Creating a neighbourhood NHS will require a partnership approach

In September, we held our first Health and Housing Conference in the West Midlands. We had the privilege of hearing from Sir David Nicholson, former chief executive of NHS England and now chair of several NHS trusts across the Black Country, who spoke about the importance of cross-sector collaboration.

Sir David’s insights were certainly thought-provoking, but what I found most surprising was that this was the first joint health and housing conference he had been invited to in his 40-year career.

It struck me that, 14 years on from the Marmot Review, there is still so much to do to really work in partnership to tackle health inequalities and, in turn, poverty. At WHG, we just might have a blueprint that could make a difference.

“The 2021 Census found that just over half of social housing residents in Walsall reported very poor health or having a disability; this drops to 34% for people who own their own home”

The story behind the recent Darzi Review is not just about under-investment in the NHS, it is about a widespread failure to tackle poverty that is entrenching inequalities and driving up demand for acute services.

The Joseph Rowntree Foundation’s UK Poverty 2024 report found that escaping poverty has become much harder over the past two decades, and six million of the poorest people would need more than double their incomes to move out of hardship.

Almost half of social housing tenants live in the most deprived 20% of neighbourhoods in England, and too many families are living below the poverty line. People in social housing are also disproportionately affected by poor health and disability. The 2021 Census found that just over half (52%) of social housing residents in Walsall reported very poor health or having a disability; this drops to 34% for people who own their own home

All this points to one fact: social housing tenants experience some of the worst health inequalities, which have a profound effect on their lives.

As a social housing provider and a charity with a strong social purpose, we take our commitments to our customers extremely seriously and want to support them to live healthy, successful lives. This is why we have started to work differently with our health partners in the Black Country.

Working strategically with the Black Country Integrated Care Board, we have taken a data-led approach. We know that 80% of the homes we manage in Walsall are in the NHS Core20Plus5 (a way of reducing health inequalities) target population. We have a direct relationship with many of the people our colleagues in health struggle to engage with.

We use our community champion model to help our customers access healthcare services and focus on prevention rather than treatment. We recruit champions from our customer base to act as authentic, accessible role models in the communities where they live. They are able to access marginalised groups in a way no other service can. Often described as a human bridge between the individual and the service required, they increase access and take-up of services.

“The programme has saved the NHS money, sustained tenancies and minimised the negative impact for many children who would otherwise have been absent from school and away from their family and routine during hospital stays”

Take our ACEing Asthma programme. This initiative is making a real tangible difference to children’s lives by managing their asthma better through combining health and housing interventions to support families. Since it started, we have supported over 200 children, which has ultimately prevented hospital admissions.

Working with the NHS, we have played a crucial role in health outcomes, focusing on prevention. The programme has saved the NHS money, sustained tenancies and minimised the negative impact for many children who would otherwise have been absent from school and away from their family and routine during hospital stays.

This is not about asking for more government money. This is about joining up our services, pooling resources and ultimately thinking about how we best deliver for the individual – whether they are a patient or tenant.

The health secretary’s vision of a neighbourhood NHS must encompass the whole system, from social care to housing. We all want to see healthy and thriving communities. If we really work together, we could turn the dial once and for all.

Fay Shanahan, corporate director of operations and IT, WHG