Housing to Health and the coronavirus pandemic
During the coronavirus pandemic, a health and housing scheme in Nottingham is showing the value of partnership work in supporting residents to find good quality housing that helps them stay healthy and reduces unnecessary time in hospital.
Nottingham’s Housing to Health (H2H) project, is run between the NHS, Nottingham City Homes and Nottingham City Council. It provides fast-track housing solutions for patients in hospital and in the community. In the first wave of the pandemic, the service helped to rehouse 39 patients, and gave practical support to shielding and vulnerable residents and their families. A recent report recognises the project as a national exemplar and recommends this and other similar models be used for national learning.
The project supports people to leave hospital safely, free up acute and community care capacity, and realise savings for the NHS and its partners. The project was launched in November 2015. To date, the project has rehoused 454 individuals into suitable social housing, and worked with 49 people at risk of homelessness.
Coronavirus has highlighted the importance of housing to people’s health and wellbeing. Delays in patients being discharged from hospital have also been identified as a significant issue for the NHS nationally. Research estimates that the NHS spends around £820m a year treating older patients who no longer need to be in hospital. This scheme, which has helped to reduce the number and length of hospital admissions, has been shown to avoid 310 admissions to Nottingham’s hospitals, reducing costs to the NHS by £1.6m.
There are benefits for other partners too with reduced demand for adult social care services and extra income through letting properties more quickly.
In Nottingham, H2H partners work together to identify patients in hospital and in the community who are living in poor or unsuitable accommodation that is negatively affecting their health. The aim is to provide fast-track housing solutions to rehouse people into good-quality social housing.
The project has also evidenced improvements in the health and wellbeing of patients and their carers, enabling them to live independently and reducing their ongoing use of health and care services. As a result of the service, 98 per cent of patients now feel safe in their home, and the pressure on hospitals has improved because re-admissions per person have reduced from four to two per year.
The system works by Housing Health Coordinators (HHCs) taking referrals from health professionals in hospital, community or mental health trusts. The three key client groups are older people in hospital or in the community whose health is at risk due to their housing, essential wheelchair users of any age occupying a high-demand hospital bed because of a lack of accessible accommodation, and mental health patients of any age who are ready to move from a high-demand bed in a mental health ward or step down unit into a one-bed apartment in the community.
HHCs help source suitable accommodation, such as independent living or wheelchair-adapted homes. They also support the individual and their family through the whole process, ensuring they are set up to live independently in their new home.
Mr Walter* was the subject of a referral to H2H from the Council’s Environmental Health team. He was living in hazardous conditions that were potentially harmful to his health. His house was in a serious state of disrepair with no running water, no gas supply or central heating, dangerous electrics, a rat infestation and structural damage. Mr Walter had been using a bucket of rainwater on the flat roof to bathe and wash his clothes. The Health and Housing Coordinator found Mr Walter an independent living property to move into immediately, and supported him to move into it the next day with a handful of personal belongings. The project also helped him get furniture from a charity and supported him to get his benefits in place.
After initially not wanting to engage with any support, Mr Walter now has ‘comfort calls’ from social services, arranged through H2H, and is managing by himself in his new home.
*Name has been changed
David Pearson MBE, Independent Chair of the Nottingham and Nottinghamshire Integrated Health and Care System: “Having a safe, secure and appropriate place to live is fundamental to being able to sustain people’s health and wellbeing. Now in its fifth year, the programme continues to provide benefits to the community and proves that quality housing is essential to maintaining people’s independence by enabling as much choice and control in their lives as possible.
“I’m excited to see the fruits of work we have undertaken described within a commissioned report: ‘Harnessing Housing Support: Nottingham Housing to Health Service’, which showcases positive examples of local partnership working between health, housing and local government and to help facilitate discussion around how similar services could be utilised across the country.”
Richard Holland, Assistant Director of Housing Operations at Nottingham City Homes, said: “This recognition is testament to the hard work of everyone involved in H2H since its inception. Someone’s housing conditions can have a real impact on their health, so this is such an important programme both locally and now nationally. This project is a great example of how working in partnership can make a real difference to people’s lives.”
Cllr Linda Woodings, Portfolio Holder for Planning, Housing and Heritage at Nottingham City Council said, "We're really proud to see this important scheme being rolled out more widely following recognition of the positive partnership work to deliver the best outcomes for our citizens.
"Good housing has such an important impact on people’s health and wellbeing. The work done through this scheme to support vulnerable people into social housing will not only help to aid their recovery and save the NHS money, but also helps to free up hospital beds for others who need them, which is even more important at the moment given the additional pressures the NHS faces due to Covid-19."