Where does housing fit in Integrated Care Systems?
I was recently reading the King’s Fund’s updated explanation of Integrated Care Systems (ICS) which are now taking shape and having an impact. A couple of things struck me, as a housing professional.
The first was the need to understand the structures and geographies that sit below an ICS. This will vary significantly in different locations but the King’s Fund gives a valuable guide. The Systems cover populations of around 500,000 to 3 million. This is the level at which health and care partners set the overall strategy, manage resources and performance, plan specialist services and drive strategic improvements. Places cover a town or district with populations of 250,000 to 500,000. At this level local government, NHS providers, VCSE organisations and social care providers join up the planning and delivery or services. Neighbourhoods are smaller areas with populations of 30,000 to 50,000. Here, groups of GP practices work with community health services, social care and other providers to give a more co-ordinated approach. This may include the formation of primary care networks.
Housing is seen as an important determinant in health and wellbeing and tackling inequalities. This raises the question around at which level housing organisations should engage with the integrated care structures. Many of housing’s practical prevention contributions will have the greatest impact on reducing pressures on NHS providers and social care commissioners at the Place geography. Many housing organisations are also very community focussed so this may lead to engagement at the neighbourhood level. However, some other services, such as home improvement agencies and overarching strategies for supported housing, homelessness, key worker accommodation, etc. may operate most efficiently and have the greatest impact when working across the whole area of an ICS. If housing is to fully contribute to improving health and wellbeing this will demand engagement on very many different levels.
The second point is that Integrated Care Systems should be partnerships of equals to fully deliver the benefits. So how can housing gain an equal place at the table? Health has the big money and there has been lots of media coverage about the crisis in social care that never gets resolved. Integrated Care Systems face the challenge to shift towards prevention to avoid the need for more costly interventions. Housing organisations have much to offer, including:
- Planning and housing authorities identify the need for suitable housing to meet the varied needs of the local population allowing people to maintain their independence and reduce the pressure on health and social care.
- Housing authorities and services such as home improvement agencies offer funding and services that help people to maintain and improve their homes, to manage independently, to help with affordability and to resolve more complex issues such as hoarding. There is often an emphasis on new homes but it is just as important to maintain and improve our existing housing stock.
- Many housing organisations now offer social prescribing services, working very much at the local community level.
- Housing associations and local councils provide the homes for many people who work in the health and social care sectors. They are building more homes and there are opportunities for partnerships to build even more.
- Existing relationships with some of the most vulnerable people in communities (social housing tenants, homeless people, etc) upon which valuable preventative interventions can be built.
- There are many links between the workforces in health, social care and housing with people moving between the sectors. There are opportunities to look how skills across sectors can be developed to strengthen resilience.
With significant experience working across health, care and housing systems, ARK Consultancy are well placed to work with the new Integrated Care Systems to assist them in ensuring that housing services play a full role in the integration agenda.
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