluation and ‘how to’ info Self Help Housing Information linked to major long term health conditions (stroke, heart disease, dementia, respiratory, macular disease, arthritis) [click Home from Hospital]

 North Somerset – Weston Hospital  Led by Supporting People  Utilising all of the SP funded voluntary sector services within Home from Hospital Partnership  Early days re: truly joint commissioning but seen as paving the way/ building evidence

 Main gain is to health and social care. Will need health ‘buy in’ to continue due to SS funding only for critical and housing funding low priority  Adult social care uncertainty – housing mentioned in White Paper but to what extent?  Identifying common outcomes drivers

 Do you have local examples to share?  What do you see as main challenges?  Ideas for overcoming the challenges?