We need a systemic approach to housing and social care

Indeed, it is reported that he asked for this change, and we know he is already fully sighted on the significance of the relationship between health and social care (and of course social care is delivered by councils).

We need to provide evidence of the fundamental part housing can play in this, as it can so easily slip out of view.

For housing secretary Sajid Javid it may take longer, although the importance of supported housing is now well understood.

“Ambitious plans to build more housing of whatever tenure type need to include housing for older people.”

The issue here is more subtle: ambitious plans to build more housing of whatever tenure type need to include housing for older people, many of whom can live independently and well, with low levels of support, if the design and infrastructure are right. Further, by doing so there is the potential to release under-occupied housing for families because the offer is attractive and realistic.

To both, then, I would like to offer the following thoughts and ideas about what might be done to ease the pressure on health and social care, while increasing housing supply for older people and consequently more widely.

Above all, there is a need for a systems approach to be taken, focusing on the well-being of individuals and communities.

History tells us that structural changes won’t by themselves work, in part because they are crafted in isolation and don’t start from the realities of how citizens live their lives. Everyone needs decent, appropriate and secure housing. It is both an enabler and a connector to much else.

“A systemic approach demands a hard look at the interconnections between services within health and across to social care and housing.”

Conversely, if it is absent or inappropriate, it disproportionately impacts on the wider system – slowing it down, costing money and creating unhappiness.

A systemic approach demands a hard look at the interconnections between services within health and across to social care and housing.

It is important, as part of this, to recognise the impact of different cultures within the health, housing and social care worlds and think about how these might be overcome.

Examine the wider determinants of health and social care: housing, employment, exercise, loneliness, air quality and nutrition. Think about following the lead of Wales, assessing policies in terms of their health impact.

Take a renewed look at the benefits of prevention and early intervention.

It is a false economy not to reinvigorate local authority public health budgets and assess relative costs between prevention and expensive treatments and what steps might be taken to move the dial on this.

“It is a false economy not to reinvigorate local authority public health budgets and assess relative costs between prevention and expensive treatments.”

Require and support stakeholders and providers to get better at providing evidence of the positive impact of their preventative work, so it can be shared and therefore inform commissioning practice in the future.

Revisit the Barker Commission on health and social care and, in particular, look at the balance of private and public funding and model different scenarios of these to understand what might be possible.

This will also show how significant these choices have been, and could be, in determining wider outcomes including the role of housing.

And one for the future.

While the government’s track record on digital transformation has been fraught with difficulty, the successful delivery of a joined-up, citizen-led system which links housing, health and social care could be significantly assisted by integrated, secure technology.

“There is real potential for the right information to be shared so that services could be delivered compassionately.”

With the necessary safeguards in place, there is real potential for the right information to be shared so that services could be delivered compassionately, intelligently and appropriately at the right times, thereby achieving not only better services for citizens but better value for money too.

The pressures of the day job and the immediate may make all this sound utopian and impractical.

Consider, though, the size of the prize if this join-up could happen.

Think of the impact that devising positive, long-lasting improvements to this wider system would have, not only to the quality of people’s lives and the public purse but to confidence in our ability to identifying solutions to these stickiest of issues. It really is a bit of a no brainer.

Dame Clare Tickell, chief executive, Hanover