The Housing Contribution to Health and Social Care: Key Challenges

This briefing outlines the key challenges facing Health and Social Care Partnerships (HSCPs) from a housing perspective.

Significant progress has been made in relation to housing’s role within health and social care integration since the development of the 2016-19 Strategic Commissioning Plans, Housing Contribution Statements and the new Local Housing Strategies.¹ In many HSCPs there is a clear commitment to collaboration and prevention, along with an understanding of the importance of maintaining strong links between housing, health and social care.

However, the external environment remains challenging. Over the next ten years need for housing, care and support is projected to outstrip current supply.² These needs include long term care and support, low level home care, on site housing support, adaptations and small repairs. To meet current and future need collaboration across health, social care and housing must be sustained and enhanced.

In this context HSCPs and their delivery partners should consider the following as priority areas for forward planning and joint working:

• Improving the joint analysis of housing, health and social care needs: a move towards joint analysis and a shared evidence base for the Joint Strategic Needs Assessment, Local Housing Strategy and Housing Need and Demand Assessment so these are more closely aligned in future.
• Improving strategic and operational planning structures: in particular how housing, health and social care authorities collaborate and interact in relation to strategic planning, service commissioning and service provision. For example by ensuring that housing authorities and housing associations are integral members of the Strategic Planning Group and Locality Planning Groups.
• Identifying and implementing initiatives to gain a better understanding of the housing sector’s role in improving health outcomes: housing, health and adult care services should develop closer working relationships in the commissioning of supported housing and housing support services to maximise impact for individuals and the wider health and social care system.
• Providing effective Housing Options advice: ensuring Housing Options advice is effective and widening this service to help people stay at home for longer as they get older. Opportunities exist through relationships with housing, health and social care to prevent and intervene earlier for at risk groups, including those at risk of homelessness.[3] This should involve communities, the voluntary sector, primary and secondary health care, allied health professionals, social care, housing and homelessness departments.
• Responding to the needs of the older population: the updated national older persons housing strategy[4] must connect with other policies and strategies which affect older people, complete with clear outcomes and measurable actions. The challenge for HSCPs is to connect the dots across areas such as dementia, social isolation and loneliness.[5] Some HSCPs and Integration Joint Boards have a Transformational Programme which will redesign services for older people including Discharge to Assess, Hospital at Home, telehealth and telecare.
• Measuring the success of the housing contribution: housing’s contribution to health and wellbeing can be measured in a number of ways including through the Strategic Commissioning Plan Annual Performance Report and annual monitoring of the Local Housing Strategy. Housing partners should monitor their operational functions as they relate to the Local Housing Strategy outcomes, e.g. on housing management, housing investment and homelessness. To improve this future Local Housing Strategy annual reports should contain a specific statement on housing’s contribution to the National Health and Wellbeing outcomes and Strategic Commissioning Plan.
• Homelessness prevention: joint working in relation to the prevention of homelessness and repeat homelessness through early intervention should be enhanced. ^[6] To do this Housing Options should be extended to include identifying health and social care needs. There is also a need for HSCPs to develop a better understanding of homelessness prevention so that services are more able to identify and respond where people are homeless or at risk of homelessness. This should include a specific focus on at risk groups, including care leavers and those leaving prison.

[1] As reflected in the Integration Joint Board Annual Performance Reports and Local Housing Strategy Annual Reports

[2] Taking into account Local Housing Strategies and Strategic Housing Investment Plans

[3] Scottish Government, Health and homelessness in Scotland: research’, July 2018

[4] Scottish Government, ‘Age, Home and Community: next phase’, August 2018

[5] Scottish Government, ’A Connected Scotland: our strategy for tackling social isolation and loneliness and building stronger social connections’, December 2018

[6] Following on from the Housing and Rough Sleeping Action Group’s recommendations see Scottish Government, Homelessness and Rough Sleeping Action Group: final recommendations report, June 2018