1. The Bigger Picture: Policy drivers & implications for housing & care options services Sue Adams, CEO, Care & Repair England

2. Aim Understand the wider context within which you are delivering services and hence….. Identify the more likely drivers for supporting continuation of services

3. Policy Backdrop Massive reductions in public expenditure Reducing role of the state in most areas of public life Housing – very radical changes

4. Government spending as a share of GDP projected to approach its lowest post-war level (around 36%) by the end of the consolidation in 2019-20.

5. Resolution Foundation (2015) Seven charts that show the changing shape of the state in Britain

8. Health spending – safer than houses? NHS facing massive funding pressures – not a golden goose Revealed in Spending Review – tomorrow BUT Social care even more squeezed Housing – role of state ends? Welfare reform – major reductions

9. Can you reduce health pressures? Hospital admission levels, especially amongst older old, linked to speed of discharge & readmissions Costs to GPs – multiple appts/ again hospital costs – both higher for older people / people with multiple LTCs [Meet Targets/ Outcomes]

10. Pressing Other Sectors’ Buttons Adult social care Facing major funding reductions/ rising need PRIORITIES? Reduce residential care cost Reduce social care costs more generally Meet Duty / integrate [Targets/ Outcomes] Housing Stock shortage/ build new homes (with no state funding) is top of agenda I&A ‘selling points’ – Making best use of stock – Cut waiting lists (social) – Effective use of DFG/ adaptations / repairs

11. Pressing Other Sectors’ Buttons Public Health Prevent ill health Reduce inequalities Meet outcomes/ targets Key role in H&WBBs/ joint commissioning DWP Welfare reform (includes changes to help with housing costs eg. mortgage/ loan interest Self help/ use own resources (incl. Pension pot/ home equity) Pension changes have put independent I&A on the policy map

12. Housing - Big Changes Housing and Planning Bill Headline issues around social housing – Rents (1% cut, market rents, pay to stay) – End security of tenure – Extension of Right to Buy to housing association tenants – incl specialist/ supported – Shrinking supply of social rented homes Mainstream housing – Focus on first time buyers (reducing LA powers re what built eg starter homes, planning changes etc)

13. Implications for I&A As yet many unknowns but…. Need for good, impartial I&A will become greater than ever as income/ pensions/ housing / care costs in later life become ever more intertwined

14. Imperative – demonstrate value Being a ‘good thing’ & clearly improving lives -not enough Quantify impact/ value across health, social care, housing, welfare sectors

15. The Big Challenge Do more for less Do things differently Be part of integration agenda Evidence, evidence, evidence Can’t stand still…………..

16. Red Queen Syndrome