A Foot in the Door: engaging housing organisations in JSNA and JHWS Ed Harding, HK Consulting For the Northern Housing Consortium January 2012

Who we are Policy Efficiency Practical tools and support –‘A Foot in the Door’ published Oct 2011 –Co-designed with housing, public health, NHS & care

Health inequalities Life expectancy at birth by social class England and Wales, 1992–

Cost of health inequalities Health inequalities every year account for:- Between 1.3 and 2.5 m years of life lost Increased NHS treatment costs well in excess of £5bn Lifestyle factors estimated to cost the NHS £10bn pa, society £37bn and cause 140k preventable deaths pa Together smoking and alcohol cause 25% of the DALY lost in the UK Losses from illness associated with health inequalities –Productivity losses of £31-33 billion –Reduced tax revenue and higher welfare payments of £20-32 billion Source: Fair Society, Healthy Lives: A Strategic Review of Health Inequalities in England Post-2010

Overarching agenda 1.Give every child the best start in life 2.Enable all children, young people and adults to maximise their capabilities and have control over their lives 3.Create fair employment and good work for all 4.Ensure healthy standard of living for all 5.Create and develop healthy and sustainable places and communities 6.Strengthen the role and impact of ill health prevention

Why engage housing in JSNA and JHWS?

History of improvements but problems remain 6.7 million homes in England failed the decent homes standard Fuel poor households in England dramatically increased from 1.2 million to 4.6 million Year on year, poor housing conditions are implicated in –up to 50,000 deaths (over 36,000 excess winter deaths in 2008/09 in England and Wales), –cause 0.5 million injuries and illnesses that require medical attention; and contribute to increased risk of cardiovascular diseases, respiratory diseases and depression and anxiety.

Cost of poor housing The estimated costs to the NHS in England each year stand at £600m to treat the health impacts of poor housing. Later revised to more than £1bn after reviewing the costs due to Excess Cold.

But don’t forget….. Unsuitable housing Lack of affordable housing Space standards Homelessness Overcrowding Unemployment, debt, lack of enterprise culture Poor educational attainment Crime, domestic violence and anti-social behaviour Exposure to green space Pollution

Looking ahead - welfare reform? 670,000 households affected ‘Up to 5 years to find alternative housing’ HFN: of those ‘under occupying’: –72% have disability or major health concern –81% have no one in employment –42% to struggle financially

Housing has a broad offer

Council Registered Provider ALMO LSVT Charities, Almshouses etc Housing is a broad sector

The case for investment is strong £1.6bn spent on housing related support = £3.41bn saved to the Treasury including £315m saved in the NHS pa Cap Gemini (2008) Research into the financial benefits of the Supporting People programme, DCLG £1 spent on adaptations = £69.37 saved in NHS over 10 years £1 spent on insulation = £34.19 saved in NHS over 10 years £1 spent on overcrowding = £6.71 saved in NHS over 10 years HCA 2010 Frontier Economics, Financial benefits of investment in specialist housing for vulnerable and older people

Competing pressures Poor outcomes Persistent health inequalities Rising costs, demand and expectations Something better for less Old problem, unique opportunity

New partnerships

New opportunities

(New) approaches “The asset approach values the capacity, skills, knowledge, connections and potential in a community. In an asset approach, the glass is half-full rather than half- empty.”

Our case studies Wakefield – early intervention in the community – Health inequality workers Newcastle – housing-led hospital discharge teams Bristol – using JSNA to change the relationship between housing and health Doncaster – using cost neutral approaches to make housing and indispensable partner

Contact Sarah Taylor Ed Harding