Opportunities to Reform Healthcare Northern Housing Summit 22 February Manchester Neil Revely Executive Director People Services, Sunderland City Council Chair, Association of Directors of Adult Social Services, Housing Policy Network

Housing – not new in supporting Health & Care! Public health in the mid-19 th century established to tackle the cause of infectious diseases – poor housing & sanitation Much of what the social housing sector does was born out of the public health movement Better designed and better housing standards fundamental to improvements in health and daily living since early 20 th century Modern planning and design fundamental in supporting independent living Home adaptations and disabled facilities grants long established Innovative new models of housing supporting current and future generations to live independently

The Policy Context Marmot Review - to improve Health and Wellbeing, need to improve the social determinants of health Health and Social Care Act - Reforming health services and creating Health & Well Being Boards Care Act - An overarching vision for adult social care including an emphasis on housing solutions Better Care Fund – requires integration and needs to drive significant efficiencies Five Year Forward View – Healthy New Towns Memorandum of Understanding – Improving Health through the home

Memorandum of Understanding NHS England initiated discussions with the Housing and Care sector ADASS hosted the process supported by DH and PHE Live action plan Regional/Local action and implementation

Revised Pathways – out of hospital care Manage Demand & Avoid Cost Prevent or reduce levels of demand; acute (inpatient, A&E and outpatient care), primary (community health) and social care (residential, intensive home care) Reduce Costs Reduce unit costs e.g., tariffs for condition specific interventions Reduce costs of pathways Reduce staffing costs/overheads Outcomes for People Most importantly much better for people and families

Making Housing Count – the opportunities Housing is critical to deliver revised pathways Housing impacts on physical and mental well being and health inequalities Supports maximising independence Keeping people central to their communities The housing offer is evolving to meet new and emerging demand and aspirations Achieves improved outcomes for people, carers, families Willing partner supporting integrated working and substantial health and social care efficiencies

Components of the Solution Vision to Reality 1 Stop Information/Advice Home Improvement Agency Generic Home Support Services Aids/Adaptations Telecare/Telemedicine Health & Social Care Assts/Teams (24/7) Integrated Primary Care Teams (Incl Rapid Response) Rehabilitation Supported Housing Specialist Housing Schemes

Housing Delivery Models Structural Traditional – identify need, secure funding, build Council Stock/Housing Associations (Existing Stock, incl adapting) Purchase from Housebuilder/Developer (Reduce lead in time) Private Rented Sector (Utilise existing stock or purchase – new and through the property market) Support Core and Cluster Integrated Teams/Linked Schemes Rapid Response Dedicated teams

Alternative funding sources: what’s new? Institutional lending/bond market Special Purpose Vehicles Social Finance Insurance-backed products Public/Private partnerships Personal equity/individual asset management Neighbourhood based solutions eg co-housing Partnerships/JVs with NHS trusts Use of NHS Estate/ public land disposal (Building a better Britain) Home to Buy/Mortgage Guarantees

Specialist Housing – example Seafarers Way Extra Care Development Extra care housing designed for dementia – new build Grade 2 listed ‘Old Orphanage’ - refurbishment Informal Partnership – Investor, LA, RP, HLF Private investment linked to Pension Funds

Specialist Housing – example Dovecote Meadow Extra Care ‘village’ 175 units including 17 for people with dementia Avoiding Public Subsidy Partnership Funding/Shared Risk Flexible rental/purchase

Contact Details Neil Revely Executive Director People Services Sunderland City Council Civic Centre Burdon Road Sunderland SR2 7DN Tel: