Report

Health and housing: building the evidence base A Paper for Kent Surrey Sussex Academic Health Science Network by the Housing Learning and Improvement Network

Written by Liz Cairncross and Jeremy Porteus for the Housing Learning and Improvement Network

April 2017

© Housing Learning & Improvement Network

www.housinglin.org.uk

1. Introduction This paper provides a review of the evidence base in relation to projects and pilot initiatives across the UK which bring together health and housing, with a particular focus on older people. Evidence has been included about projects which contribute to: •

Improving health outcomes

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Reducing demand/expenditure

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Improving patient/resident experience

At a time of considerable pressure on budgets and resultant system transformation and service reform across health and social care economies, the review will be used to inform Kent Surrey Sussex Academic Health Science Network’s (KSS AHSN) planning for future service development and potential investment, particularly around hospital admissions and delayed discharge of care. This is part of the Network’s strategic priority to promote ‘Living Well For Longer’ (LWFL). The review involved a search of key websites and databases, including: the Housing Learning and Improvement Network (LIN), King’s Fund, National Housing Federation, Age UK, Centre for Ageing Better, Institute of Public Care (IPC), Association of Directors of Adult Social Services (ADASS), Personal Social Services Research Unit (PSSRU), NHS Improvement and NICE, as well as telephone interviews with key stakeholders to provide a detailed understanding of effective health and housing initiatives. The review provides a strategic overview of the policy context, followed by sections covering: •

Housing with care

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Housing advice and information

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Aids and adaptations

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Handyperson schemes

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Falls prevention

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Assistive technology and telecare

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Discharge services

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Design of the built environment

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Warm housing and fuel poverty

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Dementia related initiatives

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Other projects

Each section contains a brief introduction, a review of relevant research, and examples of current projects and initiatives. The conclusion summarises the evidence in terms of the three areas specified above, as well as setting out points for consideration.

© Housing Learning & Improvement Network – www.housinglin.org.uk

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2. The policy context – a strategic overview Key issues: •

There is a strong policy drive for integrated approaches to preventing admission to hospital and expediting hospital discharge.

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Delayed transfers of care and system wide pressures, including the funding of adult social care, are affecting the ability of the NHS to cope

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The role of housing in helping to relieve these pressures and enable older people to live in their own homes is increasingly recognised both in policy and funding provision.

The role of housing as a determinant of health has been reflected in recent policy. The statutory guidance around the implementation of the Care Act 2014 asserts that: “Housing is therefore a crucial health-related service which is to be integrated with care and support and health services to promote the wellbeing of adults and carers and improve the quality of services offered.” Section 15.50, Care and support statutory guidance Under the Care Act, 2014, there is a requirement for closer cooperation between services that support the health and wellbeing of those who may be in need of care and support in order to deliver more