1. Wheatley Academy, Glasgow
Social housing providers: a gateway to better health and wellbeing Gillian Young
Understanding tenant needs: better intelligence, better services Monday 21 November 2016
Wheatley Academy, Glasgow

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Overview
RESEARCH EVIDENCE
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... of impact
Triangulation
... that cost effective
Widen understanding of role of housing in shaping health and wellbeing
Is there research to substantiate the housing contribution?
Some observations on the evidence challenge

4. Healthy and sustainable homes and places
Sufficient supply of mainstream and specialist homes to meet local needs
Chronic under-supply increases numbers inadequately housed and deepens accessibility problems (overcrowding etc)
No reliable method for estimating and projecting supply and demand for specialist housing provision
Extra Care (England) and Housing First (international) can be cost-effective but lack evidence for other specialist housing
Well designed and maintained homes
Well documented links between poor quality and hazardous housing and various physical and mental health problems
Costs to NHS (£1.4 billion in England)
Evaluations shows actions to improve homes and tackle fuel poverty most cost effective when targeted at people ‘in need’
Attractive and accessible places to live
Location matters: access to work, health facilities etc
Physical neighbourhood (green space, amenities etc) associated with positive health and wellbeing
Impact and cost effectiveness of location and physical upgrades to neighbourhoods unclear

5. Living and aging well
People can access suitable and well situated homes at a cost they can afford
Sub-market social rents make it easier for low paid to escape HB & housing cost induced poverty (both on rise)
Secure tenancies enable people to put down roots but allocations can disadvantage some vulnerable groups
Rent arrears can signal other problems, including, physical, emotional or mental health problems
Lacking evidence on impact housing management
Fewer people are homeless and struggle to access community based services
Costs to the public purse of failing to prevent and resolve homeless promptly are very considerable
Do not always benefit from post resettlement support to ensure continuity of health and social care
Lacking evidence on impact and cost-effectiveness of housing prevention and multi-agency solutions
Integrated pathways improve a person’s experience of getting and staying home
Evidence broadly supportive of housing role throughout the care pathway, including intermediate care provision
Large gaps in our research based understanding (not just housing)

6. Stronger, resilient and connected communities
Living and aging well
People can access the advice and support they need to occupy, pay for and maintain their home
Adaptations and property related services: prevent falls, prompt discharge & improves subjective health and wellbeing
Lack of advice and practical support for vulnerable households to navigate housing system/move house
No major evaluation of housing related support
Stronger, resilient and connected communities
Engage and empower communities in the co-production and delivery of services
Communities that function well are healthier, cause less management problems & less expensive to manage
Tenant participation and volunteering has tangible community and individual benefits
Social landlords often well placed to build social cohesion and community assets (advocacy, catalyst, navigator roles)
Lack robust evidence on health , wellbeing and poverty outcomes
Strong, cohesive and safe communities

7. Reality bites Research evidence based is very mixed
Many reasons why it is hard to establish solid evidence on the health and wellbeing benefits from housing interventions
Disputes over methods and data - expectations? stalling? avoiding?
Many other forms of evidence: expert knowledge, local evaluations, individual vignettes, guidance
Evidence based or evidence informed?

8. Some tentative conclusions
Policy making in the real world is complex and messy
Be clear about local context , local H&SC Partnerships priorities and what is wanted
Be clear about what outcomes you want to achieve and how going to deliver this (theory of change)
Killer stories that are rich in context (quantitative and qualitative)
Invest in getting to know partners , building mutual understanding and trust, data capture, data sharing and evaluation