Presentation on theme: "Housing and Health The Brighton and Hove Experience Geraldine Hoban Chief Operating Officer Clinical Commissioning Group."— Presentation transcript:
Housing and Health The Brighton and Hove Experience Geraldine Hoban Chief Operating Officer Clinical Commissioning Group
Housing - A Key Determinant of Health
Links Between Housing and Health Quality of housing has a substantial impact on health needs Utilisation healthcare particularly for vulnerable groups The Building Research Establishment has calculated that poor housing costs the NHS at least £600 million per year *
Brighton and Hove Housing Strategy 2015 Vision We want Brighton & Hove to be an inclusive city with affordable, high quality, housing that supports a thriving economy by offering security, promoting health and wellbeing and reduces its impact on the environment.
Brighton & Hove Context & Housing Challenges City of contrasts - with areas of extreme affluence and areas of deprivation Drug and alcohol, homelessness, mental health Pressures from an increasing population and limited space for new development One of the highest average house prices outside London within the top 10 L.A’s but relatively low wages High rents in the private rented sector making rent unaffordable for many.
Partnership Working Strong City-wide strategic partnerships City Management Board Health & Wellbeing Board Strategic Housing Partnership Joint Commissioning Approaches – Better Care Fund - focusing particularly on vulnerable groups CCG Sustainability Plan – strengthening links into Council services – ie warm homes
Case Study Supported Accommodation Pathway for Mental Health Jointly reviewed supported accommodation mental health pathway Identified that there was insufficient capacity at all tiers in the pathway - particularly for people with most complex needs e.g. dual diagnosis Pooled budgets and undertook a joint procurement process
Key Successes 100 additional units within the same financial envelope Multiple providers working together within pathway to increase move on opportunities Greater range of accommodation options from the most complex (24 hour support) to start up tenancy support
Better Care Fund Opportunities Strategic opportunity to further integrate health, social care and housing support. Two key priorities – frailty and homeless Multi-agency involvement in the development of integrated care teams based around clusters of GP practices Incorporating statutory and third sector providers and taking a broader holistic view of health and social care needs
Homeless Health Need Increasing numbers of homeless –increase of approx. 40% over the last 3 years (JSNA, 2013) Increasing health &wellbeing needs & complexity 84% reported at least one physical health problem 53% had a diagnosed m.h condition 40% take drugs or are recovering from a drug problem 26% drink four or more times a week (Homeless Health Needs Audit, 2014)
Homeless Health Need High utilisation of unplanned care National figures indicate homeless people are 5 x more likely to go to A&E and 3X more likely to be admitted to hospital, longer lengths of stay and higher re-admissions Locally, the Homeless Health Needs Audit (2014) showed 36% of respondents had attended A&E in last six months
Starting Point System of Care Dedicated homeless GP practice Some excellent individual services and teams – but inconsistent Care largely commissioned and delivered in silo’s – not co-ordinated or proactive Strengthening capacity across all organisations Integrating ways of working into one MDT working to proactive care plans
Vision Multi-agency Homeless Integrated Health & Care Board. “To improve the health and wellbeing of homeless people by providing integrated and responsive services that place people at the centre of their own care, promote independence and support them to fulfill their potential”
Future Model of Care
Summary Joint working is essential and increasingly direction of travel address inequalities improve outcomes of care Make best use of scarce resources Housing, Social Care and Health need to forge better working relationships Housing needs to be embedded within JSNAs, Health and Wellbeing Strategies and working of the H&WB