In the year that we celebrate the 70th birthday of the NHS, we often forget that the man credited with its creation, Nye Bevan, was not just the Minister for Health, but also for Housing. His vision for the creation of the NHS was equally matched by a vision of a country living in new vibrant neighbourhoods, rebuilt after the war. In the ten years after the war, 2.5 million homes were built, three-quarters of which were social housing. Nye Bevan, like many of our greatest reformers, understood the connection between good housing and good health.
70 years later we find ourselves in the grips of a crisis, in both housing and in the NHS. Sadly, there is no longer one Ministry responsible for health and housing, and the division between the two policy areas feels far too large.
For many housing providers, integrating with health has always felt like the right thing to do. We all use the NHS, and the people and families who live in our homes often experience some of the worst health inequalities. Tenants, patients, service users, residents, customers – whatever we call them – are the same people, and it makes sense to work together to provide the help they need to live life to the full.
But why is it so difficult? Why does integration feel so out of reach? And how can we make collaboration happen when our attempts to engage seem to go nowhere?
As difficult as it may seem, integrating housing and health can be done. There are many great examples of housing providers who have made it work, who have taken the time to build the right understanding that opens doors, meets the right people and makes conversations easier.
HACT and the NHC are working together to deliver a Seminar in June that will build understanding about the NHS, and share insights about how to make it work in practice. The seminar will give housing professionals everything they need to know about the healthcare sector and the providers they are seeking to engage with.
From the outside looking in, the operating environment for the NHS can seem daunting. Housing providers often struggle with knowing how best to engage, with whom and with which organisations. They often misunderstand how the healthcare market works and struggle to realise the opportunities available to them.
Like the housing sector, the NHS is diverse and made up of a complex network of independent businesses. Like all parts of the public sector, it exists within a complex legislative, regulatory, quality and financial framework. As complex businesses, NHS providers have a range of strategic and operational performance frameworks that, together with defined methods of practice, drive behaviours. And the strategic environment is constantly changing.
The Seminar will build the core understanding needed by housing providers to support their engagement with the NHS. It will explore the key mechanisms and market dynamics of healthcare delivery and share examples and experiences from those who have successfully developed new partnerships, such as Home Group. It will be essential for anyone looking to improve their relationship with the NHS.
The concept behind the ‘home from hospital scheme’ is simple, says Rachel Byrne, executive director for new models of care at Home Group, which has 55,000 homes nationally and works with more than 26,000 vulnerable people through supported housing, justice and health services.
“Not everyone has friends or family to help them settle in safely at home after a stint in hospital, and without that support a patient can’t be discharged,” she says, spelling out the dilemma faced by hospital administrators countrywide. “So that’s where we come in.”
Offering a six-week package of home support, a team of eight full-time care organisers aided by volunteers work across in-patient and accident-and-emergency wards, assessing the needs of patients whose discharge has been delayed due to an absence of a capable carer.
The Home Group team does not offer hands-on physical care, but act as patient advocates, service providers, social groups and a patient’s extended family to help build a support network that not only eases their return home but seeks to guard against re-admittance. “And the scheme is proving as efficient as it is simple”, adds Ms Byrne.
“Up to 90% of our clients are frail and elderly,” says Ms Byrne. “They are often lonely and isolated. What we do is to put the practical stuff in place – make sure the shopping is being done, that they are aware of transport services such as dial-a-ride, and in some cases liaise with online services that can deliver.”
For Ms Byrne the pilot is part of a wider, emerging relationship between health and housing services, where social landlords have a clear offer, and where the results speak for themselves.
“Social landlords are geared up for this kind of role. In many cases we would be delivering this kind of care to our own residents anyway, but here we are extending to the wider population with great results. It’s a win-win situation.”
Book onto our ‘understanding and working with the NHS’ seminar here.