Working with housing to improve the NHS

  • Government cuts require a further £22bn of efficiency savings to be made by the NHS
  • Greater integration between the health and housing sectors could play an important role in future innovation and the transformation of healthcare
  • It could also help address unmet health needs amongst tenants and the communities in which they operate
The NHS is believed to be in one of its toughest states for a generation, with trusts in England amassing a huge £930m deficit in the first three quarters of 2015. The Autumn Statement brought the welcome announcement of additional funding to some areas such as health and social care, mental health, and new hospitals. However, this was accompanied by a 25% cut to the Department of Health’s overall budget, and a requirement for the NHS to achieve £22bn in efficiency savings. To meet this monumental challenge, experts have suggested a rethink about how and where healthcare is delivered. Better integration between social housing and health providers could play an important role in this potential future innovation.

Mounting pressures

The challenge to cut costs by £22bn comes at a time when resources across the NHS are already spread incredibly thinly. Emergency hospital admissions, for example, have increased 35% in the past ten years, despite there being one third fewer beds than 25 years ago. This is compounded by the growing number of patients being urgently readmitted within 30 days of discharge, which currently stands at 14%. As a result, the NHS is struggling to curb unplanned admissions, reduce its financial deficit and bring A&E waiting times back within targets. With no sign of the additional funding needed to keep pace with rising demand, urgent calls are being made to reduce the reliance on NHS services and shift the emphasis towards community-based care models.

Why work with housing providers?

To ease pressure on the NHS, an ideal solution would improve community health, reduce hospital admissions, shorten the length of stays and limit the need for readmissions. However, many of the factors influencing these outcomes are closely linked with what happens outside hospitals, so are very difficult for the NHS to control. For example, whether a patient is eating healthily, or has a home environment suitable for any underlying condition, is very difficult to monitor without employing a carer or occupational therapist to visit regularly. The social housing sector has strong links with the community. They are often in regular contact with residents and consult on a wide variety of issues. In fact, frontline housing staff have two-and-a-half-times more contact with their residents than a GP. Additionally, the housing sector is very values-led and is used to being flexible in the way it helps people. Preventative care is also a familiar concept, and means that most housing associations should be willing to work with the NHS to achieve better public health and wellbeing for their residents. The NHS is also not alone in its financial difficulties; social housing has experienced government cuts in recent years and is looking for ways to achieve cost savings and increase revenues. Many housing associations already run their own residential care homes, open to both social and private tenants, and organisations may be keen to explore new revenue streams by enhancing their role as carers in the community and selling services to the NHS.

Where can housing associations add value?

Before embarking on any partnership working, it is important that NHS Trusts identify the sources of greatest pressure. Generally speaking, there are some key areas that are currently causing issues for many NHS services. Our ageing population is an important factor that will certainly require innovative solutions and greater partnership working. A large proportion of readmissions are elderly patients, who often also have complex needs, such as dementia, which many hospitals are simply not equipped to deal with. Rising levels of homelessness are also taking their toll on NHS resources, and, worryingly, 70% of homeless patients are being discharged back onto the streets, which presents significant risks to their recovery and increases the likelihood of readmission. Infections are one of the biggest cost pressures for the NHS, with patients frequently being readmitted simply to receive intravenous drugs. Similarly, discharges from hospitals are regularly delayed while patients await complementary care that could be provided in the community. This includes rehabilitation, physiotherapy, injections, and the dressing and cleaning of wounds. With readmissions alone costing the NHS £2bn a year, targeting problem areas such as these could go a long way to achieve the latest savings targets.