Is the only ship you wouldn’t sail in a partnership?

Published on Tuesday, 24 April 2012 11:54
Posted by Scott Buckler

Despite some success, the history of health and care in England contains a long chapter on missed opportunities, stubborn organisational boundaries and failed partnerships. The maelstrom of the re-organisation surrounding health and care offers an ideal opportunity to look again

Here, we take a closer look at partners who are doing just that, using housing as our lens– although similar lessons could be learnt in any sector – to see how building strategic relationships and working together not only improves outcomes for individuals, but offers a solution to some of those big problems around resources, investment and cuts.

Housing has long talked about evidence linking bricks and mortar to health and wellbeing. So why don’t partnerships across health, care and housing happen more often? Here we look at two examples – strategic partnerships (Bristol) and service design (Newcastle) - to give you a taste of how things might work differently where you are.

Using JSNA to change the relationship between housing and health

Housing officers in Bristol City Council used their local JSNA to build stronger strategic partnerships by working with the JSNA team to use housing data - including the Housing Health and Safety Rating System (HHSRS) - to predict where the worst housing conditions were and how they impact on health.

The findings led to a partnership between the Private Rented Sector team and public health to run a programme of Home Action Zones (HAZs) targeting the ten most deprived areas of the city. The service offers a range of home improvement and adaptations informed by JSNA analysis and include subsidised energy efficiency improvements, subsidised loans for home
improvements, free home fire safety checks, and small adaptations and equipment such as bath boards, grab rails, WC pan risers and grabbers/pickers funded by disabled facilities grants Bristol. The team also offers support and advice to landlords managing housing for vulnerable people.

The Chartered Institute of Environmental Health’s HHSRS Cost Calculator has implied annual savings from the programme to the NHS of £7.4m. A satisfaction survey of Bristol residents also found that very high numbers of people who had received from a home adaptation or improvement felt healthier, happier, and more comfortable.

Housing-led hospital discharge teams in Newcastle

Newcastle’s multi-disciplinary team deals with hospital discharge and homelessness in the city. The need for an improved and integrated service was clear; preventing homelessness was a priority for the local authority and improving independence, quality of life and health and wellbeing for vulnerable groups was high on the NHS agenda. Partners knew that timely support and suitable housing maximises the chances of an individual recovering independence and quality of life post discharge, whereas homelessness or inappropriate housing can increase dependency, poor ill-health, continued service use and hospital readmission.

An agreed protocol between Newcastle Strategic Housing Service, Social Services, Newcastle Hospitals NHS Foundation Trust and Your Homes Newcastle signs all agencies up to a set of working principles about the way peoples housing needs are managed across services. The protocol enables the joint commissioning of housing-based services that
ensure appropriate housing is available for clients when they leave any of the hospitals in the city.

The programme has reduced the average wait for priority need cases from making an application to moving into appropriate accommodation from 179 days to 29 days. Although the programme is yet to be subjected to robust cost modelling, reduced hospital stays and readmissions, along with increased sustainable tenancies and appropriate housing of vulnerable people has realised substantial savings and improved outcomes across the system. Your Homes Newcastle is now looking to build on the success of the cross-agency, multi-disciplinary working and has developed an approach with drug and alcohol agencies.

Over to you

How does it work in your area – is your health and wellbeing board clear about who they will need to build bridges with, and who to prioritise? What have you already got, and does it need change? Is it all about commissioning – or is leadership about going beyond the money and getting agencies pulling in the same direction? What are the challenges in setting new
partnerships up, and how do we get people speaking the same language? We look forward
to hearing from you.

For more information visit: www.hkconsulting.co.uk

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