1. Housing’s offer for health
Sarah Davis, Nov 2013

2. A Revolution in a Century
Addressing the health and social problems arising from poor housing were key drivers of early housing improvement

3. A Revolution in a Century
Life Expectancy in 1901 was 49yrs (women), 45yrs (men)
Life Expectancy 2008 was 82yrs (women), 77yrs (men) with 50% living to 80
Start of the NHS in % died before 65yrs - now it is less than 18%
Healthy Life Expectancy at birth is 63.5 years for men and 65.7 for women.
Increase in life expectancy is currently outstripping the increase in Healthy Life Expectancy

4. Housing impacts Respiratory problems Cardiovascular problems
Increased risk of infections
Falls and accidents
Hypothermia and excess winter deaths
Depression
Mental health
Emotional and educational impacts
Decent homes: 65% O/Occ, 22% PRS,
13% social

5. Why it matters & what we can do together
Housing & Health
Why it matters & what we can do together

6. The Housing Sector Challenge
Can we rebuild the health connection and put housing centre stage again?
Does Housing understand health sector priorities?
The NHS needs to make £20 billion of efficiency savings
Integration with social care
Role of Public Health
Are we able to clearly set out how housing can contribute?

7. Cost of poor housing to the Health purse
Pick a number between £850m - £1.5b per annum
Included & some unknown additional costs
delayed hospital discharge
admissions to A & E
repeat GP visits
other emergency interventions eg asthma, cold homes, end of life
prescription costs incl anxiety, stress……etc

8. Practical housing examples
Hospital 2 Home
Blue light falls service
SHOOTS
Smoking cessation
Exercise classes
Cookery lessons
Loneliness & social isolation
A Good Death
Housing conditions
Range, quality, choice
Decent and accessible neighbourhoods
Thriving communities
Connected neighbourhoods – facilities, transport, opportunities
Mental and physical wellbeing
Inclusion, involvement, safety
Health inequalities and PH messages
Quality of life

9. JRF reports
Housing, health and social care agencies are not effectively collaborating to provide services for vulnerable people
There is little evidence of three-way links between all the agencies.
Links between social services and health are reasonably good, but both tend to exclude housing.

10. Ready for ageing?
HoL committee on public service and demographic change:
Government and our society are ‘woefully underprepared for ageing’
‘ A better health and social care system to support people to stay living independently needs adequate housing and support in the home’
Adaptations and repairs needs to be universal
More specialist housing
Quickly through – explains where we are coming from, why we are doing this

11. Housing & Health Policy Drivers
What’s hot

12. Wider policy & practice drivers
Public Health – demography & inequality
Welfare reform
Rising demand for health & social care services
Health & Social Care Act
Care Bill
BUDGET REDUCTIONS
Skills & capacity

13. What Housing needs to know
Health structures & opportunities

14. What Housing needs to know
Local structures – Health & Wellbeing Board, Public Health & CCGs
Local priorities – all of the above & JSNA
Local drivers – demographic profile, housing needs, current provision, public sector cuts, welfare reform
National and local outcomes frameworks

15. What Housing needs to do
Work in partnership across the local area
Build a concise, costed and outcome focussed housing offer
Demonstrate VFM, impact and outcomes across the outcomes frameworks
Identify local champions
Lobby, inform and evidence Housing needs, impact and contribution
Celebrate successes!

16. Real time example West Leics CCG – strategic priorities
Early identification and prevention
Improved self management
Supporting independence
Increase planned care
Targeting inequalities
Reduced hospitalisation
Supporting early discharge and reablement
Supporting death in usual place of residence

17. Rhetoric to Reality Chartered Institute of Housing: www.cih.org
source of information, support and professional membership
Hospital 2 Home resource pack
Integrating Housing Help into the Hospital Setting
‘If only I had known…’ [go to Home from Hospital] – Cost benefit evaluation and ‘how to’ info
Housing LIN

18. Targeting partners’ priorities
Older people

19. An ageing resident profile?
2.4million more older households by 2036
9 million people over 65 in England can currently access just over 1.35 million places in specialist housing or care homes.
Over 40% of households in social housing have a disability or are over 65. This figures is set to rise
People with dementia over 65 years of age are currently using up to one quarter of hospital beds at one time
But majority of older people live well at home into older age

20. Older people’s housing
Older people spend 70-90% of their time in their home
2.4 million older households live in non-decent homes. Conditions are worse where occupants:
- are aged over 75
- have lived in the same house for over 30 years
- are from black and minority ethnic communities

21. Housing our ageing population
90% of older people live in ordinary housing
Nearly 70% are home owners, the remainder are predominantly in social housing
Supported housing for older people accounts for less than 5% of the market (729,818 units)
1.5m individuals report having a medical condition or disability that requires specially adapted accommodation
Shortfall of 240,000 specialist housing with care to keep pace with demand, including housing for people with dementia

22. And…
Average cost of dementia care is £24,647 pa more than average UK salary, and
Falls cost Govt £981m, 59% on NHS
£121m every month could be saved on care home places if support at home was available
Social isolation impacts
59.2% of those cost on NHS, 66% falls in over 75s
49.4% inpatient admissions
41% long term care
SCIE 30 and 60 on isolation

23. But….
In June 2013 there were over 1 million workers over the age of 65 in the UK – the highest since records began.
28% of those aged 75 and over have internet access in their home. 3% of over 75s own a smart phone.
A poll by the Royal Voluntary Service found that one in five - around 2.2 million people over the age of 60 - help out with at least two different charities

24. Creating housing choices for life
Your views & ideas please

25. Specialist housing

26. CIH/ Housing LIN Getting us ready for ageing
A new vision of and role for retirement housing
Positive models – how can we build on these?
What will make it possible?

27. Options Legacy: Remodelling/converting Retro-fitting/refurbishment
Upgrading, maintenance and repairs
Decommission
Change of use
Service models:
Hub and spoke
Clusters
New development – housing with care and support fund

28. Thank you Contacts for further thoughts project ‘scribe’:
Domini Gunn, Director of Health and Wellbeing CIH,
Jeremy Porteus, Director of Housing LIN

29. Thank You Thank you for listening. Happy to take questions.