To support the Health and Housing Impact Network, we are bringing together a selection of resources, and signposting members to useful background material and examples of good practice. We will add to this throughout the programme with material relevant to each of our annual themes. Throughout, we will draw out the connection between health and housing.
You can read a write-up of our previous event on a population health approach to health and housing outcomes here.
London’s health and housing priorities
The Mayor of London takes a “Health in all policies” approach and has developed a Health Inequalities Strategy and Implementation plan to tackle the huge (and in some cases, widening) health inequalities in the capital. NHS London and London Councils share the mayor’s ambition to make London the healthiest global city. Pan-London priorities act on the wider determinants of health and the influence of factors outside the healthcare system in order to improve well being and prevent or reduce physical and mental ill health.
London’s affordable housing crisis is well-documented and widely acknowledged as one of the greatest challenges facing the capital. The Mayor of London’s vision for housing is that everyone has a good quality home they can afford. You can read more on the relationship between housing and health from the Health Foundation here.
Housing and Integrated Care – our theme for 2023
Why Housing and Integrated Care?
Integrated care systems (ICSs) bring together NHS organisations, local authorities and others to plan services and take collective action to improve health and reduce health inequalities on an area basis. In London, there are five ICSs, covering North West, North Central, North East, South East and South West London. Overall, the intention is to improve outcomes for people and services, reduce inequalities, enhance productivity and value for money and address broader social and economic challenges – of which housing is one. Some activity takes place at these sub-regional levels, others at a more local or neighbourhood level, as appropriate. The rationale is that collaborating in this way will help health and care organisations tackle complex challenges more effectively. For example, supporting those with long-term conditions or mental health issues and improving the life chances of children and young people.
Populations, Places and Pathways
In any one location, the NHS, local authorities, voluntary, community and social enterprise sector and others might agree on health and wellbeing priorities while bringing diverse approaches, cultures and language to the table. To make the most of this richness, it is important for different sectors to understand each other’s terminology and explore the opportunities for addressing health in different ways.
In reality, there is overlap between these concepts or terms but we have chosen to organise this year’s Network events around the broad themes of populations, places and pathways. The idea is to think about the role of housing in successful integrated care from a variety of angles that speak to both health and built environment colleagues.
The concept of “population health” builds on the idea that there are a wide range of determinants of health besides health and care services and that these are particularly significant in relation to health inequalities. It is sometimes used interchangeably with “public health”, but the thinking behind “population health” as a distinct term is that it conveys more strongly that different services and sectors have a role to play. It is the preferred term of ICSs. In practice, this may mean that the NHS reviews its service pathways as part of an integrated strategy which is informed by local people’s needs and characteristics, and with a greater emphasis on prevention of ill health or staying well.
For the purposes of the Network, our “population” focus will be on the role of Housing and Integrated Care in improving the health and wellbeing of particular groups and reducing health inequalities, for example children living in temporary accommodation or older people with long-term health conditions. Our next event will focus on population health, considering the link between air quality and wellbeing of children and young people.
How places are planned, designed, built and managed significantly influences the wellbeing of communities. This includes not only homes themselves but also their social and physical context. For example, the proximity of our homes to shops and essential amenities including community spaces, access to parks and green (or blue) spaces, and the provision of public transport and safe walking and cycling routes. Together these provide social connection, good air quality and opportunities to be active.
Integrated Care Systems present an opportunity to strengthen the place-based approach to health, more usually associated with councils, by ensuring that health and care services are appropriate for neighbourhoods where people live and work.
A health or care “pathway” is a structured and comprehensive plan that covers patient care from diagnosis, through treatment and follow-up. In the NHS, there may be a standard, evidence-based clinical pathway for treatment of a specific disease. An integrated care plan will extend to wider multidisciplinary services, such as social care or occupational therapy as well as GPs, and the role of the patient’s support network such as family and friends. Increasingly, planning and delivery of pathways for groups or individuals takes into account people’s circumstances such as the nature and condition of their home and the accessibility of community support.