Roy McNally

Foundations

How can housing associations support

independent living?

Foundations

National body for home improvement agencies

Department for communities and local government

older / vulnerable client group

Interventions in the home

what’s a home improvement agency?

Why home improvement agencies?

Design their services around the needs of the client

Project manage works in the home

Protection from rogue traders

Casework to bring in other assistance measures

HIA Coverage

Housing Association HIAs

Interesting facts………..

65 + age group will make up 28% of population by 2028 (England)

People born today can expect to live to 100 years

Living longer but with multiple health conditions

In UK 80 % of over 65s live in own home

NHS

PUBLIC HEALTHSOCIAL CARE

HOUSING

primary and secondary care service

health improvement

Essential………often overlooked!

community care

• Deliver substantial benefits

• To the client – wellbeing

• To the public purse –independence away from statutory services

• Outcomes that cut across statutory frameworks

• Better Care Fund – forcing integration

Why are housing interventions so important?

• 20th Century drop in Infant Mortality

related to house building not just health

innovations

• 19th & 20th Century rises in life

expectancy overwhelmingly associated

with environmental factors

• Where you live matters

• Hilary Thomson’s review of 39 studies

1887-2012 confirms health improvements

from housing

Longitudinal impact studies

Non-integration – A long history

operating in silos

siege mentality

poor data-sharing

sovereignty

A common scenario

Woof Woof !!

I’m cold and can’t afford to heat the

house?I can’t get upstairs

to the bathroom?

They’ll want me to go in a home?

I’m feeling depressed!

Money problems

I don’t want to be a burden to my kids!

Where do I go? What do I do?

I can’t cope

If anything happens to me

who’ll look after my little dog?

I miss doing the garden

Home security

Respiratory problems

Fear of crime / social isolation

Slips trips & falls

Mental Health issues

Financial abuse / Rogue Traders

This is the plan This is the plan This is the plan This is the plan

Integrated Care

Forcing integration

Planned at CCG / H&WBB

Supports Prevention

Expects Innovation

Better Care Fund – Turning it inside-out?

BCF – A mechanism to force integration

New Care Bill emphasises ‘duty’ to integrate

Driven by austerity – no new money

Seeks reduction in duplication and cost

Designed to protect Social Care budget

Reduce expenditure in ‘acute’ to invest in prevention

Social Care

B

A

D

C

Source PSSEX1 England, 2011-12 Final Release

A – Older people (65 and over) £8.79 bn

B – Adults with physical disabilities (18-64) £1.58bn

C – Adults with learning disabilities (18 – 64) £5.19 billion

D – Adults with mental health needs (18-64) £1.15 billion

Social care expenditure by user 2011/12

• Funding pressures – doing nothing no longer an option

But……• A opportunity to leverage other non-public purse

funding.

• An opportunity to develop more creative partnerships which are both more cost-effective and cause-effective

Austerity – Cost & Cause effective solutions

The Liverpool Healthy Homes Example

Reducing health inequalities

Focus on environmental / lifestyle

Focus on most deprived SOA

BRE estimate save £50M

The Bolton Example

Self–assessment of well-being

Common assessment framework

Predictive modelling software

HIA / Housing integral to plan

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