‘A foot in the door: a guide to engaging housing and health’ demystifies the organisational structures and assurance processes of health and care and sets out six clear steps for housing organisations to take when putting together their offer and building stronger collaborative relationships with the new leaders of health and wellbeing.

The toolkit, which is sponsored by Gentoo Group, has been designed to help the housing sector engage effectively with health and care leaders who are facing large-scale change and huge cuts to budgets, and help them set out their contribution to health improvement.

“We must take the opportunity presented by NHS reform to address past failures”, said our Chief Executive, Jo Boaden. “So far, the policy debate has been centred around the internal workings of the health and care system. If we are ever to tackle complex issues such as persistent health inequalities, there needs to be as much energy invested in building partnerships with those who have levers over the wider determinants of health.”

Jo went on to say “housing organisations are not only landlords but commissioners, service providers, community leaders and innovators. We sit at the heart of the community, often providing services to the most vulnerable and those in greatest need. As a sector we must continue to work hard with colleagues at a local and national level to reshape old attitudes and have housing recognised as a legitimate partner in health improvement.”

The toolkit reminds the housing sector that they already have an invitation to get involved and that the agenda for change is clear:

• Year on year, poor housing conditions are implicated in up to 50,000 deaths (over 36,000 excess winter deaths in 2008/09 in England and Wales)[1], cause 0.5 million injuries and illnesses that require medical attention; and contribute to increased risk of cardiovascular diseases, respiratory diseases and depression and anxiety.
• The estimated costs to the NHS in England each year stand at £600m to treat the health impacts of poor housing[2].
• Almost half of all families with a disabled child live in unsuitable accommodation[3] and the care costs of a seriously disabled child whose home is unsuitable are estimated to be £690 per day.
• The average cost of a fractured hip is £29,665; five times the cost of an average adaptation and 100 times the cost of fitting hand and grab rails[4].
• Research shows that investment of £1.6bn in housing related support generated savings of £3.41bn to the public purse including £315m of savings to health service in a year.[5]
• Studies show that investment in specialist housing results in savings to the public purse of £639m each year, including an estimated saving of £11751 per person to the NHS for people with mental health problems[6].

Chris Shaw, Director of Health Improvement in Sheffield said: “we are seeing changes in the landscape of both housing and health in our city and the two are inextricably linked. The demographic, the changes in housing ownership (private rented numbers are about to overtake council owned stock) the increase in housing related conditions and a reorganisation of our health system all point to a need for housing professionals to make connections and use them , be they in primary or secondary care or through wellbeing boards.

“The housing sector has long understood that it is not simply the bricks and mortar of a house that impact on health and wellbeing, but also the wider determinants such as financial inclusion, access to education, training and employment, and environmental factors such as noise pollution and exposure to green space. This tool has been designed to help housing organisations build stronger collaborative relationships with local leaders, putting housing at the heart of the health and wellbeing agenda. Current NHS reforms provide an opportunity to revisit existing relationships and build new ones.”

Professor Richard Parish, Chief Executive of the Royal Society for Public Health said: “as a multi-disciplinary organisation we welcome this publication. With health promotion and protection of wellbeing at our heart, we are supportive of any efforts that encourage those with levers over health and wellbeing to work together for the benefit of the community.”

Councillor David Parsons CBE, Chairman of the Local Government Group Environment and Housing Programme Board said: “the tool gives a clear and comprehensive summary of the health and wellbeing agenda and how housing organisations can make an effective contribution to improving the health and wellbeing of local communities. The section on the journey to engagement and the case studies will provide housing organisations with constructive and timely advice on how they can engage with new structures for improving health and wellbeing. The LGA supports the central premise of the document: that safe, affordable and well-planned housing is an essential prerequisite for health and wellbeing.”

[1] ONS 2010 Excess Winter Mortality by Age Group
[2] BRE 2011 The Real Cost of Poor Housing
[3] Every Disabled Child Matters Campaign 2008
[4] Counsel and Care 2011 Living Well at Home
[5] DCLG 2008 CapGemini, Research into the financial benefits of the Supporting People programme
[6] HCA 2010 Frontier Economics, Financial benefits of investment in specialist housing for vulnerable and older people