Health Correspondent Mark Smith looks at why health boards and housing associations should work together to address underlying health concerns in communities in Wales online, 6 July 2015
Living in poor-quality housing can have a lasting impact on people’s health and wellbeing.
It leads to an over-reliance on the health and social care service in Wales which is already struggling to meet demand.
Here, Mark Smith looks at how working prudently in the housing sector can make a vital contribution to improving health in Wales.
Living in poor housing has long been recognised as a key factor in affecting both physical and mental wellbeing.
With rising poverty in Wales and welfare reform, more people are relying on a wide variety of services, from health and social care to housing, to help them cope.
It is important to consider how best to meet this growing demand, and a vital factor is working prudently to get the best outcomes for people and best value from the system.
Launched a year ago, prudent healthcare is currently being adopted by health organisations across Wales to change the way services are delivered to ensure the Welsh NHS not only survives but thrives.
It is based on four key principles:
1. To achieve health and wellbeing with the public, patients and professionals as equal partners through co-production;
2. Care for those with the greatest health need first, making the most effective use of all skills and resources;
3. Do only what is needed, no more, no less; and do no harm;
4. Reduce inappropriate variation using evidence-based practices consistently and transparently.
It’s an approach also being considered by housing associations across Wales who, like the NHS, have no option but to become prudent if they are to meet increasing demands for help while also striving to improve the quality of service delivered.
Matthew Kennedy, policy officer for Community Housing Cymru, believes housing associations can play a key role in doing the right thing at the right time for people.
Housing associations ‘a key partner’
But he also thinks NHS Wales should be looking at housing associations as a key partner and by working more closely together, people’s needs could be met at the same time and better health outcomes achieved for communities.
The first international prudent healthcare summit will take place at City Hall on July 9
He said: “Housing association staff – from tenancy officers to specialist nurses – should be considered as an extension of the healthcare workforce in Wales.
“There are excellent opportunities to serve our communities through a focused approach which makes the most of our knowledgeable, versatile workforce.
“Prudent healthcare rightly encourages healthcare staff to only do what they are skilled and able to do to ensure expertise is being used in the right way for the right people.
“However, we also need to consider what other staff across the public sector can do in partnership with the health service.
“We know poverty cannot solely be solved through meeting a housing need. Employment, health, and social inclusion are just some of the other elements which must be addressed.
“This is why it remains so vital that across public services, and evermore increasingly between health boards and housing associations, needs are served at the right time.”
Housing associations are often deeply involved in some of the most deprived communities in Wales and their roles go far beyond the traditional landlord role, providing support and care in a number of areas.
This understanding could help make a real difference in a collaboration with the NHS.
For example, organisations could work together to ensure end-of-life care can be received at home or to identify and ensure early interventions are made to improve the lives of those who misuse substances or suffer domestic abuse.
In Newport, the Lighthouse Project is another example of the difference that can be made when you harness the expertise and workforce of both sectors.
Taff Housing Association work closely with Newport City Council to provide housing support to vulnerable adults to maintain their independence in their own home.
The project has ensured a more efficient service for those waiting to be discharged from hospital and reduced readmissions thanks to the continued support.
Another key factor of prudent healthcare already being used in the housing sector is co-production, when organisations work with people to design services that meet needs.
Tenant scrutiny, focus groups and volunteers have all helped to drive grassroots activity that not only improve personal development, but help build stronger communities and better health and wellbeing.
For example, many housing associations in Wales use an approach called “timebanking” which rewards people for investing their time, skills and expertise between each other and with organisations.
The simple concept gives a person a “time credit” for each hour they contribute which can be redeemed against a range of activities provided by organisations.
And research shows it make a difference, with a recent survey indicating that 45% of participants reported feeling healthier, 95% said they wanted to start a community group and 19% said they had visited the doctor less.
Mr Kennedy said: “Prudent healthcare drives us to think more profoundly about the factors impacting on an individual’s life outside the hospital door, post treatment.
“At the same time we need to put people back in control of improving their own wellbeing offering support rather than creating reliance on our services.
“It is essential that we make best use of resources and the opportunities to support people in the right way, at the right time.
“Successful prudent healthcare would be seeing organisations across health, social care and housing pooling their resources to deliver projects that are well evidenced.
“We also need to increase grassroots activity so that people can support their own health in their own communities as well as co-producing with the health service to be more sustainable going forward.”