1. Dr Lynne Livsey, Health Partnership Coordinator National Housing Federation Presentation to NE Housing LIN Meeting Middlesbrough, 15 th April 2015 The Memorandum of Understanding – A new direction in integration?

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 desire for collaboration is not new! Since social need is complex it can rarely be divided so that each part is satisfactorily dealt with by a separate service…….. ……because problems are complicated and interdependent, co-ordination in the work of social services of all kinds is crucial. In many cases effective help will continue to depend upon the assistance of more than one organisation” Report of the Committee on Local Authority and Allied Personal Social Services, July 1968. (The Seebohm Report).

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

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

6. Getting serious about prevention “………the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health” (NHS, 5 Year Forward View 2014:3)

7. Other relevant documents…. Care Act 2014 implemented from 1 st April NHS 5 Year Forward View (2014) PHE ‘From ‘Evidence to Action’ (2014) Dalton Review (2014) Due North Report (2014)

8. Future models of care NHS England 5 year forward view proposes new models of care - whole system approaches across primary, community, secondary and social care. There is a new models of care learning network led by NHSE, Monitor, TDA, LGA – working with 6 areas over next 6 months to translate some of the best models internationally to an England context. More detail of proposed ideas for new models of care, can be found in chapter 3 of NHSE’s 5 year forward view http://www.england.nhs.uk/ourwork/futurenhs/5yfv- ch3/

9. The building blocks Coordinated Policy Collaboration and Integration Promoting housing contribution to health Workforce Development

10. Where can housing help? Population and place Targeted help and support in community High intensity support or specialist housing

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

12. 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

13. What needs to happen? Change social conditions and the economic and political systems that sustain and increase social and health inequality. –Collaborative action – Central Government, Regional and Local Agencies and communities – Invest in economic growth and fair distribution of proceeds –Build on regional and community assets –Invest in people and place

14. What can housing associations do? 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

15. 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’

16. Some key messages for our sector Clear aims and objectives Multi-agency governance – strategic and operational Build evaluation into planning stage Be prepared to invest to demonstrate innovation Involve service users Include health economics in evaluation Think about time-scales It’s all about people

17. What is your experience of Integration/ What is working well in your areas? What are the barriers? What needs to change? What additional skills, information and knowledge do you need?

18. Emily Bird Policy Lead, Health and Wellbeing Emily.bird@housing.org.uk Follow@natfedemily on Twitter Look at the Health Partnership Hub http://www.housing.org.uk/policy/health-care-and- housing/health-hub/