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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www.foundations.uk.com