“The NHS bed blocking crisis will only deepen unless we build a new generation of adaptable and care ready homes.”
These are not my words but those of the National Housing Federation that earlier this year issued a stark warning that bed blocking will only get worse unless we build homes designed for later life to include onsite care services.
Significantly, it is not just housing umbrella bodies such as the federation that are championing the case for a renewed focus on the integration of housing and health.
In a recent speech, Michael Dixon, chair of the NHS Alliance, argued that housing organisations could save the NHS billions of pounds each year.
He also reasoned that hospital discharges could be swifter if people had a safe and warm home to go back to while emergency admissions and GP appointments could be reduced through preventative measures.
So if the benefits of integrating housing and health are so clear, what is stopping both sectors working together? And what can we do about it?
Traditionally, housing and health have worked worlds apart, adopting a so-called “silo mentality” – each striving to achieve, often similar, objectives and targets but in different ways.
This is partly as a consequence of differences in funding regimes, as well as contrasting governance structures and regulatory and legal regimes.
While housing has conventionally focused on bricks and mortar and the difference that a “decent” home can make to health, the health service has taken a more reactionary response, concentrating on improving services at the point of entry.
Even where housing has been built for a specific group – for example sheltered housing for older people – linking in with healthcare services or providing them on site has often been an afterthought, and therefore significantly more difficult to achieve later on.
Likewise, the NHS has admitted that it has failed to get a firm grip on prevention in the past and the service is now being urged to look beyond its own confines for solutions to this.
In addition, housing’s “offer” to health has not always been clear, easy to digest or strategically robust enough to appeal to the needs of the health service.
All this matched with different ways of working and professional cultures has, as Richard Humphries, assistant director of policy at the King’s Fund, outlined in a recent blog, risked adding further barriers to the integration of housing and health.
Yet there is good news: things are changing.
NHS Alliance has recently developed an online resource (housingforhealth.net) to allow professionals from both sectors to network and share learning and best practice.
In addition, individual housing providers like ourselves are playing our part by forging closer links with local health bodies and listening and acting on their strategic objectives.
For example, in Birmingham we are working with a local clinical commissioning group with the aim of integrating discharge to assess accommodation into our new multi-million pound care village, College Green.
A first for the city, the village will be home to more than 400 older people and people with disabilities once it is complete. Importantly, it will have a health and wellbeing centre on site.
Within the centre there will be a GP practice, pharmacy and a range of healthcare services, as well as possible accommodation for people leaving hospital who need a little extra help to get back on their feet.
This accommodation is desperately needed in the city and we hope that by providing it at our care village it will play an important role in alleviating bed blocking and ensuring a smoother transition for patients leaving hospital for home.
Prevention has also been a key consideration in the creation of the village and many of the housing elements of the scheme will incorporate wellbeing facilities – such as a fitness suite and an “enriched opportunities” suite for people with dementia.
While work to build the care village is well under way, work to successfully and fully integrate health services continues and we are determined to do it right first time.
We want the village to be an exemplar of how housing and health can work together, and we are confident that we have made the right links and share the same goals as our partners in the health sector to be able to achieve this.
Peter Roach, chief executive, Bournville Village Trust
This article first appeared in LGC’s sister title HSJ