NHS Plan: Good health begins at home

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The 10-year plan for the NHS is too good an opportunity for the housing sector to miss, writes Dave Smith. It’s a chance to put affordable, good quality homes at the heart of the health agenda

WITH so much political capital focused on Brexit, it would be easy to overlook the significance of the new NHS 10-year plan which was announced this month.

Dave Smith
Dave Smith, customer first director, First Choice Homes Oldham

The plan sets out where an extra £20.5 billion of health spending will be focused. Crucially £6.8 billion of this money will be targeted at primary and community care and mental health services.

Both the new plan – and the money that accompanies it – give the housing sector a great opportunity to put the provision of affordable, safe, secure, warm and quality housing, which meets people’s individual needs, back at the heart of the health agenda.

Good health begins at home – without good housing conditions, leading a healthy life is almost impossible. We often forget that it was the Department of Health & Housing that led the creation of the NHS at its inception 70 years ago.

The BRE estimate the cost of poor housing costs the NHS £1.4 billion each year, while other studies have had this cost as high as £2.5 billion. This shows the scale of the impact we as a sector can have.

However, for us to influence and shape this agenda and the resultant programme, we need to be engaged individually and collaboratively at the local, borough, regional and national levels – putting our cases, offers and asks forward.

We need to be at the table working and innovating with GPs and primary care providers and our local communities to support local population health improvements and preventive services.

We need to be part of our Health & Well-Being Boards and newly integrated health and care organisations, sharing data and knowledge, planning strategies, co-designing, commissioning and delivering services with them.

The health and care sectors – and this is especially true where we operate in Greater Manchester, with the devolution of responsibilities and funding for health – have been pre-occupied more recently with integrating services, commissioning and governance arrangements and with dealing with the crisis so evident in A&E, hospitals and adult social care (too often centred on clinical solutions).

This is an opportunity for us to change the narrative and agenda for them to co-invest with us into primary and community care services and initiatives that housing can be at the centre of.

To do this we need to demonstrate the difference we can make and how we are prepared to also co-invest into the solutions as well.

Our business-as-usual offer is already quite impressive as we have always provided affordable and high quality homes to many of the poorest and most vulnerable in society, provided specialist supported and extra care housing to the elderly and other vulnerable groups, and provided many other community support services, which deliver positive health and care outcomes.

We play an active role in The Greater Manchester Housing Providers group which has come together and developed its own Health & Well-Being Pledge to outline to our new combined authority and the regional Health & Social Care Partnership how we can help them do more.

This focuses action on five key pledges to better:

  • manage long term conditions and self-care at home
  • connect housing and mental health
  • reduce health inequalities
  • integrate housing, health and care services
  • support discharge from hospital and prevent admissions

Since then, 25 providers in the region have been working hard individually and together to turn these pledges into meaningful outcomes.

For example, First Choice Homes Oldham and several housing providers have now developed hospital discharge services.

In Oldham we 50% fund this with our clinical commissioning group (CCG) and council partners. Our officers are based on wards in our local hospital and identify patients with housing related issues that could delay their discharge.

We put plans in place that utilises our existing services to enable people to return home as quickly as possible – freeing up more beds for new patients. Our work includes arranging temporary and permanent accommodation for the homeless, carrying out minor and major adaptations to homes, or providing resettlement and on-going housing and community support.

The model has been so successful we now provide similar services and interventions based in our local A&E department.

This is a great example of the difference that we can make. We need to do more, and we need to help change the conversation to focus on prevention to improve population health and to provide community care at home.

We also need to do more to help improve support and services for people with mental health issues.

For the housing sector, this could well be our moment.


Dave Smith is customer first director at First Choice Homes Oldham


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