28 Apr 2022

Helping to tackle health inequalities

Poor homes are costing the NHS £1.4 billion a year, according to BRE’s updated analysis of the financial impact of poor homes in England, with wider societal costs possibly as high as £18.5 billion. Where we live matters, and housing is a significant determinant of the underlying health inequalities that have been shown up so starkly by the pandemic. The physical condition of the home; the security it brings; what it costs to run and maintain; the accessibility and adaptability to the needs of the occupants – all of these are factors that impact positively or negatively on physical and mental wellbeing. Tackling health inequalities and preventing ill health is a focus for both councils and the NHS, and the social housing sector is a key partner for them in achieving those aims.

New opportunities to support such a strategic join up were included in the government’s adult social care reform white paper, People at the heart of care, with the ambition to ‘make every decision about care a decision about housing’, and a commitment of £300 million to support robust strategic planning, integrating housing with health and care. This was followed by the health and social care integration white paper, joining up care for people, places and populations, with emphasis on designing shared outcomes that place person centred care, improvement of population health and reducing health inequalities at the heart of integration.  

Many places have already begun to look at how better to tackle issues for shared communities and develop integrated approaches built around people and places, and are well placed to capitalise on this emerging national and local impetus.

A virtual roundtable held by Grand Union Housing Group and CIH looked at how the sector could capitalise on the strong focus on health inequalities and the new opportunities for partnership working that are emerging from changes in the health and care landscape. Bringing together public health leaders across three councils (Bedford, Central Bedfordshire and Milton Keynes) and social housing leaders from the area and beyond, the aim was to reflect on successes so far and how to build on that foundation to extend the positive outcomes across the communities both sectors serve.

Bringing services and support together around individuals and communities

Social landlords are often dealing with housing management problems that arise from complex health needs but can struggle to get access to support for residents. Making those connections has paid off for one rural community where previously significant anti-social behaviour and crime was being driven by drug and alcohol misuse. Grand Union housing and public health partners drew together a toolkit of training for housing staff, and referral pathways to existing services that enabled them to provide positive support for households, and reduce the impact on and concerns of the wider community. It’s a blueprint for the partnership approach now being extended to other areas, involving other social housing providers.

Investing in building trust and relationships

For public health, the ability of social landlords to reach large numbers of households and communities who are key recipients for important health messages and intervention is critical, as is their long-term investment in those communities. So the team took on housing expert to broker relationships and build trust with social landlords and through them, their residents. Provider partners are similarly taking on health expertise to help them to understand health priorities and to talk health’s language. Investing time and resources to build trust and relationships is key.

Scaling up, ready to take new opportunities

The next step for the three councils and their housing partners is to move beyond separate individual schemes to embed this as the natural way of working, together and with communities, finding a framework that is flexible enough to adapt to the different needs of different areas, but clear and accountable to the communities with which they work as well as all the partners.

Getting this right will set the partners up well for the new opportunities that are arising from the changes in the health landscape, as the current integrated care systems develop into statutory integrated care boards in 2022, and as these boards establish integrated care partnerships with the local authorities, with a renewed focus on improving health across local places.

Making that happen would require housing partners to find ways to collaborate and organise into networks to ensure appropriate representation. But these might provide the best opportunity to take forward ways for public health, health and housing to work better together for the benefit of their communities.

Find out more with the paper from the roundtable: Sharing the art of the possible: developing stronger health and housing partnerships.