Transcript Document

Commissioning Housing Support for Health
and Wellbeing
Jeremy Porteus, CSIP Networks, DH
About the Housing Learning & Improvement Network
• Policy Implementation: to support DH
to deliver care closer to home agenda
• Key priorities: extra care housing
programme, telecare, national strategy
on housing for an ageing society
• Building capacity and capability:
information, advice and tools on new
markets for commissioners and providers
• Looking at outcomes: new opportunities
for older people and vulnerable people
• Delivery mechanism: network partners
Independence, well-being and choice
“Housing supply has increased substantially in the
last few years but it is still not keeping up with
housing demand from an ageing, growing population
(Source: Homes for our Future, Housing Green Paper,
Communities and Local Government, 2007)
“Shifting care closer to home is one of the pillars that
supports our vision of improved community health
and social care”
(Source: White Paper. Our health, our care, our say: a
new direction for community services, DH 2006)
Policy – housing, health and social care:
• Darzi review (DH 2008)
• Consultation on the future of care and
support (DH 2008)
• Health England report (DH 2008)
• Putting People First (DH 2007)
• Joint Strategic Needs Assessments (DH 2007)
• National Strategy for Housing in an Ageing
Society (CLG, 2008)
The thrust of these policies is to help people
to remain more independent, and to have
greater control over their lives and how
services are delivered
Policy – some imperatives
• Efficient commissioning and procurement (Value for Money)
• Services that maintain independence and prevent deterioration
• Person-centred individualised services
Policy – personalisation and commissioning
Shift towards services that are
personal, sensitive to the needs of
the individual and focused on
maintaining independence
Reorient services towards promoting
health and well-being, and proactive
prevention of ill health
Create a stronger focus on
commissioning for outcomes,
across health and local government,
working together to reduce health
inequalities and promote equality
What are the health drivers for good quality housing?
• over 15 million people in England with a long term condition
• includes heart disease, diabetes, asthma, respiratory problems
and dementia
• proportionally far higher users of NHS and PCTs
• Account for 55% of GP appointments, 68% of outpatient
appointments and 77% of inpatient bed stays
• more likely to be older and have other complex needs leading to
disabilities which require care and/or support
• they live in poor housing, which could exacerbate their condition
and make them more likely to be admitted to a care home
Need a closer look at preventative aspects of housing and related
services to promote well-being of individuals and achieve greater
improvements/efficiencies in local health & care economies
What type of services do people want?
• those that are personable and meet their whole needs not just
sickness and crisis response i.e., low level support as well as FACS
• offer genuine choice and control i.e., individual budgets
• support people to remain independent in safe and caring
communities i.e., floating support, telecare and role of carers
• are delivered as near to their homes as possible i.e., advice and
information, handyperson services
• are better designed for “liveability” and lifetime neighbourhoods
• are joined up so that people don’t have to struggle to find their
way through the system or be given the same information time and
time again i.e., common assessments and ‘one stop’ approach
Shaping and building the market
• Commissioning for price?
• Commissioning for volume?
• Commissioning for health and
wellbeing/prevention?
• Commissioning for innovation?
• Commissioning for improvement?
• Commissioning for service users?
• Service users commissioning?
Thinking, planning and working differently
• Prevention - evidence demonstrating positive practice by providers and
commissioners of housing for older people – including factors that influence
success and maximise health/care benefit/impact
• Partnerships - picture of good links between housing and the health and
well-being agendas:- practice/service based strategic links – eg
(meaningful) inclusion of HIAs, extra care and related services in Local Area
Agreements or in local strategies for older or other vulnerable people
• Personalisation - future of housing and housing related care and support
services for older people and vulnerable people within national and local
delivery frameworks around IB, direct payments, self-directed support
• Performance – meeting local/regional commissioning priorities,
improvement and efficiency gains, and agreed national targets to deliver
local outcomes/shared outcomes eg LAAs
What next for the housing and planning sectors?
• move from opportunism to strategic
commissioning and partnerships with
health and social care?
• understanding system changes in
health and social care eg new NHS
operating framework
• investing in relationship building to
influence key stakeholders in health
and social care?
• implications of future revenue
housing streams from grants to equity
release, from benefits to self directed
support
Some final hints and tips?
• do you understand the needs and aspirations of existing residents
with support needs and those in areas where you are keen to
develop?
• have you taken into account major policy changes and impact on
capital and revenue eg personalisation, regulation and inspection
• how plugged in are you to local strategic partnerships at a
corporate level, especially with health and social care?
• what safeguards have you made for downturn in housing market?
• what impact does the local labour market have on workforce
development, recruitment and retention?
• would you move into the scheme you are commissioning and/or
developing?
Tools and resources from the Housing LIN
• Commissioning Housing Support for
health and well-being (2008)
• Housing for Older People
implementation guide and information
pack, More Choice, Greater Voice
(2008)
• Connecting Housing with the health
and social care agendas (2007)
• Regional Advisory Note and resource
pack (forthcoming 2008)
• Comprehensive list of factsheets,
casestudies and on-line resources
• national and regional network
meetings and events
Questions
• Which partners currently invest in housing related support in your
locality/service?
• Which organisations are missing that could make an effective
contribution
• What approaches could you take to engaging potential partners
in your locality/service?
• Are there performance indicators you could use as incentives?
Thank you!
Jeremy Porteus, National Programme Lead
CSIP Networks
Enquiries:
[email protected]
Website:
www.icn.csip.org.uk/housing