Why is it so hard?

Blog by Sue Adams, CEO of Care & Repair England





Talk to Joe (or Joan) Public about whether your home affects your health and most would say it was ‘blindingly obvious’ that having a safe, warm, secure place to live is good for you.

So why is there virtually no mention of housing conditions in the new NHS Long Term Plan, despite its emphasis on prevention, not to mention delivering more healthcare in people’s own homes?

The omission was doubly disappointing given previously encouraging remarks by Minister Matt Hancock and the government’s vision statement about prevention.

In the light of the recent publication of the World Health Organisation’s excellent Housing and Health Guidelines it can be hard to not despair of ever joining up health, care and housing policy, let alone practice, in England.

With yet more cuts to local authorities’ expenditure on the horizon we are seeing signs of further contraction (or closure) of the invaluable preventative housing services offered by holistic home improvement agencies. These include Handyperson, Hospital to Home, Housing Options information and advice, help with essential home repairs, tackling cold homes, hoarding – the list goes on.

Whilst it is perfectly reasonable that the NHS Long Term Plan states that it cannot fund every aspect of provision that impacts on population health (Clauses 2.3, 2.4), the Plan could have gone so much further to pave the way for concerted joint action to tackle the housing conditions that affect health, not solely fund action on homelessness (important and welcome as this is).

Failing to mention home modifications in the context of falls reduction (despite the stronger evidence base for these compared with exercise programmes), let alone cold homes and the large increase in pneumonia amongst the older population, was doubly disappointing.

So, back we must all go to building the evidence of impacts, promoting successful models and trying to embed housing in the forthcoming Prevention Green Paper.

It is good news that the ‘What Works’ UK Centre for Housing Evidence (CaCHE) has added health, care and housing connections to its new list of research priorities – never has fresh evidence and impetus for change been more critical [January 2019]