NHS Alliance's special advisor on housing, Merron Simpson, feels primary care and housing providers are natural partners in enhancing community health
There has been a lot of talk recently of ‘better integration’ in health and care as a route both to a seamless and therefore better experience for patients and to reducing waste in the system. And it is a cross-party ambition. The Coalition’s Integrated Care Framework
and Labour’s developing Whole-Person-Care approach
are the latest efforts, following closely on the heels of the newly established Health and Wellbeing Boards that bring together NHS commissioners and public health with local authority commissioners and services.
So, lots of efforts to integrate health and care, but as yet very little focus on those natural integrators who are already part of the system. District nurses, occupational therapists, pharmacists, community GPs, housing officers, sheltered scheme managers … these are the professionals who get to see people (patients) in their natural habitat – their homes and neighbourhoods – and who see the implications of a dis-integrated system on their lives. Precisely because they have this knowledge, they also hold the key to putting the system together.
Primary care and housing providers are, in theory, natural partners in enhancing community health and wellbeing. They serve many of the same people for a start. Having largely achieved the Decent Homes Standard, councils and housing associations are going well beyond their core role of providing good quality affordable housing. Many of them now have thriving community and care programmes that help both their residents and other citizens to live healthy and productive lives. Retirement housing with specialist dementia wings, food growing and healthy eating programmes, helping people to settle back safely in their home after a spell in hospital, supported housing with specialist care for people with mental health problems, apprenticeship and work programmes, tradesperson safeguarding … I could go on and on. The potential to develop these activities, and integrate them with formal community health services, is vast. As GP practices become more concerned with keeping people out of hospital than being a gateway into hospital, I believe they will find their local housing partners invaluable.
The NHS Alliance is setting out on a journey to radically reinvent primary care in line with our manifesto for primary care Breaking the Boundaries.
We want to see a fundamental shift in healthcare from acute to primary setting, from hospital to community and more emphasis on managing health, wellbeing and non-urgent care within the community and in people’s homes. Depending on how it’s done, we see this shift as part of the solution to the enduring inequalities in health identified by Marmot. And we don’t see an alternative route to resourcing health and wellbeing as more people live longer with life limiting illnesses that would have, only a few decades ago, sent them to an early grave.
We don’t yet know where this journey will take us but we do want housing and other community-based professionals who believe they can be part of the solution to join us in shaping the primary care service of the future. We have developed elements of our membership package especially for organisations whose principal role is housing but who also have roles in promoting health and wellbeing. Joining the NHS Alliance is the best way to participate and have an influence in this debate. For more information on membership, please click here.