1. Health and housing PHE’s perspective Gill Leng Housing & health lead, PHE Housing LIN NW 3 November 2015

2. 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

3. The challenge? Health impact Poor housing affects 3.6m children, 9.2m working age adults, 2m pensioners 19% of adults in poor housing have poor mental health 28% of young people in cold home have 4 or more negative mental health symptoms, compared to 4% in warm homes Average council works with 1,470 people facing multiple needs p.a. C. 40% have poor mental health Average age of death of single homeless person 47 years NHS costs p.a. At least £1.4bn poor housing: cold homes & falls related to the home >£85.6m single homelessness – A & E attendance & admission >£26m delayed transfer of care – lack of housing £ as a result of mental health?

4. Cost to the NHS? Sources: Nichol S, Roys M, Garret H (2015) The cost of poor housing to the NHS, BRE; and Garret H, Burriss S (2015) Homes and ageing briefing, BRE The cost of poor housing is estimated to at least £1.4bn p.a. (first year treatment costs only) New BRE calculation – over 55s 2m households in poor housing 1.3m homes with Cat 1 hazard £624m p.a. cost to NHS –£442m excess cold, £131m falls Between 4 – 7% accessible

5. PHE’s role in local public health Remit to Develop capability in the local public health system Inform decision making, based on evidence Enable a shared understanding of Relationship between home and health locally The national framework & the local response What these mean for policies & plans to improve health & wellbeing – challenges and opportunities The effectiveness of housing interventions, for whom and when How working together professionals can plan & deliver for better health

6. PHE commissioning support Homeless health needs audit & annual report – Homeless Link Health and homes resource – CIEH Home adaptations & integration – Care & Repair England 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

7. Analyse: Homes & health evidence resource Website: www.cieh-housing- and-health- resource.co.uk

8. Analyse: Homeless health needs audit www.homeless.org.uk/our-work/resources/homeless-health- needs-audit/health-needs-audit-toolkit

9. Plan: Home adaptations & integration www.careandrepair-england.org.uk

10. Plan: Cold weather plan Websites: https://www.gov.uk/ government/upload s/system/uploads/a ttachment_data/file /468160/CWP_201 5.pdf

11. Do: Wider public health workforce Website: www.sitra.org/policy- good- practice/housing-for- health/housing-and- public-health/

12. Do: Housing and health exchange http://www.housinglin.org.uk/Topics/browse/HealthandHousing /Health-Exchange/

13. Review: Standards on evidence http://www.hact.org.uk/standards-evidence-housing

14. The future? Where can we have an impact? Children and families: essential to improve life chances Working age: connecting homes, health & a job, securing future older population’s health Ageing well: enabling care closer to a healthy home Pressure points across life course eg, hospital What do we need to do? Support systems leadership Continue work on intelligence and evidence Develop workforce & others (home a consideration for all) Enable partnerships & market, incl. private & & VCS Raise public awareness to inform decision making

15. Contact Gill Leng Housing & health lead Tel: 07766 660799 Email: gill.leng@phe.gov.ukgill.leng@phe.gov.uk Twitter @gill_leng