Patrick Vernon - Health Partnership Coordinator National Housing Federation Health Session

1. Patrick Vernon - Health Partnership Coordinator National Housing Federation Health Session BMENational Annual Conference

2. Priorities for health commissioners • Persistent health inequalities • Ageing population • Unmet mental health needs • Premature deaths • Complex conditions • Prevention • Health promotion • Self-care • Shifting resources out of hospitals • Designing integrated services • Early intervention

3. The Memorandum of Understanding (Dec 2014) Principles Context Framework Shared action plan

4. Shared Commitment to • Healthy homes, communities and neighbourhoods to: • Reduce inequalities • Deliver better health outcomes

5. Talk of Integration • Care Act 2014 • NHS 5 Year Forward View • PHE ‘From ‘Evidence to Action’ • Dalton Review • Spending Review and Budget • Better Care Fund

6. The building blocks

7. Where can housing help?

8. Take a life-course approach Life Course Starting well Living well Ageing well Mental health support Homeless interventions Healthy lifestyle choices Access to employment Refuge support Troubled families Teenage Parents Specialised housing Adapted housing Home based support Tackle isolation

9. What makes a difference? • Decent and affordable housing • Employment and access to adequate income (minimise debt) • Good child-care and education • Healthy life-style choices • Supportive and healthy neighbourhoods • Good social networks

10. What can housing associationsdo? • Invest in decent housing • Invest in people and place • Become part of the platform of opportunity and forge strong relationships with Public Health • Target resources – improve the health of the poorest fastest • Adopt a life-course approach • Invest in evidence, research and evaluation – look at data-sharing and partnership opportunities

11. Some Challenges • Silos persist • Competitive contract culture • Mismatch - commissioning cycles and long-term investment • Evidence about integrated services is mixed! • Risk, Reduction, Resources • Housing left holding the ‘baby’

14. Our examples are drawn from a large audit (and personal knowledge). We have both missed good examples, but also found good practice. But the large majority of HAs in the audit were not currently using economic arguments. • Doing which economics, for which audience, at what time is where the skills lies, don’t do an all-signing cost-benefit analysis unless its really needed. • Interviewees expressed frustration that despite ‘good numbers’ and ‘economics’, health wasn’t always listening. The call for evidence, including economic evidence, can be a delaying tactic. • But, stick with it, in place-based systems these are and will be important tools. • ‘Doing the economics’ is important in itself, but can also clearly signal commitment, helps build trust and strengthen relationships. But a good business case is NOT all about the economics…

15. Outputs

16. Evidence & Other Factors • Government policy and requirements • Recognised best practice • Decision-makers’ personal beliefs • Acceptability of intervention by health community • Confidence in person/organisation • Local priorities, political support, timing • Narrative: how the intervention will solve a problem • Whether it will reduce NHS demand, save money • Cost-effectiveness, value for money

17. Five economic arguments Housing associations… …homes are safe, decent homes that enhance wellbeing. This has health impacts that are valued, and can save the NHS money, quickly can help to alleviate the overall cost burden of illness and treatment can help to offset and reduce the NHS and care costs of delivering care to individuals can demonstrate cost-effectiveness in meeting health and NHS objectives can demonstrate positive cost–benefits in terms of the value of health produced and savings to the NHS

18. Developing a business case:what does good look like?

19. Key Points for Business Case • Their context/drivers are changing • They need to feel they understand you “Anything resembling a sales pitch is not good” • You need to be very explicit/precise about how you believe your intervention will solve their problem (whether or not you have economic evidence of it) – logic models, living case studies • Just counting ‘numbers assisted’, not enough • Choose most persuasive economic evidence to draw on / generate • Sequence well and be punchy!

20. Using NHS surplus Land Better Project

26. Transforming Care • Building the Right Support, (https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-nat-imp-plan-oct15.pdf ) • Developed jointly by NHS England, the LGA and ADASS • 48 Transforming Care Partnerships across England to re-shape local services, to meet individual’s needs • New Service Model for commissioners across health and care that defines what good services should look like

27. The Transforming Care programme has the following focus: • More choice for people and their families, and more say in their care; • Providing more care in the community, with personalised support provided by multi-disciplinary health and care teams; • More innovative services to give people a range of care options, with personal budgets, so that care meets individuals’ needs; • Providing early more intensive support for those who need it, so that people can stay in the community, close to home; • For those that do need in-patient care, ensuring it is only for as long as they need it.

28. Role of the Federation • Working with Department of Health and NHS England as a partner to promote the housing offer and to influence the local commissioning partnerships. We have a national Task and Finish Group with a range of stakeholders to promote the housing and care and support agenda. • Please keep us informed of your local experiences of Transforming Care as we can provide directed feedback and comment to the Task and Finish Group. • NHS England is currently developing resources to support commissioners in developing housing to achieve the objectives set out in Building the Right Support. We are looking for case studies on any housing models you currently provide for children, young people or adults with a learning disability and/or autism. Please find attached • We are also collecting case studies on Learning Disabilities and housing which will contribute to new guidance being produced by NHS England for local commissioners

29. Launch of Capital Fund for Housing and Technology for People with Learning Disabilities • DH new capital investment fund of £25m over the next two financial years (£10m in 2016/17 and £15m in 2017/18) in technology and housing for people with learning disabilities as part of Transforming Care programme. • DH is not looking to identify a single ‘winning’ approach. • DH expects innovation and impetus to come from local authorities, working closely with people with learning disabilities and family carers

30. The Department are looking for proposals that increase the capacity to deliver assistive technology and housing arrangements that provide innovative, person centred and flexible approaches to supporting independent living and maximising individual rights. • This capital funding will be deployed to enable local authorities to lead the way in bringing about a real change in how assistive technology and housing for people with learning disabilities can improve quality of life and outcomes for individuals and their families. • For further information and the application form please visit: https://www.gov.uk/government/publications/housing-and-technology-fund-for-people-with-learning-disabilities. The New Story can be found at: https://www.gov.uk/government/news/help-for-people-with-learning-disabilities-to-live-independently • Please also note the closing date for applications is 28 October 2016. Any queries should be sent to: H&TC-Fund@dh.gsi.gov.uk.

31. Role of Better Care Fund • Opportunity in placing housing as part of the integration agenda • Vision beyond DFG grants and focus on system and transformation change • Winter Pressures/Delayed Discharge potential Win Win scenario • Better Care Fund Mark2 launch in November

32. Board Engagement • Developing database of board and senior executives who also sit on NHS boards • Aim to share experiences on sitting on boards • Sharing good practice • Promoting the opportunities of health and housing integration

33. Patrick.Vernon @housing.org.uk Follow @ppvernon on Twitter Look at the Health Partnership Hub http://www.housing.org.uk/policy/health-care-and-housing/health-hub/